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Supporting self management for people with diabetes
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Dr Simon EatonConsultant Diabetologist, Northumbria Healthcare
Clinical Lead for Long Term Conditions, NHS North [email protected]
All-Party Parliamentary Group for Diabetes, March 9th 2010
Dilemma
• Numbers of people with diabetes rising ++• Costs attributable to diabetes rising +++• Burden of diabetes is huge• Much of the burden is preventable• Not just about access to new technologies• Decisions that people with diabetes make
every minute of every day…
…& the role that health services play in this
Pathways and Journeys…
Pathways and Journeys…
Consultations with Healthcare Professionals
‘Pathways’ – e.g. at diagnosis, treating foot
ulcer, pregnancy
Avoidable admissions or unplanned care
People with diabetes ‘self-manage’ >99% of the time
Quality & Productivity…
Consultations with Healthcare Professionals
‘Pathways’ – e.g. at diagnosis, treating foot
ulcer, pregnancy
Avoidable admissions or unplanned care
People with diabetes ‘self-manage’ >99% of the time
…support people to develop confidence and competence in managing the challenges of living with their condition(s), in order to have
a better quality of life and better clinical outcomes. This will also enable more
effective and appropriate use of health and social care resources.
Long term conditions clinical leads networkSeptember 2009
High Quality Care should…
‘We do that already…’
HCC National Patient Survey
‘We do that already…’
Picker Institute, 2007
‘We do that already…’
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Pilot sites:Calderdale and Kirklees PCT
Tower Hamlets PCTNHS North of Tyne
Diabetes Year of Care Programme
Diabetes
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Engaged,
informed patient
HC
P com
mitted to
partnership working
Organisational processes
Commissioning- The foundation
Information/Structured education
‘Prepared’ for Consultation
Emotional & psychological
support
Supportingself-management
I could focus on the important things for
me and get help
Time to read [results] and think about what to raise… you know
what was coming
Took the ‘cork out of the bottle’
I enjoy doing the clinic a lot more now… working with them rather than at them
It’s absolutely 100% better for me and for
the patients
People feel more
relaxed
Preparing? - why bother?
Engaged,
informed patient
HC
P com
mitted to
partnership working
Organisational processes
Commissioning- The foundation
Information/Structured education
‘Prepared’ for Consultation
Emotional & psychological
support
Consultation skills / attitudes
Senior buy-in & local champions to support & role
model
Integrated, multi-disciplinary team & expertise
Send test results beforehand
Contact numbers and safety netting
IT: clinical record of care planning & able to feed data into commissioning
Quality assure and measure
Procured time for consultations, training, & IT
Identify and fulfil needs
Develop market to meet current
and future needs
Establish & publicise
menu of care
Supportingself-management
Lifting the words from the page
• Huge burden of diabetes still to be addressed• Lack of support for a vital resource
– the person with diabetes• Need planned, proactive, anticipatory services• Designed around needs of users, not systems• Support people to make informed and personally
relevant decisions • Confidence and skills to manage challenges of
living with their condition(s)• Effective measures of progress & improvement
Engaged,
informed patient
HC
P com
mitted to
partnership working
Organisational processes
Commissioning- The foundation
Information/Structured education
‘Prepared’ for Consultation
Emotional & psychological
support
Consultation skills / attitudes
Senior buy-in & local champions to support & role
model
Integrated, multi-disciplinary team & expertise
Send test results beforehand
Contact numbers and safety netting
IT: clinical record of care planning & able to feed data into commissioning
Quality assure and measure
Procured time for consultations, training, & IT
Identify and fulfil needs
Develop market to meet current
and future needs
Establish & publicise
menu of care
Supportingself-management
Care Planning
