What is it?
The Diabetes Project has been designed to help ensure that your patients receive the best possible Diabetes Care from diagnosis onwards.
We are going to share and build on the current high standard of care that our Diabetic Patients receive with the majority of the service being delivered in a Primary Care setting.
We know that the Diabetes Care can be variable; one of the goals of the project is to ensure that all Practices are treating to a defined pathway which will ensure that the optimum care is given and we are working with acute colleagues from SASH to achieve this.
The Project
In May of this year a group of people got together to lead on this Project.
They include Lead GP’s, Secondary Care Clinicians and Expert Patients. We have been supported in this project by Lilly and GSK who have provided support with resource particularly in relation to practice support and data.
We are establishing a baseline of where we are and defining where we need to get to.
There has been a great deal of detailed work looking at Data from different sources which includes DiabetesE, Health Intelligent Tool-a miquest query and Hospital Episode data.
Now that we have much of this data we are able to map out what there are gaps which we need to address as a Consortium to make sure that the best possible service can be given to everyone within the available budget.
This chimes with ESyDoc’s commitment to the provision of high quality patient services which deliver the right health care, at the right time, by the right healthcare professional and in the right environment.
What has been done?
There have been three work streams set up
- Baseline Assessment
We have established the baseline report using the Health Intelligence Tool. All practices have now downloaded this and the reports have been run. We are now designing a dashboard for practices to examine the results.
What does HITs tell us? - It provides many insights including the link between appropriate management, clinical outcomes and resource.
Providing real-time local data, we can then look at the existing Diabetes services and improve patient care pathways more effectively.
We do need all the DiabetesE reports sent back to complete the baseline audit so please can you make sure that your practice has done this.
Practices will soon receive an invitation to commence an ‘in practice’ skills and training programme run by the National Services for Health Improvement (NSHI) and it is hoped that every practice will participate.
- Service Redesign
Along with this there has been a work stream looking at Map of Medicines. This guides local thinking about the most effective Pathway for the area. It shares best practice and details what we need to think about. There have been several meetings to make sure that Map of Medicines and Tiers of Diabetic Treatment will fit with our Consortium.
- Care Planning
Care Planning is ensuring that the Patient is at the heart of their treatment and fully involved in how their Diabetes is managed.
This work stream has taken the form of a Pilot Project. It involves workshops for Healthcare Professionals and consultations with anonymised data collection from about 5 patients from each practice that participates.
What Happens Now?
We will make sure that the Project is well communicated and transparent.
This will mean that you may be approached by someone from the project team as it is our intention that you should feel fully supported with any changes that may need to take place as a result of the baseline audit.
Plans to re-design the service will be considered and approved by the ESyDoc Board and you will be given an opportunity to comment on the draft.
In a year’s time we will be running another report to look at the difference that has been made as a result of the interventions.