Sunday, April 8, 2018

Up Next...

So, its April. For most people, thats spring time- for NHS circles- especially in financial terms- its the start of the yearly cycle. For us within the NHS England Diabetes team, its a fresh time for planning as well as ensuring some of last years good stories continue down the line.

The last year hangs over us as a start of hopefully something different in diabetes care- and much kudos to all in the NHS England diabetes team for what has been delivered so far:

  • Further roll out of the National (Type 2) Diabetes Prevention Programme 
  • Launching of the Digital arm of the NDPP- with assessments in place regards efficacy
  • NHS RightCare pathway for Diabetes to focus on specific priority areas for Return on Investment
  • In excess of 40 million £ invested to help in uplifting of education spaces (>90000 spaces) or increase in Diabetes nurses (>90 WTE nurses recruited) as well as improvement in foot care and treatment targets
  • Landing of Freestyle Libre in Nov 2017- and steady progress across the 4 nations
This year thus becomes more of taking some of the work forward. So- a sneak peek into whats in the pipeline over the next few months- or as much as feasible within the limits of reason. 

To begin with, a national website/ portal to help with self management of those diagnosed with Type 1 diabetes is long overdue- and hopefully will be finished shortly. Multiple stakeholders - including working with existing good portals such as T1resources , Diabetes UK, JDRF etc- but the focus of this has been / is to increase tools for self management; encourage peer-support and hopefully steer many towards much needed education courses. What has been educational has been working with many of those living with T1D and HCPs, under the guidance of NHS Digital, to develop this- hope the finished product will be what it says on the tin.

The recent acceptance of a paper in Diabetic Medicine hopefully opens the door for the much needed discussion on individualised care in diabetes and the relevance of QoF in this context. An ageing population. frailty are important factors- and diabetes care need to be adjusted accordingly- rather than incessant drive to targets which end up harming people. I anticipate a long road on this but so far, the signs have been positive with all relevant primary care stakeholders being receptive to this- so hopefully this will go ahead and take us - ironically- back to individualised care.

Language Matters- and the relevance of it is close to my heart- and delighted that this piece of work is in its final stages- many thanks to Anne Cooper, Bob Swindells, Cathy Young, Rosie Walker, Jen Nash, Sarita Naik- and many others. I have been much impressed by the willingness of all relevant diabetes organisations to engage in this piece of work- and glad its not taken us years to finish this. Hopefully out soon- but in my opinion, its a fundamental shift in culture as to how we interact with those living with diabetes- which holds a major key ti improving care. Let's see!

Treatment of diabetes patients via ambulance crews and paramedics have needed an upgrade with the existing guidelines being perhaps a bit out of date- plus protests to that effect has been noted. Again this hopefully should be complete soon too- and fingers crossed, helps with improved care- and maybe even reduce admission rates to hospitals across the country.

Another piece of work hopefully concluding soon is a nationally agreed pathway for access to diabetes technology- being developed by some of the brightest minds in Type 1 diabetes care- along with those living with diabetes. Hosted jointly by the NHS England diabetes team and Diabetes UK, hopefully this will help / aim to standardise access - as well as look at issues of procurement, education of staff etc etc. A HUGE piece of work- but the early signs are good- and much grit and patience will be needed by the collective to achieve progress on this in present times of financial strains and competing priorities.

Other bits of work -over the next few months will look at role of pharmacists, dieticians as well as mental health side of things in diabetes. 
Throw in discussions and mulling over Out of Hour support across the country, discussions around Type 2 diabetes education in digital context, some educational material specific to south east asian population and accreditation of existing education programmes…and we have a fair few things to keep us all busy. The work around reviewing hospital services in diabetes begins in earnest too from May (some pilot runs end April) - and hopefully all of this will come together to keep driving quality of diabetes care up.

Another update perhaps in July on how much we have delivered on the above and what subsequent plans are. As mentioned at the beginning, there are a few other bits - and hopefully we will have some further good news to share. 

Till then? Wish us luck- and thank you to all for the support and kind words- which makes it all very worthwhile x


  1. Great to read what's happening in England. Maybe one day we will get updates in Scotland too!

  2. So much achieved in the last few years.
    Voices heard, people with diabetes, their career and HCP who give a damn.
    And much of it a common sense approach, people helping people with diabetes

  3. What an wonderful post. Very nice to read. I very much appreciate the way you have provided extremely useful information about diabetes. These days people in general are extremely concerned about diabetes and always on the lookout for an effective solution. Recently I came across a book called "The 7 Steps to Health and the Big Diabetes Lie". Trust me the book practically breaks hundreds of myths related to the disease and provides an effective solution. I have found it extremely useful and effective. Maybe you can also read it out at once.