1. 1 Diabetes Clinical Stream

2. The Diabetes Clinical Stream  Established in October 2008, and soon after joined with the Renal, Cardiac and Stroke Streams to form the Vascular Network.  The key strategic roles and responsibilities for the Diabetes Clinical Stream are: –Facilitate strong relationships –Clinical Practice improvement –Development and/or implementation of models of care –Planning

3. Facilitate strong relationships  Between staff across the AHS, GPs and external partners to support clinical service delivery  Professional development – Enhance peer support and professional training and education for staff, inclusive of VMOs and General Practice staff  Information – Facilitate the provision of information for service providers and consumers and their families to support access to appropriate care

4. Clinical Practice improvement  Guidelines and protocols - Coordinate the development, review and use of appropriate clinical practice guidelines across relevant services  Have input and provide leadership in matters of quality and patient safety as it relates to diabetes

5. Develop or implement models of care  Enhance service delivery through recommendations relating to models of care and support facilitation of consistent coordinated integrated models of care

6. Planning  Significant participation in the development of a clinical service plan and support for the implementation and monitoring of the plan  Data - Collect, analyse and evaluate data in relation to service delivery and outcomes  Resource equity – Recommendations for resource prioritisation and allocation  Workforce – Recommendations and facilitation of activities in relation to the retention, recruitment, succession of staff  Advice - Recommendations to Area Executive and others as appropriate on service delivery and planning priorities

7. Stream Leadership Group  The Diabetes Stream Leadership Group was formed to progress and monitor Stream initiatives and to facilitate actions in the Operational Plan. It comprises representatives from General Practice, Aboriginal Health, Area Diabetes Services (medical, nursing, allied health and management) and other key Area staff. The Executive Sponsor is Scott McLachlan, Director of Primary and Community Networks.

8. Diabetes Stream: 2010-11 Issues Summary  Robyn Beach and Dr Sham Acharya are enthusiastically leading Stream initiatives in their roles of Stream Co-ordinator and Clinical Lead.  The Chronic Disease Management System with diabetes services as the forerunner is almost ready to go live – the software program will run within CAP.  An area-wide CPG for treating hypoglycaemia and a companion Standing Order for glucagon hydrochloride administration have been endorsed and implemented. A CPG for treating diabetic ketoacidosis is under development.  A successful area-wide diabetes workshop for HNE Health non-medical clinicians was run in Tamworth in 2010 and a 2 day forum is being offered in Newcastle in October 2011. The latter is a collaborative venture with GP Access and is targeting general practice staff as well as HNE Health staff. A workshop on care of foot wounds for Community Nurses was also run in 2011.  A Diabetes Stream website on the HNE Health intranet, and a collaborative space (portal) for the Stream, along with the Stream newsletter Dialogue, provide easily accessible information area-wide. A set of common nutrition resources for people with diabetes which can be used by staff across the area was developed.

9. Diabetes Stream – partnering  A Telehealth High Risk Foot clinic between Newcastle and Tamworth was conducted, with reduction in amputation risk and upskilling of staff at the remote site as positive outcomes. A diabetes outreach clinic was initiated in Moree.  A joint mental health and diabetes clinic established in Newcastle is providing skills and tools for diabetes self- management, basic education and ongoing support and motivation for mental health patients with diabetes or pre- diabetes.  The Stream is working toward a closer liaison with obstetrics and paediatrics to modify risk among Aboriginal families has been made a priority for next 12 months.

10. Diabetes Stream – linkage  The Stream is committed to the alignment of the Integrated Chronic Care for Aboriginal People program with Diabetes Stream initiatives when developing and implementing strategies to enhance the provision of diabetes services for Aboriginal people across the area.  Some diabetes services participated in the 2011 ANDIAB (Australian National Diabetes Information Audit and Benchmarking) data collection.  Linkages have been developed with the Agency for Clinical Innovation and a commitment to establish a pathway at state level about diabetes and endocrine issues.