Supporting self management for people with diabetes Lifting the words from the page Dr Simon Eaton Consultant Diabetologist, Northumbria Healthcare Clinical Lead for Long Term Conditions, NHS North East All-Party Parliamentary Group for Diabetes, March 9 th 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…

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 network September 2009 High Quality Care should…

‘We do that already…’

HCC National Patient Survey ‘We do that already…’

Picker Institute, 2007 ‘We do that already…’

Lifting the words from the page Pilot sites: Calderdale and Kirklees PCT Tower Hamlets PCT NHS North of Tyne Diabetes Year of Care Programme Diabetes

Lifting the words from the page

Engaged, informed patient HCP committed to partnership working Organisational processes Commissioning - The foundation Information/ Structured education ‘Prepared’ for Consultation Emotional & psychological support Supporting self-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 HCP committed 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 Supporting self-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 HCP committed 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 Supporting self-management

Care Planning