This World Diabetes Day we are very excited to share with you all the transformational work occurring in type 1 diabetes outpatient care in south east London.
The Impact of Type 1 Diabetes
Type 1 diabetes is a potentially devastating diagnosis for individuals and families, putting enormous demands on people to manage their diabetes every single day. More than eight per cent of people in the UK with diabetes have type 1 diabetes, and new diagnosis rates are increasing by four per cent each year. Recent advances in technology and understanding of type 1 diabetes have been huge, and the avoidance of diabetes complications is now possible for everyone.
Diabetes complications can be severe, and avoiding these is linked to good glucose management. The NHS supports this through structured education sessions, clinic-based support from diabetes specialists and access to technology such as insulin pumps and glucose monitors. All people with type 1 diabetes should be receiving care from specialist services in order to support them to achieve and maintain safe glucose levels.
Unfortunately, there are still variations in access to, and outcomes of, diabetes care. Recent analysis in Hackney and Brent suggests that around 30 per cent of people who are diagnosed with type 1 diabetes are not under the care of a specialist diabetes team. Nationally we measure whether people with diabetes meet three key treatment targets (HbA1c, cholesterol and blood pressure) as an indicator to how well we are managing diabetes at a population level. The recent National Diabetes Audit shows that only 24.4 per cent of Londoners living with type 1 diabetes have achieved all three treatment targets. This is even lower among people of ethnic minority groups and those living in more deprived areas.
What We’re Doing
To address these variations NHS London Diabetes Clinical Network have created the Type 1 Diabetes Outpatient Transformation Framework. The framework challenges providers and commissioners of diabetes care to question how we can make changes which reduce inequalities in diabetes care access and outcomes. Its ambition is to ensure 100 per cent of people living with type 1 diabetes have access to structured education, self-management support, specialist diabetes care and technology in a way that meets their needs and expectations, irrespective of location, ethnicity, and deprivation.
We have convened a network of outpatient and community providers on behalf of south east London ICB in order to respond to and implement the framework. Collaboration and transformation is at the core of this network. It has strong representation from all outpatient provider sites in south east London, as well as community providers and mental health trusts. The network provides a space for providers and commissioners to work together on transforming and adapting local type 1 diabetes care to the needs of south east Londoners.
Provider-commissioner collaboration and co-production will continue to be at the heart of what we do at the network. Healthcare transformation and improvement is inherently a WICKED problem. It is through the network’s diversity of thought and experience that we can hope to address this problem, and to unpick the challenges people with type 1 diabetes face daily when trying to manage their health. We are in the beginning stages of an exciting journey in south east London; a journey that we are embarking on as a team.
I have really enjoyed working with south east London colleagues in setting up the network. It has given us the chance to understand the challenges and aspirations of providers and commissioners, and unite in our efforts to improve T1 diabetes care. – Dr Sophie Harris, Chair of South East London Type 1 Outpatient Transformation Network
