Sunday, August 21, 2016

Where We At

So I have started my new role. At least I think I have. I mean, I have a badge which gives me access to Skipton House, so I must have. Either way, its been about 3 months or so in this new role as Associate National Clinical Director in Diabetes with NHS England. Did I hear a boo and a hiss? Ah well, anyway, it's a role and as promised to many of those who live with diabetes, here goes as regards an update as to where we are! After all, its all about transparency,isn't it?

So lets start! Recall me making the three priorities? So where we at? 
As a follow on from some of the work started on a Type 1 diabetes pathway, paths merged with some fabulous work being done by the London network- and to cut a long story short, we are very close to having a national Type 1 diabetes pathway- which hopefully will guide CCGs and STPs to develop these accordingly. Before my primary care colleagues jump up, no, this does NOT involve you doing more work- so rest assured- and hold fire till you see it. It hopefully will have the blessings of all relevant diabetes organisations soon- specialist/patients etc- and we should be able to progress things soon!

Next up in the pipeline are plans to develop online educational modules for diabetes patients (Bournemouth are already doing a fabulous job at one for Type 1 diabetes - and I don't like reinventing the wheel- may as well back something of excellence!) To emphasise, these will be in conjunction with existing structured education platforms so hopefully will help to support education. Other exciting developments are possible online platforms for blood sugar downloads etc- and yes, as part of all this, am meeting all and sundry to see whats out there- and try to narrow it down to the best available.Other exciting areas are a national Type 1 diabetes platform- that anyone can be referred to- patient or carer- a sort of one stop shop of all curated information available.

As regards technology, a lot of discussions with Abbott and debates regards Libre availability. We- after plenty of coffee and discussions- hopefully do have a plan and I can only assure all that we are working very closely with the company. I must stress that there is a process involved and if we are to invest public money into it, evidence is key - which takes time to gather and accumulate. We shouldn't be too far off it (the recent data published at the American Diabetes Association meeting and the work done by the Scottish group are certainly helpful)- but again, do bear with us on this one- its not something that has been rejected or put on the back burner! I personally would like this to happen- as I do see its benefit- but patience and time please.

As regards inpatient diabetes, again, plans are afoot- which involves role of CQC, a possible adaptation of self administration of insulin becoming a necessity, definition of inpatient diabetes teams or indeed its presence in the diabetes aide-de-memoire for STPs to follow. The aim is not to have inpatient diabetes teams as an "option" but as a fundamental part of acute Trusts- given that 15-20% patients admitted at one point have diabetes and the errors are far too many!

What else? Much actually…the "impossible tour"? Oh yes, letter being drafted to go to all teams- and if they want, will be visiting for sure! There's a meeting with the Night Scout team coming up, there's keeping an eye on data from Cheshire, there's discussion on information for pregnant mothers, education run by patients for professionals ("Flipped Education"!) and of course, the issue of extending the Best Practice Tariff…did I ever say its actually been quite good fun?

Finally, a mention to the team with whom I work- the background work being done by many is simply amazing-and especially Jonathan Valabhji who as NCD has been a fantastic guide- and believe it or not, in diabetes care, changes should be coming. There are many more ideas but for now, even landing those above will be a step forward.And of course there's TAD 2 (wasn't the 1st one fun?) and the Type 1 diabetes comic book.

3 months or so in- about 9 to go- No, its not a time limited job for 12 months but its a point where I assess my own role. If in 12 months, nothing much has changed, it maybe time for someone else to try. Till then, its actually not all doom and gloom…a tweet recently said "If you are not in revolt, you are in cahoots". Well, I respectfully disagree. I have a limited time doing the job I do- and I will work with anyone to try and improve diabetes care- whatever be the structure or political colour.There are many ways to help patients- I respect your fight- in return I ask that you respect mine too.

Over the course of time, as projects are launched, I will take time to pay tribute to some amazing professionals and patients who have been helping along the way. For now, you know who you are- and a genuine thank you. 
Much more to be done- but the support received so far? Simply magic- and thank you for that. To everyone else. I reiterate it again…if you have a good idea or a constructive suggestion, come and talk to me. I will always find time- promise!

Will update again in 3 months- but till then? Keep asking, keep suggesting and keep prodding…just do it with awareness for some one who also has a life, a family and a full time day job too! :-)

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