Diabetes Programme Progress Report Dr Charles Gostling, Joint Diabetes Clinical Director October 2013

1.Supporting self-management including patient education and care planning 2.Adopting new technologies 3.Enabling an integrated care system for diabetes (new models of care and working across organisational boundaries) Work group meetings were held over the summer with a wide range of attendees from across south London including service providers, service users, commissioners and representatives from industry. We have now developed a project plan that outlines the key programmes we will be developing. Diabetes high level themes

9 July: workshop on self management was attended by over 30 participants from across health and social care Key priorities and emerging themes: Improve systems and processes for encouraging people with diabetes to participate in education and training programmes to support self-management. Work with commissioners and providers to increase the choice of education programmes available, including development of online courses, culturally sensitive methods of delivery and “short taster” courses. Looking to adopt and defuse IT solutions to help people improve their ability to monitor and manage their routine care Improve care planning by promoting direct patient access to GP records including personal medicines information, blood glucose and other important test results. Clinical problems scoped in planning workshops

Key priorities and emerging themes: Work with teams in primary care to identify the cohort of people with type 1 diabetes, being managed by their GP, community service or other, whose condition might be improved if they had improved access to care and self management technologies. Improve self management in people with type 1 diabetes through the adoption of appropriate technologies such as insulin pumps and continuous blood glucose monitors. 31 July: workshop on the adoption of new technologies attended by over 30 participants from across health and social care Clinical problems scoped in planning workshops

Clinical problems scoped Enabling an integrated care system for diabetes, new models of care and working across organisational boundaries IssuesCauses Potential solutions/ innovations Prioritisation 11 September: information fed into major stakeholder workshop

Planning workshop Key priorities and emerging themes: Working across the network to develop and defuse the LAS community response hypoglycemia urgent care pathway. Working with providers, area prescribing teams, London Procurement and pharmaceutical companies to identify current uptake and usage of therapeutic agents to ensure good compliance with NICE guidance. Working with industry to develop tools to start to identify high and low risk patients who would most benefit form having care delivered in new ways - such as being managed via phone clinics or via tier three multidisciplinary teams. 11 September: over 70 participants from across health and social care and representatives from industry

1.Improving self-management of insulin therapy through better access to appropriate use of technologies 2.Improving the management of unscheduled care by developing pathways for the management of hypoglycaemia care in the community 3.Improving access to Structured education and related support for self- management 4.Review the use of insulin management for people with Type 2 diabetes to optimise care and support the effective use of resources. 5.Improving the prevention care and treatment of diabetic retinopathy by sharing test information across care settings Projects being taken forward in

Organisational Processes Feedback from working group participants “Everyone was open to ideas” “Opportunity for active input form all delegates” Diagnostics Company representative Pharma representatives Best thing was “Table discussions and information sharing especially when ones ideas and comments get highlighted” Service user “Excellent and motivational speakers giving succinct presentations” Commissioner “Clear process for decision- making with a large number of stakeholders” Best thing was “Broadness of discussions” Clinician

Organisational Processes Key milestones and delivery dates February to April Completed Wide engagement with expert groups and stakeholders to identify priority workstreams. Identify areas of good practice locally and nationally. Identify NICE guidance best practice standards and current delivery performance against quality measures. July to early September Completed Planning workshops with wide range of stakeholders to identify key themes and issues in workstream as part of project planning. Continue to collect detailed data on areas of good practice locally and nationally. Conduct further analysis of and base line service provision and delivery performance against quality measures. September October In progress Scope 5-6 potential projects for feasibility and impact on care. Identify volunteers for task and finish groups with membership from all sectors. October In progress Present Project Initiation proposals to AHSN Board on 10 th October. Fully develop the priority project work plans and task and finish groups to deliver priority project aims and objectives October to March 14 Started October 2013 Work with stakeholders and task and finish groups to implement and monitor agreed objectives as outlined in the project work plan. Work with stakeholders to develop further proposals for follow on project or new priorities for taking forward in

And yet more Develop the HIN website to support information exchange Be a focus for innovative ideas Cross cutting themes: CLARHC HESL Research networks Patient experience London Connect Support NHS England strategic clinical networks Work with other HIN workstreams – Musculoskeletal, Dementia, Alcohol and Cancer