Another week…and a few more things progressed for diabetes care- or at the very least , some steps forward were made. Previous blogs have alluded to the work we have been planning regards the area of mental health support in diabetes care- and finally, an event earmarked to flag the start of this journey was made.
Mind Over Matter- to be fair- was the idea of specialist nurse colleagues based in Medway, Kent (Rebecca Watt and Amanda Epps)- and further with the support of Sanofi, a day was organised- which tied in well with the conversations NHS England mental health team and diabetes teams had already started.
The day showcased views and the challenges in front of us all- whether it be from a primary care perspective or indeed a patient charity point of view- while eloquently laid out were the views from a psychology and psychiatry point of view-as well as from a diabetes specialist angle- captivating the present audience of about 150. A big thanks from my end to Abbie Brooks, Chris Askew, Claire Reidy, Khaleda Ismail and Richard Holt for outlining their views as well as finding the time in their busy schedule to help- though as ever, the star of the day was Jen Grieves giving the person with diabetes a voice- and perhaps driving the point more forcefully than any statistic would- as to why mental health support is so important an issue.
The subsequent workshops were aimed at showing the art of the possible- even in challenging times and dwindling resource- as to what was actually possible in different areas of the country. It was fascinating to see and hear those examples- and the positivity was most encouraging. The next steps perhaps however are the most important- the aim is to do a literature review of the role of mental health support in diabetes care- and then try and work with all parties to come up with the ideal mental health support for anyone with diabetes- wherever they are. Possibly a mixture of IAPT, psychology, psychiatry…face to face along with virtual- lets see where this takes us- all in all- there is intent from both relevant NHS England teams- we shall find out how far we can travel down this less-trodden path.
The other event was the announcement of the Diabetes Hot House. If not sure, have a look here…in short, if you have something innovative in the tank that could improve certain pre-specified areas of diabetes care (inpatient diabetes, mental health, maternal health etc) then have a look- and see if this is something you maybe interested in. A joint working between NHS England Diabetes team and ABPI- suffice to say its taken a fair bit of time to work its way through all the process. In the end, its venture the AHSNs are now facilitating- post all the negotiations done with 5 of 7 diabetes pharmaceutical companies. We talk aplenty about innovations- lets find out how much or many of them actually work- by looking at the evidence accrued. I suspect its a bit like what we are doing with using digital means to help prevent Type 2 diabetes. Does it work? We don't know. But we are investing in trying it in 5000 folks- and the results will tell us whether there is mileage in further roll out- or not. A personal thank you to UK divisions of NovoNordisk; Sanofi; BI; AstraZeneca and Takeda for supporting this venture- and for the ones who are asking- yes- it is completely product agnostic- rest assured.
Finally, it was another week of the debate around Freestyle Libre. We are now officially in the zone what is called the Laggards in an innovation curve. In that last area- where it doesn't matter what evidence you have, what those who live with the pathology want….folks who want to block it scramble to find a way- or have none but just say No. In that zone, it was heartening to see further progress across Lancashire in 8 CCGs- down to some sterling work by local folks- no small credit to Dr Rahul Thakur- which takes us close to 75% of CCGs who have now accepted the Libre in one form or another. It maybe worth for organisations who purport to speak for CCGs to speak to their members and see how this embarrassing situation for them could be salvaged- or a veritable question will continue to rise as to whether CCGs are any more fit for purpose- or whether we as a health system pay lip service to terms such as "improving variation"; "encouraging innovation" -or even the one that always make smile "-having the patient at the centre of care".
Heres a question for those CCGs- if you cant even deal with the Freestyle Libre- how will you deal with the complete disruption of the Type 1 diabetes technology market just over the horizon? If you serve the population- serve it properly. Or give it to someone who can. Or learn from a fellow colleague who seem to be doing it better.
So there we are- yet another week whizzes by…as mentioned- slow and steady progress- but progress none the less. Who knows whats next around the corner for diabetes- especially with the plans of the NHS being made for next 10 years.
Could there be something for early intervention with diets? Perhaps something for mental health support? Maybe even a technology fund to look at kickstarting the CGM/Pump sector? The future is laced with possibilities….but for now? Lets also be encouraged by the small steps of progress the community continues to make.