Learning Event Local update Dr Neel Basudev GP Lambeth Clinical - - PowerPoint PPT Presentation

@HINSouthLondon www.healthinnovationnetwork.com

Lambeth Diabetes Learning Event

Local update

Dr Neel Basudev

GP Lambeth Clinical Director Diabetes Health Innovation Network Clinical Lead Out of Hospital Care London Diabetes Network

@HINSouthLondon www.healthinnovationnetwork.com

Things to cover

Diabetes state of play

• Type 2 diabetes prevention- Healthier You
• Diabetes Book and Learn
• Tier 3 weight management
• Foot care pathway

Self-management

• Technology

Learning today

• Programme

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Diabetes state of play

Type 2 Diabetes Prevention

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@HINSouthLondon www.healthinnovationnetwork.com

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Prioritisation Approach

• HbA1c 44-47mmol/mol or Fasting

Plasma Glucose (FPG) 6.5– 6.9mmol/l

• Healthier You, NHS diabetes

prevention programme (NDPP), commissioned by NHS England

– first line option

• STEPs to prevent diabetes

commissioned locally in Lambeth

– second line option

• 6 months into new contract
• 82% have reduced weight
• 97% reduced Hba1c
• Average Hba1c change -4.66

mmol/mol

@HINSouthLondon www.healthinnovationnetwork.com

@HINSouthLondon www.healthinnovationnetwork.com

Diabetes state of play

Book and Learn

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• CDEP structured education

module available

10

• Personalised journey from referral

to completion of a course

• Allows for referral from multiple

sources, including self-referral

• Choice of all currently

commissioned courses across 12 CCGs & 18 providers including remote/digital courses

• Improves coding in primary care –

updating SNOMED codes automatically

• Motivational techniques to

encourage attendance from a specialist call center run by Spirit Healthcare

• Provides continued support – self-

management resources, social prescribing, patient able to see

• wn data (HbA1c etc.) and access

refresher learning

• www.diabetesbooking.co.uk

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Diabetes state of play

Tier 3 weight management

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Overview of 2 year pilot

• Delivered by Dietetics Dept. at Guy’s

& St Thomas’ but the programme itself will be delivered in the community

• The programme is for:

– Over 18’s – BMI ≥40 or BMI ≥35 with Type 2 Diabetes – Motivated to lose weight – Willing to take part in a group based programme requiring regular attendance

• The referral form can be found on

DXS or EMIS and referrals must be sent via eRS

• A choice of two programmes:

– BALANCE - Nutritional education alongside behaviour change, psychology and physical activity. 12 group sessions

• ver the course of a 12 month period

– FAST - Evidence-based total meal replacement programme for more substantive, rapid weight loss followed by food re-introduction, nutritional education, psychology and physical

• activity. 15 group sessions over the course
• f a 12 month period

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Diabetes state of play

New Foot Pathway

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Foot facts

• Today, and every day, how

many people with diabetes in England will have a toe, foot or leg amputated?

– 23

• The NHS in England spends

how much per year on diabetic foot problems

– over £1 billion

• What % of patients survive

for 2 years after major amputation in diabetes

– Around 50%

• What is % 5-year survival

after diabetic foot ulcer?

– 58%, similar to that for colorectal cancer, and lower than for breast or prostate cancer

15

Multi-Disciplinary Footcare Teams (MDfT) - Lambeth

• Clinics available at:

– St Thomas’ Hospital – Monday to Friday 09:00-17:00 – King’s College Hospital – Monday to Friday 09:00-17:00 – Guy’s Hospital – Thursdays 09:00-13:00 – SOS at King’s before 12:00 Monday to Friday

• Don’t wait, refer within 24 hrs via eRS

What to refer:

• Any foot ulceration
• Acute Charcot foot (hot/swollen/painful foot)
• Any foot Infection
• Septic patients should be referred to A&E with in-patient MDfT support
• Concerns or unsure? Refer anyway

16

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Self-management

Technology

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South London Diabetes test bed

• Support practices to introduce care and support

planning for diabetes

• Employ technology that allows people to take their

care plan with them, wherever they go.

• Link people to the resources that can help them

manage their diabetes.

• Utilise technology to communicate more

meaningfully with our patients about their diabetes.

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Booking process Information gathering appointment Care planning appointment Annual review

Personalised support

Support to access resources Month

1 2 3 6 12

• Video via text

message or e-mail explains why care planning is important and what to expect

• Hyperlink included to

make an appointment

• Care planning

preparation

• Introduction to

Healum platform

• Video message with

their results

• Better understanding
• Detailed care plan

and results available in Healum

• Video message with

their care plan

• Linked to education

and social prescribing resources

• Useful resources and

information constantly updated in Healum

• Nudging from app to

keep focus on goals

• Video message to

keep up motivation at 6 months

• Video message to

prepare for annual care plan review

• Link to Healum self

assessment

• Click to make

appointment

Recall Care planning Habituation Maintenance

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Communication is key

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Learning today

Programme

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This afternoon

Flash Glucose Monitoring

Anna Hodgkinson, Consultant Pharmacist

Weight loss interventions for T2DM

Alastair Duncan, Principal Dietician GSTT

Management of T2DM in practice

Piya Sengupta, Consultant Diabetologist GSTT

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Thanks for listening