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

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

3. 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%

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.

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

6. Nda data iii

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

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

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

10. New local diabetes treatment pathway developed
Other developments
New local diabetes treatment pathway developed
Lambeth CCG spent a total of £4,093, 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

11. Reduce variation

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

13. 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.”

14. National diabetes prevention

15. 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

16. Flow chart

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

18. 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

19. 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

20. Thanks for listening
Questions…..