NHS RightCare Pathway: Diabetes

NHS RightCare, in partnership with the Healthier You: NHS Diabetes Prevention Programme(NHS DPP) has published NHS RightCare Pathway: Diabetes.

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NHS RightCare Pathway: Diabetes is a tool that aims to support local commissioners to review local diabetes pathways in order to identify where potential improvements could be delivered. The pathway has been developed in collaboration with the National Clinical Director for Diabetes and Obesity at NHS England and Associate National Director for Diabetes, the NHS Diabetes Prevention Programme, Public Health England, Diabetes UK and patient groups.

NHS RightCare Pathway: Diabetes has two key elements:

  1. It describes the core components that should be present in an optimal diabetes service; right from detection and diagnosis through to ongoing treatment, management and care of people with diabetes
  2. It provides guidance for commissioners that will:
    1. Allow them to think through their existing diabetes service and compare it with an optimal diabetes service; and
    2. Provides guidance for commissioners about the scale of improvements that could be delivered through optimisation of local pathways.

Full resource: NHS RightCare Pathway: Diabetes

See also: Appendix 1: Examples of good practice

This resource outlines examples of models of integrated care between primary and secondary care, and contains useful links and resources.

 

Excellence In Diabetes Care Commissioning

NHSCC launch new report on excellence in diabetes care commissioning | NHSCC

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Image source: NHSCC

The document draws out lessons from those involved in the projects to share and embed for the future. Since 1996 the number of people living with diabetes in the UK has more than doubled. The NHS is now spending more than £9.8bn each year on treating the condition and its complications.

The new report Excellence in commissioning diabetes care features a range of programmes from CCGs across the country with case studies including:

  • Slough CCG’s approach involving both targeted support for communities and education in GP practices – the CCG is ranked second best in the country on delivering the eight care processes identified by the National Institute for Health and Care Excellence as representing good practice in diabetes care.
  • Surrey Downs CCG’s work to improve communication between GP practices and paramedics in relation to incidences of hypoglycaemia.
  • Aylesbury Vale and Chiltern CCGs’ joint approach to diabetes care, which focuses on what the patient wants to achieve rather than only their blood sugar levels.

The report is available to download here

Commissioning diabetes care

NHS Clinical Commissioners has published Excellence in commissioning diabetes care.  This report provides examples of where clinically led commissioning is changing the way diabetes care is commissioned and improving people’s lives. 

Since 1996 the number of people living with diabetes in the UK has more than doubled. The NHS is now spending more than £9.8bn each year on treating the condition and its complications.

The new report features a range of programmes from CCGs across the country with case studies including:

  • Slough CCG’s approach involving both targeted support for communities and education in GP practices – the CCG is ranked second best in the country on delivering the eight care processes identified by the National Institute for Health and Care Excellence as representing good practice in diabetes care.
  • Surrey Downs CCG’s work to improve communication between GP practices and paramedics in relation to incidences of hypoglycaemia.
  • Aylesbury Vale and Chiltern CCGs’ joint approach to diabetes care, which focuses on what the patient wants to achieve rather than only their blood sugar levels.

The report contains tips on commissioning excellent diabetes care including: involving patients in their own care; collaborating with providers on the move from activity to outcomes based approaches and using data effectively to demonstrate the case for change.

Supporting the management of type 2 diabetes with pharmacist-led reviews

Langran, T. et al. (2017) BMJ Open. 7:e013451

NHS Framework Document 2008

Objective: Describe and assess the impact of a pharmacist-led patient review programme on the management and control of type 2 diabetes (T2D).

Conclusions: The pharmacist-led review increased the number of key care processes administered and improved diabetic control during the year of programme delivery. The improvement abated during the year after, suggesting that such programmes should be ongoing rather than fixed term. The programme combined the strategic drive and project facilitation skills of Slough CCG, the general practice teams’ knowledge of their patients and the clinical and information technology skills of an experienced pharmacist team.

Read the full article here

A Structured Transition Program Among Young Adults With Type 1 Diabetes

Pyatak, E. et al. Journal of Adolescent Health. Published online: November 23 2016

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Purpose: We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care.

Conclusions: Our study suggests that, for young adults with a history of lapses in care, a structured transition program is effective in lowering A1C, reducing severe hypoglycemia and emergency department utilization, and improving uptake of routine diabetes care. Loss to follow-up and psychosocial concerns remain significant challenges in this population.

Read the full abstract here

Diabetes commissioning pack

London Clinical Networks | Published online: 22 September 2016

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Image source: London SCN

The London Diabetes Clinical Network has developed this comprehensive commissioning pack to ensure we deliver excellent type1 diabetes services for all Londoners. This pack contains recommendations to assist in the commissioning and delivery of excellent services, self-assessments to establish current gaps in commissioning and delivery, and performance targets expected which will ensure we deliver improved patient reported outcomes.

There are three parts to this commissioning pack:

» Service specification (this document) – Aimed at commissioners, this document details the care to be commissioned for adults with type 1 diabetes, including an overview of diabetes, elements of an excellent service plus commissioning recommendations.

» Clinical management: Optimal pathway – Aimed at providers, this document details the expected clinical care for type 1 diabetes.

» Implementation guide – This document provides the tools for both commissioners and providers to measure, analyse and develop improvement plans for their local diabetes service. It includes a summary of expectations and self assessments for commissioners and providers, performance targets and a sample patient reported outcome measures (PROM) form to collate patient feedback. It also highlights the type 1 care consultation tool (developed by Health Innovation Network and King’s Health Partners), which can be used in the management of people with type 1 diabetes.

Read the service specification here

Diabetes care

Diabetes UK has published State of the Nation 2016: time to take control of diabetes

The report brings together evidence from recent national diabetes audit reports covering care processes and treatment targets, inpatient care, pregnancy and foot care.  It sets out actions to improve the delivery of the 15 healthcare essentials for adults with diabetes, and to improve care for children and young people. It makes calls to NHS England, local commissioners, GPs and other NHS providers to improve care and support for people with diabetes and on the prevention of Type 2 diabetes.