Background: One complication that patients who have contracted COVID-19 are faced with is the possibility of developing hyperglycaemia, due to an increase in insulin resistance, and/or the inhibition of the production of insulin. Moreover, emerging national research suggests that when patients are treated with Dexamethasone, the problem is compounded, with patients more likely to develop significant hyperglycaemia, even if they don’t have a pre-existing diagnosis of diabetes. Aim: To initially evaluate the merit in measuring HbA1c for all COVID-19 patients upon admission, and if indicated then achieve 100% patient HbA1c testing for COVID-19 admissions by July 2021, as well as subsequent patient retesting as follow-up within 3-6 months. Method: In order to understand the impact of the use of Dexamethasone on COVID-19 positive patients, an initial audit of 40 randomised patients was carried out and the results identified that only 39% of patients had a HbA1c recorded during their admission, of which 89% who displayed either pre-diabetic or diabetic blood sugar levels and at the time, were discharged without a clear management plan. The above evaluation provided a clear mandate to amend the existing workflow to introduce a mandatory HbA1c test during admission, which linked the Dexamethasone order set on the Trust’s electronic patient record system with the HbA1c order set, along with a general awareness and training campaign. As part of the first plan-do-study-act (PDSA) cycle, the team contacted 40 patients randomly selected in the initial data set, inviting them for a follow-up HbA1c, 3-6 months post discharge. Results: When inviting the 40 patients within the initial data-set for a follow-up HbA1c, the results demonstrated that:•32% passed away•25% declined follow-up•28% remained within healthy range•10% within pre-diabetic range•5% within diabetic range The project team are now looking at the onward support pathways for the 15% of patients in the pre-diabetic/diabetic ranges: for example, recommending self-referring into the National Diabetes Prevention Programme. The second PDSA cycle includes how to support the wider cohort of patients outside of our sample data set of approximately 175 patients using Quality Improvement methodology. Discussion: Prior to the project, diabetic status of COVID-19 patients was not routinely checked or known at either admission or after 3-6 months, and therefore there was a potential for a cohort of patients to enter, or remain within, a diabetic or pre-diabetic state unknowingly and unmanaged, with associated long-term health implications. The project confirmed that the introduction of initial and follow-up monitoring allowed for an effective diabetic screening programme in an at-risk cohort, subsequent earlier diagnosis of pre-diabetes or diabetes, and appropriate onward referral, where previously there was none. This allows for more joined up management and screening between Primary and Secondary care and the opportunity to improve patient outcomes through identifying at-risk patients and connecting them to support pathways earlier.