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)

A new online tool will help prevent strokes and save lives

An estimated 68,000 people in London are living with undetected AF and at risk of blood clots, stroke, heart failure and other heart-related complications. The Health Innovation Network’s Fay Edwards talks about the launch of an important new tool.

This week together with our partners we launched the Pan-London Atrial Fibrillation (AF) toolkit. The online toolkit is the culmination of a collaboration between the three London Academic Health Science Networks (AHSNs) and the London Clinical Network (LCN).

Visualised in 2016, it is targeted at commissioners and providers who want to find more people with AF (Detect), Treat more people with AF (Protect) and improve the outcomes of those people receiving treatment (Perfect). The toolkit focuses on each of these three areas and is laid out in a logical order, first setting the scene with an introduction from Tony Rudd (National Clinical Director for Stroke, NHS England) and Matt Kearney (National Clinical director for Cardiovascular Disease Prevention, NHS England) highlighting the unmet need for appropriate anticoagulation and improved detection of AF.

Within each of the three domains there are three “opportunities for improvement” designed to stimulate ideas and focus efforts. These contain case studies, resources and best practice examples which provide guidance on how to replicate. With all quality improvement it is vital for teams to understand their ‘current state’ before embarking on the future. The AF improvement cycle (on page 7) encourages teams to consider the quality and performance of their service compared to national standards and highlights the need for them to understand and interpret their own service level data. The AF improvement cycle is a complete and concise methodology which has been developed through the understanding of the critical success factors needed to undertake AF improvement work. It can be applied to any of the three domains and opportunities for improvement.

Complementing the AF improvement cycle is a series of infographics for each London CCG which clearly and pictorially presents data on prevalence, anticoagulation rates, those known to be at risk of stroke and those who have had a stroke in the past year. These have already proved very powerful in engaging interest and understanding a starting point. For those teams outside of London, or for data more focused on each domain (Detect, Protect and Correct) there is a useful table of data sources laid out within each of these.

Supporting all of this is the AF business case model. Designed by Public Health England and the AHSNs this tool uses publically reported data of AF to help organisations identify areas for improvement in the identification management of AF. It will also quantify the cost and savings associated with addressing these opportunities.

Detect

Within detect there is a focus on AF Awareness campaigns, the importance of manual pulse rhythm checks and AF detection devices. This includes the Health Innovation Network’s AF detection device review, a detailed report which defines the current technology and software designs available to enhance AF detection. It contains examples of how to use these devices and improve actual prevalence in a variety of settings.

Protect

Within protect there is focus on how to improve anticoagulation, Initiating anticoagulation in community settings, correcting heart rhythm and rate where necessary.

Perfect

Perfect encourages high quality anticoagulation services which provide patient education, a range of treatment options and support of self-monitoring. It contains the ‘Excellence in Anticoagulation Care’ document from the London Clinical Network – a guide for commissioners and service providers to help deliver high quality anticoagulation services.

A pathway for service review is contained in this section including a checklist to assist commissioners in benchmarking their anticoagulation service or create a service specification.

There are also educational resources for patients and staff n to support self-management and self-monitoring of International Normalisation Ratio (INR) for those prescribed Warfarin.

Mythbusters

Designed to dispel the common myths and misconceptions encountered when prescribing anticoagulation, by providing an evidenced based explanation.

I hope the toolkit will inform clinicians and commissioners in the design of local services to deliver the best patient care and optimum outcomes.

Download the toolkit here.