TfL and London Ambulance Service trial workplace diabetes education to improve staff health

Image of map of London with diabetes cases

Two major London employers embedded clinically-proven Structured Education for Type 1 diabetes to tackle one of London’s biggest health challenges.

The stats

671K Londoners live with diabetes and employers in the capital lose an average £250K due to ill health each year.

An initiative with two major London employers has shown that face to face and virtual diabetes education can be successfully embedded into the workplace to improve the health of staff with Type 2 diabetes.

This comes as the NHS faces increased pressure due to the condition with over 671,000 Londoners living with diabetes and employers in the capital losing an average £250,000 due to ill health each year.

An evaluation of a project by the NHS’s Health Innovation Network with the London Ambulance Service and Transport for London (TfL) has found significant behaviour change in staff toward healthier lifestyle and eating.

Over 60 staff members from the employers attended either online or face to face structured education courses, which is recommended as a vital part of care for people with Type 2 diabetes by the NHS’s clinical standards guardian National Institute for Health and Care Excellence (NICE).

Structured Education (SE) is clinically proven to help people living with diabetes to make changes to their diet and lifestyle that help them to self-manage their condition. It also offers peer support after being diagnosed with the life-changing condition.

Staff were offered a choice to attend a course delivered remotely either by Second Nature or Oviva, which both offer programmes for people with Type 2 diabetes ranging between eight and 12 weeks. Course sessions were delivered through a trained coach with access to online advice, support and information which participants could access through their phones, tablet or computer.

An in-house session to improve self-management was delivered by trained diabetes education experts from Kingston Hospital NHS Foundation Trust. They delivered face-to-face group education using the DESMOND Type 2 Management Module, used widely across the NHS, for up to 14 people in a one-day session and a variety of resource materials were provided to participants at the session.

Twenty five staff members completed the Oviva programme and clocked up an average weight loss after eight weeks of 2.3kg, with evidence showing that participant weight loss continues up to 12 months after the programme.
For the 37 staff who completed the Second Nature programme, the average weight loss after three months was 5.7kg.

Staff taking part in this evaluation overwhelmingly welcomed the offer, and to attend, SE courses at their workplace. There was also very high approval of the three programmes from participants. Those completing either the in-house DESMOND programme or one of the remote programmes said their diabetes education needs had been met.

TfL staff who made use of the programmes said: “I think it’s a good thing that TfL are actively promoting this sort of thing. It’s a positive thing in terms of awareness around health and the impact of different health conditions. It’s good that workplaces are doing more to make people aware [of people with different health needs].”
“It’s a powerful message to send to the employee: we’re not just interested in your productivity, but also your health and how to look after yourself.”

TfL was due to start another round of the programme in September 2020 but brought it forward to May. TfL’s Health and Wellbeing Improvement Programme Manager Fernanda Siusta said:
“It was great to be involved in this work which has had such a positive effect on so many participants’ lives. While the pandemic led us to bringing the work forward, we know that for some this has been key to ensuring they stay on track if they had to shield or if they were unable to see their usual medical teams while the NHS handled the response to coronavirus.”

Head of Healthy Workforce at London Ambulance Service Gill Heuchan said:

“As someone with type 2 diabetes I know how difficult it can be when you are first diagnosed and have to attend diabetes education courses. We started the initiative at London Ambulance Service because we are very aware that we have staff whose lives do not fit the norm. Call handlers, medics and support staff are often working busy 12-hour shifts and during unsociable hours, so they can find it even harder to attend courses on learning how to manage their diabetes.

“It has been a fantastic opportunity for staff to have flexible support, not just about diabetes, but about lifestyle choices and general health on a tablet device, which they can utilise easily to fit their lifestyle. Staff who have signed up have fed back positively and many have been able to achieve personal goals because of the support they have received. This initiative has also helped form part of our ‘Wellbeing at Work’ support package for staff which aims to help them manage their own health and wellbeing in and outside of work.”

“We started the initiative at London Ambulance Service because we are very aware that we have staff whose lives do not fit the norm. Call handlers, medics and support staff are often working busy 12-hour shifts and during unsociable hours, so they can find it even harder to attend courses on learning how to manage their diabetes ”Head of Healthy Workforce at London Ambulance Service Gill Heuchan

Health Innovation Network Diabetes Programme Manager Rod Watson said:

”Diabetes is one of our biggest health challenges. Not only is it a leading cause of premature mortality with over 22,000 additional deaths each year, but it doubles an individual’s risk of cardiovascular disease and costs over £10 billion every year to manage.

“The HIN has successfully sped up the spread and adoption of a range of evidence-based programmes both face to face and digital to help prevent and treat the condition.
“We spend a third of our time at work so it makes sense for us to work with employers to help embed programmes directly into the workplace. This project shows that this is possible and I would urge all employers to read through our findings.”

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Self care is vital to help tackle the country’s biggest health challenge

Think-Diabetes

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Diabetes is one of the country’s biggest health challenges with more than 3.1 million people diagnosed with Type 1 and Type 2 diabetes in England. It’s a condition that can ruin lives and cause deadly complications but as Faye Edwards argues, it’s never been easier to access support to self-care.

Not only is diabetes a leading cause of premature mortality with over 22,000 additional deaths each year, but it also doubles an individual’s risk of cardiovascular disease. The cost of diabetes to the NHS budget exceeds £10 billion every year and this is expected to grow dramatically over the next 20 years. Recent research has shown that people with diabetes are at a higher risk of complications should they contract Covid-19.

But as we celebrate National Self Care Week, the good news for people with diabetes is that it has never been easier to stay in control of their diabetes and prevent life changing complications. The key to this is supportive, holistic diabetes education.

Learning how to lead a healthy lifestyle through diet and exercise, manage medications, maintain good mental wellbeing and how to prevent long term complications is fundamental to ensuring that people feel confident in managing day to day life with diabetes, and to ensure improvements in terms of weight loss, glycaemic control, and general wellbeing.

An innovative new service from the NHS in south London, Diabetes Book & Learn, allows people with diabetes access to education support courses at the click of a mouse. If you have diabetes you can refer yourself to the service via the website, or you can ask your GP or practice nurse to refer you. The Diabetes Book and Learn Website has a wide range of courses available to suit all needs, including a variety of language preferences and delivery modes including face to face or via a mobile app. Once referred, you can choose the most suitable option for you, or if you are unsure, our call centre team are on hand to help you decide.

Since the start of the Covid-19 pandemic it has been crucial to ensure that the service continues to provide high quality support and education for people with diabetes. We have all had to adjust to receiving healthcare via digital means, whether that is online or over the phone. The Diabetes Book and Learn service has been agile in its response to the situation, moving face to face courses online and delivering them via video conference, and increasing the access to 1:1 diabetes education support delivered via telephone and mobile application.

The Diabetes Book and Learn service is the first of its kind, uniting diabetes education providers from across our region to offer a wide range of educational support options for people with diabetes, that would be impossible for one single organisation to achieve alone.

Now more than ever it is vital that all of us strive to live as healthily as possible, especially if we have a long-term condition such as diabetes. Receiving such a diagnosis in the current pandemic can be frightening and isolating – likewise, living with diabetes can feel physically and mentally exhausting. Education and support are key to providing a fresh perspective and confidence to people for whom living with diabetes is tough. It can help with weight loss and mental wellbeing, provide much needed peer support, reassurance, and guidance.

The key to better health and diabetes control starts with education and good self-care – and all of this is available at the click of a mouse.

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Explore our Diabetes projects to learn more about how we support self-management to minimise the impact of diabetes on the lives of people with the condition.

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Joint pain programme ESCAPE-pain and young people’s Type 1 diabetes initiative win awards

Trainer helps woman exercise

A national programme to tackle chronic joint pain and a local initiative supporting young people with Type 1 Diabetes have won at the prestigious Health Service Journal Value Awards.

Chronic joint pain programme ESCAPE-pain and the Youth Empowerment Service (YES) that supports 14-19 year olds with Type 1 diabetes, have won prizes at the Health Service Journal Value Awards.

ESCAPE-pain won the MSK Care Initiative of the Year. Since being on the programme , Ann, 68, is no longer in constant pain. She said: “Osteoarthritis was really impacting on my daily life as I had to ask for help to do everyday tasks around the home. My life has significantly changed since I completed the course and I’ve continued to do the exercises and now I no longer have any pain and I live a very active life.”

ESCAPE-pain (Enabling Self-management and Coping with Arthritic Pain using Exercise) is a national programme offering face-to-face and online exercises to help people suffering from chronic joint pain. Driven by the NHS’s Health Innovation Network, in south London, and backed by Sport England and in association with Versus Arthritis, roll-out of the programme has been supported by the national Academic Health Science Network. Prior to Covid-19, the programme was running in 295 sites and has helped 19,300 participants since it started.

ESCAPE-pain programme originator Professor Mike Hurley said:

“The judges were clearly impressed with the general ethos of the programme about self-management, its effectiveness and benefits that it brings to individuals and the healthcare system as a whole. We hope the award gives a boost to ESCAPE-pain that we believe can make a major contribution to the post-Covid-19 NHS ‘reset’.

Guy’s and St Thomas’ Youth Empowerment Skills (YES) programme, which is supported by the HIN, runs vital programmes for 14-19 years-olds with Type 1 Diabetes. It won the HSJ Diabetes Care Initiative of the Year.

YES programme Lead Dr Dulmini Kariyawasam, consultant at Guy’s and St.Thomas’ Foundation Trust , said:

“We are absolutely delighted to have been named as the winners in the Diabetes Care Initiative of the Year 2020! The positive impact of this award will help to create a long-lasting legacy and bolster our efforts to expand the YES programme across London giving every young person living with Type 1 diabetes in London access to the programme.”

“The HIN seeks to speed up the spread and adoption of evidence-based innovation in health and care so both these award-winning projects highlight the value of our work to improve lives. A huge well done to both teams. ”Health Innovation Network Chief Executive Zoe Lelliott

The Health Innovation Network’s Diabetes team Project Manager, Ellen Pirie, said:

“Young people suffering with Type 1 Diabetes face many challenges and the YES programme offers them practical support on issues such as food, sexual health and handling a diabetic seizure. There are also opportunities to go on social outings and try out new skills such as driving and rock-climbing and it’s this peer support network building that I know participants really benefit from.”

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New tech: Diabetes Book and Learn launch self-referral

Technology-led service gives thousands of south Londoners quicker access to free NHS diabetes education

Today, World Diabetes Day, the NHS in south London is launching a new service for people living with Type 2 diabetes to make it easier than ever to access vital support. An innovative new service from the NHS, Diabetes Book & Learn, will now allow people to self-refer for diabetes support courses rather than go through their GP. These courses will help them manage their condition better and significantly decrease their risk of serious complications (such as blindness and amputations). The service also increases choice for south Londoners, who will be able to access expert support through face-to-face courses or online programmes and book themselves onto their choice of course via the website or by phone.

There are over 165,000 people living with diabetes in South London (QOF 18-19).

Dr Jonty Heaversedge, NHS England, London’s Medical Director for Primary Care and Digital Transformation, said: “It’s great to see south London’s NHS, GPs, hospitals and innovators working together to bring access to practical healthcare into people’s lives using everyday technology. Diabetes Book & Learn is enabling people to not only live better, healthier lives but to stay ahead of their condition and reduce their risk of serious health complications. It couldn’t be easier to learn about how to manage your diabetes if you live in south London thanks to this service.”

Dr Neel Basudev, local south London GP and Diabetes Clinical Director of the Health Innovation Network, said: “We know lots of people who are living with Type 2 diabetes across south London either weren’t offered a place on a course when they were originally diagnosed, or for many reasons, couldn’t attend one of the limited courses that were available locally.

“We expect easy booking and online services in all other areas of our lives: we order food, arrange our home insurance, do our banking, you name it, through our smartphone. In south London, we are leading the way in making sure that people can access vital support for their diabetes just as easily – it’s just a few clicks or a phone call away.

“We have opened up support for people with Type 2 diabetes. Now you can book yourself onto any one of the courses available across all 12 south London boroughs or online. I’d encourage anyone living with Type 2 diabetes to book onto a course today and find out how to better manage their diabetes and avoid serious complications.”

Roz Rosenblatt, Head of London Region at Diabetes UK, said: “Thousands of people in the south London community can book on to a course which offers significant benefits. All it takes is a few clicks on the Book & Learn website or by phone and anyone living with Type 2 diabetes in this area can join a course that will improve their knowledge and confidence, plus help them take control of their diabetes and live well for longer.”

The aim of these specifically designed courses is for people living with Type 2 diabetes to improve their knowledge, skills and confidence, enabling them to take increasing control of their condition and integrate effective self-management into their daily lives. These courses help people to take control of their diabetes through learning more about their condition and they also provide valuable peer support.

The courses have been clinically proven to have a positive impact on individuals including:

  • Lowering average blood glucose levels, thereby reducing the risk of complications
  • Reducing cholesterol and blood pressure levels
  • Improving levels of physical activity
  • Improving understanding of diabetes and self-management skills
  • Weight reduction.

Despite these benefits, attendance across south London is low. The National Diabetes Audit data shows in 2017-18, 77.3 percent of people diagnosed with Type 2 diabetes were offered a place on a structured education course, but only 9.4 percent of those people attended.  There are many reasons for this major gap between those eligible and offered a place and those attendance including; limited choice in location and timing of courses being offered. Allowing people to self-refer via Diabetes Book & Learn means that people can book onto a course when and where suits them, including an option to complete a course entirely online.

Read more about this vital service at www.diabetesbooking.co.uk/about  and for more information please contact hin.southlondon@nhs.net.

 

Cutting-edge technology transforms diabetes care across south London

Cutting-edge technology transforms diabetes care across south London

L-R: Tara Donelly, Chief Digital Officer, NHSX; Oliver Brady, Head of Diabetes Transformation, South West London Health and Care Partnership; Karen Broughton, Director of Strategy and Transformation, South West London Health and Care Partnership; Vicky Parker, Programme Lead, London Diabetes Clinical Network and Ben McGough, Workstream Lead – Digital, NHS Diabetes Programme.

South London clinicians and partner organisations gathered together at Guy’s Hospital last night (30 October) to launch a brand-new diabetes service called You & Type 2.

After receiving over £500,000 funding from the NHS Test Bed programme, the You & Type 2 service is now being piloted across south London. The service combines innovative technology, improved access to services and a personalised approach.

The ambition of the project is help people living with Type 2 diabetes to have happier and healthier lives by enabling them to have more control over their care.

Designed to provide a range of further education, support and resources, You & Type 2 enables patients to work with their healthcare provider to produce a unique care plan. Part of the service is an app that will allow patients to access and update their care plan when it suits them and receive personalised videos containing recent test results, which will prepare them for informed discussions with clinicians.

Healthcare professionals using the service can update the app in real time, offering tailored support to patients. This means they are equipped to deliver the best patient-centred care, with the support of innovative technology that is linked to personal health data and individual goals.

Thirty-five GP surgeries across south London are now piloting the service, which is expected to be rolled out more widely in 2020. Clinicians who are already using the service have reported improved knowledge and skills, alongside greater job satisfaction and increased levels of team work. So far, over 1000 patients have already created their own care plans, working closely with their healthcare professionals to make something personal and meaningful to them.

A group shot of the partners involved in the You & Type 2 service

Speaking from the service launch event last night at Guys Hospital, local GP Dr Neel Basudev, Clinical Lead for You & Type 2, said: “This is such an exciting and different way to treat people living with type 2 diabetes. We know that being diagnosed and living with a long-term condition can feel overwhelming, but by using innovative technologies and working collaboratively with patients, this service helps them to overcome difficulties and improve their overall health and happiness.

“This is an exciting opportunity and I can’t wait to see how this develops and the impact it has on people’s lives, not only in my practice, but in practices across south London.”

Victoria Parker, Programme Lead for London Diabetes Clinical Network, NHS England, said: “This is such an innovative digital service and I’m happy to be here for the launch. The NHS long term plan speaks of personalisation and patient centred care.

“This service captures the essence of the long-term plan but also pushes it to a new level, offering better care and support for those with Type 2 diabetes as well as creating a model of care for any long term condition. I am excited to see where this project goes next and for the opportunities it presents for spread and adoption across London.”

For more information on the programme visit youandtype2.org

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Making it easier for employees with Type 2 diabetes to access diabetes education courses at work

People in the workplace

Making it easier for employees with Type 2 diabetes to access diabetes education courses at work

In the second phase of the ‘Think Diabetes’ project, we have partnered with two London-based employers to promote diabetes structured education for employees diagnosed with Type 2 diabetes. Written by Don Shenker, Diabetes Senior Project Manager

Our Think Diabetes Summit held on 14 June encouraged employers to promote diabetes structured education to their workforce to support employees living with diabetes to be better informed about how to manage their condition. Our Think Diabetes report noted that less than 10% of individuals diagnosed with Type 2 diabetes who are offered structured education from their GP actually go onto access the course. One of the reasons may well be a reluctance from employees to take time off work – or not having the flexibility to fit in education around work hours.

We have recently teamed up with Transport for London (TfL) and the London Ambulance Service (LAS) to pilot access to both remote/online courses and face-to-face on-site courses for employees diagnosed with Type 2 diabetes. This means any employee living with diabetes will be able to complete a course either remotely or during work time, without having to take time off. The courses will be promoted via LAS and TfL’s internal wellbeing newsletters and are being funded through the NHS Diabetes Transformation Fund.

There is good evidence that attending a structured diabetes course improves health and reduces complications by focusing on understanding diabetes, improving diet and stressing the importance of a healthy lifestyle. The pilot courses will be delivered by NHS approved providers OurPath, Oviva and Kingston NHS Foundation Trust.

In order to evaluate the pilot, we will be conducting a survey and focus group for course attendees and tracking anonymised BMI and weight data. It is hoped that around 100 employees will access a course either remotely or on-site. Key questions will focus on whether this approach via the workplace made it any easier to attend a course and what further steps employers could take to promote education for employees living with diabetes. We will also evaluate the level of demand for the courses and which category of workers have attended or asked for a course.

The pilot went live on 1 October and results will be available in March 2020.

For further information, contact Don Shenker, Diabetes Project Manager (don.shenker@nsh.net)