1. Whitiora Diabetes Service
Gill Aspin CNS –Diabetes

2. How Can we Help?
We are a team consisting of Endocrinologists, SMOs, Registrar, Clinical Nurse Specialists that are mostly designated Prescribers in Diabetes Health, Dietitians, Health Psychologists, Podiatrist with vast experience in managing people with diabetes across the lifespan and who have multiple morbidity. We can help with many aspects of diabetes management

3. Integration -an idea that’s time has come
Vision of improved collaboration between primary and secondary services has been active for some time
Increased prevalence of Diabetes makes this an imperative – neither primary or secondary care can manage the numbers alone, we need to work together for the best outcomes for people with DM
Recent Kaitiaki Nursing journal has focussed on this with articles from Mid Central, Waikato, Hutt Valley and with a review of our own Healthy Together program at CMH

4. Where to gain the knowledge and skills to help management of people with DM
MIT - Short Course of Diabetes Management – Level 7 paper-currently running for a class of 19, covers the practical skills and knowledge needed to enable DM management with confidence and competence
Auckland Uni – Level 8 Advanced DM nursing practice
On-line - HealthMentorOnline
Ongoing mentorship from Whitiora Diabetes Service

5. Ways that we can work together
Virtual Reviews – discussion and case review with a DNS and PN for 5-10 cases. Time needed for the DNS to review the electronic records prior to meeting. This could take place at our office or yours
MDTs both locality and practice based ones have already been a forum that many of you will have regular participation in and has had many virtual reviews and case discussion

6. Ways to Collaborate -continued
Physical reviews – Again if we work together this could take place at your practice, or at the locality hub, or outpatient clinic. For patients where you would like us to review a client with you . Can be for both patient and health professional education
Structured education sessions as you require – an hour at your practice on things like -diet and healthy eating, exercise, medications, Insulin initiation and dose titration, foot checks

7. Team Counties- here is how we roll
Mentorship – this can be formal – regular meeting- time and place, with a DNS/PN and a structured review of agreed diabetes management aspects
Informal – phone contact for a quick review of patients and issues as they arise
Day with the service – in the past we have had some PN come and spend a day or half a day with the DNS at clinic or with us in MMH

8. Discharge planning for Inpatients
Currently Diabetes nurse team ~35-40 inpatients with diabetes M-F at MMH ( 200 pts with DM most days) We proactively triage the admission list and review those people who have A1c > 75. These people are also the ones that the mDCIP project has targeted. As we often target education and change the medications for these people it would be great opportunity to hand back to the primary care team at discharge. We can do this visa the Shared care plan , an or phone call to a named coordinator/ champion from your practice.

9. DNS/SMO Locality Contact List
Consultant Ph
DNS
Mangere
Zaven Panossian
Iris Blowers
Diana McNeil
Gill Aspin
Indra Dutt
Hannah Cattaway
Claire O’Brien
Otara
Elham Hajje
Ashley Gage
Kate Smallman
Manukau
John Griffiths
Bobbie Milne
Pui Ling Chan
Imelda Milich
Carl Eagleton
Roshni Prakash
Sally Morgan
East
Renate Koops
Simran Haer
Harpreet Kaur
Pukekohe/ Rural Franklin
Joyce Roberts
Community Coordinator
Caran Barratt-Boyes

10. And so…
We look forward to hearing from you and working with you to improve the management of Diabetes in our patch.
Talk to us about what would work best for you and where you have gaps in your knowledge or skills