1. Proposed Integrated Diabetes Care Model Tina Teague – Head of Locality Commissioning Trish Brown – Practice Nurse/Mid Devon Clinician to Clinician (C2C) Diabetic Lead Catherine Argyle – Specialist Diabetic Nurse

2. Proposed Care Model Aims for equity of capability & capacity Recognises the need for invest to save Proposes 4 tiers of care provision& commissioning options Identifies education (patient, community nurses, GPs) Formalises the role of community DSN Identifies local commissioning groups as being key to implementation

3. RD&E Diabetes Activity Trends – Mid Devon

5. £245/Consultation £70 £130

6. Mid Devon Diabetes C 2 C and other Meetings Trish Brown 10/01/2011

7. Local Vision To provide a world Class service, in which Primary and Secondary care is integrated. Every patient will have access to the most appropriate team to provide care. Quality will be measured and services modified with a view to improvement.

8. Restructuring Diabetes Services Entry Criteria Exit Criteria Initial management T1DM Self management - plan Complications Management stable Atypical Diabetes Established diagnosis - Plan Erectile Dysfunction Management Plan Young People Up to age 21- ? Adult Care Insulin Pump Therapy Established management Ante-natal No longer Pregnant Retinal Screening Continue as before New Referrals Stable / Management Plan Podiatry Integrated Foot service

9. Other Service Provision Community Specialist Nurse Structured Patient Education-all new T2 DM Community Consultant / DSN clinics DGH All Annual Reviews in General Practice Education Programmes for PNs and GPs (Survey) Updated Diabetes Formulary – Treatment Pathway Protocol and Pathway Development Telephone and Email advice Accessible updated website