Diabetes in Rushcliffe Presentation to CCG Governing Body July - PowerPoint PPT Presentation

Diabetes in Rushcliffe Presentation to CCG Governing Body July 2014 Dr Rahul Mohan www.rushcliffeccg.nhs.uk

DIABETES  Rushcliffe has nearly 5,000 people diagnosed, with an estimated 1,000 who are currently undiagnosed.  4 th /5 th most common long term condition in Derbyshire and Nottingham  Although Rushcliffe percentage of patients achieving all three treatment is not in bottom 25% of all CCGs, still there are areas that require improvement  Numbers of patients registered  Diabetic Specialist Nurse costs per annum £45.7k  Diabetes Local Enhanced Service Levels 1 & 2 commissioned from GPs 2011/12 2013/14 £12k £11.9k www.rushcliffeccg.nhs.uk

CCG Performance CCG Outcomes Indicator Set People who have received NICE recommended care processes  71.5% People diagnosed <one year referred to structured education  Most CCGs are performing poorly Source CCG Profiles – National Diabetes Audit 2011/12 Quality and Outcomes Framework 2012/13 overall Diabetes clinical indicators achievement  CCG average achievement 98.4%, England average 96.1%  Range of practice achievement 91.8% - 100% Standardised diabetic complication ratios for the CCG compared with England and Wales  As expected for Angina, Myocardial Infarction, Major and Minor Amputation, Heart Failure and renal replacement therapy  Lower than expected ratio for stroke www.rushcliffeccg.nhs.uk

Community Diabetes Service  NUH community contract with NNE, NW & RCCG  30 hours per week  Delivered by one Diabetic Specialist Nurse (DSN)  Current model -risk to business continuity  Reduced capacity to increase patient caseload  Current Nottingham University Hospital(NUH) workforce plan may not include community DSN services across the three CCGs  City CCG model has increased existing DSN community workforce to 6wte plus a further 4wte to work across NUH and community www.rushcliffeccg.nhs.uk

Structured Patient Education & Self-care  Juggle – Structured education for Type 2 diabetics (excluding patients on insulin) Provided by 4 sessions covering dietary, lifestyle and patient education  Rushcliffe 60% attendance for all 4 sessions  Identified need across 3 South Notts CCGs to improve uptake and provide more inclusive education for all Type 2 patients  Proposal of modular programme approach www.rushcliffeccg.nhs.uk

PATHWAY DEVELOPMENT Hypoglycaemic patients Aims to  reduce unnecessary ambulance conveyances to hospital  reduce unnecessary unplanned admissions  Improve patient experience  Enable timely follow-ups for patients with their practice/DSN  Targeted patient educational support to prevent further occurrences www.rushcliffeccg.nhs.uk

ISSUES FOR CCG TO CONSIDER  Expansion of DSN services  Coordination among the 3 CCGs (NNE, NW & RCCG)  Improving the uptake and delivery of Structured Education  Diabetic foot care delivery – reduction in both major and minor amputation rates www.rushcliffeccg.nhs.uk