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 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