You & Type 2 Risk Stratification Evaluation

Covid-19 posed many challenges to the delivery of routine primary care, including the completion of annual diabetes reviews. During this time, the You and Type 2 Risk Stratified Pathway was developed by the HIN in collaboration with primary and secondary care clinicians. The pathway prioritised people at the highest risk of developing diabetes complications for review.

The Risk Stratified Pathway introduced the You and Type 2 care and support planning annual review pathway to four practices in south London. People were invited to complete the You and Type 2 pathway based on a risk stratified patient list. The list sought to identify people at higher risk of having developed diabetes complications, or having existing diabetes complications worsen, over the course of the pandemic. The risk stratification framework was developed in collaboration with diabetes specialist teams at King’s College Hospital.

This evaluation investigated the number of people identified by the risk stratification, their characteristics, and the experience of implementing the pathway.

• The risk stratification framework effectively identified a manageable subset of the practices’ type 2 diabetes population who were at higher risk of both the development and progression of diabetes related complications.
• There were significant barriers to pathway implementation at a practice level. These were predominantly linked to pressures on primary care due to the COVID-19 pandemic, and the continued workforce challenges.