Gaynor Kebbell Lucy Lightfoot The Potential Reward for Improved - - PowerPoint PPT Presentation

Dr Marc Atkin Gaynor Kebbell Lucy Lightfoot

The Potential Reward for Improved Diabetes Control

Every 10 mmol/mol reduction in HbA1c REDUCED RISK Deaths from diabetes Microvascular complications Amputation or death from peripheral vascular disorders

10 mmol/ mol

43% 37% Fatal or non-fatal MI 21% 14%

Data from Stratton IM et al. BMJ 2000; 321: 405‒412.

Prescribing Incentive Scheme 2016-17 Focus on Type 2 Diabetes

 Aims to fund practices to spend time reflecting on

cardiovascular risk management in patients with T2DM

 Process mapping the practices care pathway for

hypertension and lipids management in patients with T2DM (and one other area of your choice)

 Practice level audits of BP management, statin and

aspirin prescribing in patients with T2DM

 Complements work of Diabetes MDT

Prescribing Incentive Scheme 2016-17 Focus on Type 2 Diabetes

 Using shared learning from this scheme:

 Is there scope to reduce local variability?  Identify needs for improved local processes,

education and guidance

 Can practices share what works well?

 See full Prescribing Incentive Scheme 2016-17

document and your practice based pharmacist, or contact lucy.lightfoot@nhs.net for more detail

Prescribing Incentive Scheme 2016-17 Focus on Type 2 Diabetes

Questions?

National Diabetes Prevention Programme

 Exactly what it says on the tin

 Attempt to stop the increase in T2DM cases (>550 in banes last year)  Based on 36 studies with an average of 26% reduction in incidence in t2 dm  Encompasses 13 sessions over 9/12, at least 16hrs of face to face contact  Eligible:- Adults with HbA1c 42-47  Commissioned directly from NHSE  Intervention delivered by one of 4 national providers

 What does it mean for me?

 Somewhere to send your prediabetes patients to  Once identified & referred, somebody else pays for and carries out intervention  STP will be looking into ways of simply identifying and referring potential

patients

 Starts accepting referrals april 2017

 Primary care support is key (80 v 34% uptake rate)

Diabetes virtual clinic update

Now being rolled out across BaNES



Coming to a surgery near you



Paid for in LES

What are we trying to do?



Support primary care with increasingly complex patients



Look at ways in coping with increasing demand



We are not trying to push more patients into primary care

What do we do?



Diabetes Nurse Facilitator (Gaynor Kebbell)



Does not hold a case load



For primary care support (GP & PN)



On the job support and guidance (joint clinics and virtual clinics in practice)



For advice on diabetes service set up/skill set



Consultant-lead sessions



Once every 6/12 in each practice



1 hr education to the cluster – various topics



Virtual clinic of selected patients in the practice



Selection- challenging patients/searches (GK)



Done using system one/emis



12-18 mth care plan put directly into notes



Aim for 20+ patients per session



Educational



Review of audit/ diabetes clinic set up on second visit

New Diabetes Template

Diabetes Transformation bid

Money for transformation of diabetes services from NHSE

 £70 million over 2 years  Bids invited for 4 areas that offer greatest impact



Improved uptake of structured education



Improving no of patients reaching HbA1c, BP & Cholesterol targets



Foot clinic



Inpatient diabetes

BaNES bid is mainly primary care based



Upskill primary care to “sell” structured education



Adopt expert diabetes course



Support best practice across the CCG



Target interventions in the under 70s



Support and educate HCPs to do their job as well as possible



Develop robust data collection and evaluation tools – diabetes dashboard

If successful we should have the money to implement this by April 2017