Better diabetes care: it’s not all about the money – by Beth Stout
Last year, NHS England awarded around £44 million in transformation funding to help diabetes services across England improve footcare, diabetes education, access to diabetes inpatient specialist nurses, and to help people meet targets for blood pressure, cholesterol, and HbA1c. Some areas were successful in getting some of that money, some weren’t. But is a big investment the only way to improve the services the NHS provides for people living with diabetes?
At Diabetes UK, we’d argue that it’s not. We’ve been working with our Clinical Champions for four years now, and we’ve learnt a lot about what one passionate person can do on a shoestring. And as we start the search for our next group of Clinical Champions, it’s a great time to think about that.
It’s about bringing people together
Sometimes better diabetes care is just about bringing people together. Dr Ian Wallace, a Consultant in Belfast, has brought the diabetes and dialysis teams together in a ‘mobile diabetes clinic’. While people are receiving dialysis, they can talk to the diabetes consultant, and even have their eyes screened for retinopathy. This reduces the number of appointments people need to take time out of their busy lives to attend, making it easier for people to get all the health checks they need.
It’s about asking what people want
We know that moving from paediatric to adult services can be a really difficult time for young adults. That’s why it’s so important healthcare services meet their needs. Our Clinical Champions working in transition services make sure they ask young adults what they want their services to look like – and it’s having some great results. Dr Vicky Alexander, a Consultant Paediatrician in Dundee, is holding gardening clinics, so that people can spend time together and have some fun while talking to their DSN.
Dr Sarinda Millar, a Consultant Paediatrician in Newry, Northern Ireland, has organised pre-university cooking classes, and even sports events with local celebrities. She wants to make her diabetes service a place for people to make friends, support each other and share experiences.
At the start of each appointment, Sarinda also asks people what they want to talk about that day. It’s a really simple thing – but don’t we all like to be asked what we actually want?
It’s about making it easy
We know that there are 4.6 million people living with diabetes in the UK, but almost 1 million of these people are living with Type 2 diabetes that hasn’t been diagnosed.
It’s a big problem – if people have a diagnosis of diabetes they can get the care and support they need to manage it well. But it’s difficult to get an appointment to even get a diagnosis – last summer the average waiting time for an appointment was nearly 3 weeks. And when you do get an appointment, often it’s in working hours, and getting out of work can be a real challenge for some people.
So how can we make it a bit easier? On World Diabetes Day last year, Dr Paul Newman’s GP practice (pictured above) in Glasgow texted everyone on their database to offer them a drop-in blood glucose check. People were able to fit it in around their own plans. Paul has now run this twice – with the numbers of attendees tripling in 2017.
We know from our Future of Diabetes survey that one of the things the needs to change in diabetes care is healthcare professional knowledge about diabetes. That’s why DSN Sarah Gregory developed a ‘snakes and ladders’ game on hypo awareness to train other staff at her hospital in Margate. And why Dr Parijat De, a Consultant in Birmingham, has pushed for every healthcare professional at his hospital to take on online course on insulin safety. They’re making it easy for healthcare professionals to learn more – so there’s no excuse!
It’s about starting conversations
Working with healthcare professionals to improve diabetes care, one of the most common things people say to me is ‘I’d love to do it…but the IT systems just make it so hard!’
DSN in Belfast Joanne Quinn was really keen that IT issues weren’t going to hold her back from making care better for people with insulin pumps. She started a conversation with her IT team, and managed to get the programmes she needed on the clinic computers so healthcare staff could look at pump downloads. There were a few problems to work around, and for one programme she had to get a separate laptop, but through collaboration she did it.
We know that healthcare professionals are really stretched and it’s not getting any easier to work in the NHS. And we also know that more money is essential when it comes to setting up new services, radically changing existing services, or recruiting new staff. But we also work with some amazing people, who, by taking the time to have conversations, bring people together, and ask people what they want, are able to make diabetes care a lot better.
We’re currently recruiting Clinical Champions. If you’re a healthcare professional interested in improving diabetes care, find out about applying to the programme, which we run with support and funding from Novo Nordisk.