Dr Marc Atkin Gaynor Kebbell Lucy Lightfoot
The Potential Reward for Improved Diabetes Control REDUCED Every 10 mmol/mol reduction in HbA 1c RISK 14% Fatal or non-fatal MI 10 21% Deaths from diabetes mmol/ mol Microvascular 37% complications Amputation or death 43% from peripheral vascular disorders 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
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