Lambeth Diabetes update Dr Neel Basudev Lambeth CCG Diabetes Lead Clinical Director Health Innovaton Network

The here and now What is going on in Lambeth right now….

State of play In 2015 there were 16,239 people aged 17 years or older who had been diagnosed and registered with diabetes in Lambeth It is estimated that 30,596 people aged 16 and over registered in Lambeth have non-diabetic hyperglycaemia In Lambeth, people with diabetes are 90.4% more likely to have a heart attack and 67.8% more likely to have a stroke than people without diabetes. The additional risk of mortality for people with diabetes was 31.4%

Nda data i QOF & NDA Indicator Definitions: DM003 – The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the apreceding 12 months) is 140/80 mmHg or less. DM004 – The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within athe preceding 12 months) is 5 mmol/l or less. DM007 – The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 59 mmol/mol or less in the apreceding 12 months. NDA – T2 Eight Care Processes – The percentage of people with Type 2 or other diabetes receiving the Eight Care Processes. NDA – T2 Attended SE – The percentage of newly diagnosed people with Type 2 or other diabetes recorded as ‘attended' a astructured education program.  

Variation in care is a local and national problem Nda data ii Variation in care is a local and national problem

Nda data iii

solutions What are we doing to help address some of these issues

LTC incentive scheme Data collection and data analysis…what are the trends and areas to target? Virtual clinics for suboptimal control

Facilitate data entry. Ensure data accuracy. Reduce variation Helping primary care Facilitate data entry. Ensure data accuracy. Reduce variation

New local diabetes treatment pathway developed Other developments New local diabetes treatment pathway developed Lambeth CCG spent a total of £4,093,432.91 on prescriptions for diabetes items between April 2015 and March 2016 Educational events held Well attended by 66 clinicians coming from 35 different practices Work with “poor performers” More structured working across practices and work plans developed and reviewed We continue to deliver high quality diabetes education for both patients and healthcare professionals

Reduce variation

Diabetes prevention What are we doing to tackle the burden of diabetes

STEPS to prevent diabetes: a diabetes prevention course The STEPS short prevention course focuses on increasing activity through walking among people at high risk of developing type 2 diabetes. GP referrals to STEPS have increased year-on-year and almost 900 people attended in the past three years. There was no progression to type 2 diabetes for most participants. QIC award finalist Judges comment: "A great and well-designed project that fits in well with the national agenda. The project clearly recognises its limitations, but also identifies the potential impact.”

National diabetes prevention

Overview Free, nine month community-based behaviour change programme to help people prevent the onset of Type 2 diabetes Lambeth is one of the first wave sites and has “gone live”. Partnership across South London lead by HIN and Southwark CCG 18 supportive, group-based sessions for up to 20 people delivered by trained, local staff. Provider is Reed Momenta Programme designed by experts and underpinned by a decade of research into community-based diabetes prevention

Flow chart

On the horizon Lambeth remains at the forefront of innovation and pushing the boundaries

Innovative joint renal and diabetes clinics Joint clinics Innovative joint renal and diabetes clinics Target those with declining renal function who are often missed Unmet patient needs Kidney function Time

Diabetes Treatment and Care Programme. Central funding National agenda Diabetes Treatment and Care Programme. Central funding Improve treatment targets, drive down variation Improve uptake of structured education Lambeth engaged with the development and coordination of bids for funding

Thanks for listening Questions…..