Saturday, June 17, 2017

Together- we can

So its landed. Money. Yup. New money. To improve diabetes care. No ifs and buts about it, no money moving around spreadsheets- simply new money- in excess of 40 million £. To be accurate, its exactly as below:
11.1 M to increase uptake of structured education
13.9 M to improve treatment targets
6.7 M to improve amputation rates
3.9 M to improve inpatient safety
A further 4 million for those areas whose bids weren't successful but needed improvement as datasets suggest needs while another 2 million to support improvement in areas with significant inequalities in diabetes outcomes
A total of 42 million £. For diabetes care.

Now? For the hard part. To those who say, money will solve everything, here you go. Time to deliver. I personally have never believed money is the end all and be all- BUT appreciably this may go a long distance. Let's see the outcomes and delivery. The aim is to monitor the outcomes and track results- so this isn't a money hand out to shore up services. Its to deliver clear outcomes- improve safety, improve amputation rates etc

Appreciably there will be some not happy, some feel more could be done, some who feel 42 million £ is very little- perhaps so- but look around you in the NHS and appreciate this money, if used well, could go a long way in present environment of financial crunch. Money will also be released in segments depending on outcomes, ability to recruit etc- so if you are an HCP in diabetes care, I wish you all the very best. The time is now, the time is to deliver.

In the background of this, sat a recent visit to San Diego- for there annual conference of the American Diabetes AssociationMuch learning and debate especially around the exciting prospects of classes of medications showing signs of cardiovascular outcomes, debate about their side effect profiles, while studies looking at impact of Metformin in Type 1 diabetes certainly caught the eye.

However 2 stand out events whetted the appetite if not simply to replicate what is happening in other countries. 
Firstly, went to an event - kindly invited to by an amazing patient advocate, Amy Tenderich and sat and took on board the concept of patient led innovation. Met Professor Eric Von Hippel from MIT whose research and work suggested the importance of giving patient led innovation space albeit in a non-profit environment. I was instantaneously told via Twitter we already had this- excuse my impertinence, but on the ground, in the NHS, at least from the diabetes point of view, I haven't seen any wide spread adaptation or even any national forum where patients have the opportunity to do so. Tech companies, absolutely yes; Clinicians, yes...patients or users? Not much I have seen. So you know what? Let's do something along those lines. 

A similarly fascinating session was one on language we use with patients. Indeed we have chatted much about it but in the world of diabetes the UK, I haven't seen a document or guidance present as to what are words to be avoided, and what's acceptable. To some, it will be PC nonsense- to me, it's not for me to judge when I don't have diabetes. If simple tips about better engagement results in better outcomes, it's worth it. It appears the Americans are due to pass a position statement on it, the Australians have done some amazing work on this- so we must follow suit. Without any hesitation, I have reached out to them and the response has been much heartening. We will do this in the UK- the question is who wants to join me in doing so.

So, new money, and a couple of new initiatives to drive patient engagement….in these hard times, it is appreciably, not easy to feel the world isn't collapsing around us. But we must try. We must believe. And we must keep doing the job we do. Use the money well, be prepared to have tough conversations about outcomes- and come help me do something more for patients. 

Together? We can. We absolutely can.

Friday, June 9, 2017

Limbo and Hope

How's that step into work feel for you today? Laced with a spring or laden with lead...or simply maybe a bit confused? It's tricky to try and interpret anything to do with politics today but we, as a nation, are now officially in limbo land. The country seems to have turned around and said we aren't giving you any winners....let's see whether you politicians can actually try and resolve it like adults- working together. As many know, I have always found Brexit odd especially in a world where isolationism is a relic of the past. Today, we are having a collective push from the nation which says...pause. And think please. You have to love democracy for that. There will be many permutations and combinations, many theories...but at the end, the politicians will have to show us the way. Show us the way to do something different - something a bit more measured.

The election campaigns have been frankly awful- whichever media you choose to see, whichever side of the debate you sit in and I suspect a vast majority of people, beyond the hard core folks have winced at the lies, half truths and blind belief in issues to suit the phenomenon of confirmation bias. And I am sure we will continue that again in the near future. But for now, it must be a time to pause and see what can be done together. All this talk of moral or Pyrrhic victory is only that...a bit like a hard fought draw. The bottom line is that democracy has said no extreme options as put forward by the main parties have been seen as acceptable enough to give them a majority- however one would like to paint that.
I like to look at things with a positive twist and this result is no different. Life never stops for anything but to wake up and contemplate the possibility of a second referendum on Europe, a softer Brexit and personally, a dismantling of the UKIP vote has been worth all the uncertainties of a hung parliament. 

What about the NHS? Perhaps not the best - as it could do with some sort of time for further planning. Could this be an opportunity to get the main parties to actually come up with something sensible together? Could we think of a different style of working? Or do we go to elections again for a clear winner? What happens if the public says "Sorry neither plans are good enough for us"?

The country as a whole has a big few issues in front of it- namely Brexit and from a personal point of view, of course, the NHS. I suspect the choice is ours whether we interpret the election results as one that's indecisive and needs repeating...or whether we take it as a mandate saying the electorate are fed up of the pettiness and would want our politicians to work together on such vital issues?

Who knows? For now, once the dust settles, limbo land is an odd place to be in. One way or another, we all need to know where we are heading and to me, it appears the voters have said to all our politicians..."Do it together" 
We all live in hope. In the interim, once purdah lifts, it's back to business on the diabetes front- and hopefully some good news to I said, we all live in hope. We must.