Subject: Diabetes feedback in the London borough of Newham

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1 Subject: Diabetes feedback in the Lndn brugh f Newham Surce: Infrmatin and Wrkshp: Have Yur Say n Diabetes User Engagement Event, 18 th July, 2014 Purpse f the Reprt: t prvide an understanding f the diabetes landscape in Newham Authr: Charlie Ladyman, Healthwatch Newham Manager Key Recmmendatins 1. Intrducing grup sessins with dieticians, infrmatin and advice n diet and exercise 2. LBN G Fr It grant 3. Diabetes infrmatin in a sign language DVD fr deaf cmmunity, audi fr blind cmmunity 4. Marketing and campaigns thrugh the use f different medias including billbards, Newham Mag, buses, undergrund/dlr statins 5. Access t Diabetic Specialist Nurse at every GP Practice; supprt wrker/diabetic Friend t supprt diet and exercise prgramme 6. Cntinued access/supprt fr gyms, walking grups, swimming pls 7. Diabetes preventin prgramme in schls, nurseries, clleges 8. Cntinued widespread use f Health Checks Purpse f recmmendatins: t prvide evidence-based knwledge t the Health and Wellbeing Bard, Newham Clinical Cmmissining Grup and service prviders Backgrund One f the key strategic pririties fr Newham s Health and Wellbeing Bard is lng-term cnditins. Subsequently, Healthwatch Newham held an Infrmatin and Wrkshp: Have yur Say n Diabetes n Friday 18 July The Lndn Brugh f Newham has ne f the highest prevalence s f diabetes in the UK. Demgraphically the 330,000 ppulatin includes: 1

2 21,451 peple living with diabetes 5,000 peple living with pre-diabetes 21,000 high risk f develping diabetes And that this prevalence is due t: High rates f besity Lw levels f physical activity The ethnicity f ur ppulatin 1 User Event Dr Gill Hd, Barts Health NHS Trust Diabetic Manager NIHR Clinical Research Netwrk: Nrth Thames gave tw presentatins n Understanding diabetes and Lking after yur diabetes. There were tw wrkshps, facilitated by Healhwatch Newham, fr attendees t reflect n the Infrmatin talks and gather ideas in respnse t the wrkshp questins: Wrkshp 1: As a persn with diabetes, what supprt d yu need? Wrkshp 2: Hw d we, as a cmmunity, cntinue t raise awareness and prevent mre peple getting diabetes? Infrmatin and supprt n diabetes in the frm f leaflets and psters was kindly prvided at the event by Barts Health; the NHS Diabetic Eye Screening Prgramme, and; frm Diabetes UK (wh als recruited tw lcal vlunteers t ffer advice at the event). Healthwatch Newham wuld like t extend its thanks t thse rganisatins fr their cperatin and prviding resurces at the event. User Feedback The ht tpics f discussin at the wrkshps included what can services d t supprt thse with diabetes, and what can the cmmunity d t prevent the increase in diabetes. Attendees were service users with diabetes, r thse wh had lved nes with diabetes. Many viced their cncerns abut the lack f educatin and awareness arund the brugh. Sme attendees utlined that there was nt enugh peer supprt in Newham and that the Healthwatch Newham event was their first pprtunity fr supprt utside the health service. 1 LBN Public Health figures, February

3 Diabetes Supprt Suggestins made thrugh Wrkshp 1 in terms f what peple with diabetes need t supprt their cnditin included: 1. Grup sessins with Dieticians, specialist Nurses with infrmatin and advice n diet and exercise wuld supprt them. A gd Dietician culd lk at each persn s eating and exercise habits. Family supprt where there is multiple diagnsis f diabetes in a family; teaching family members the tls f self-managing the cnditin. One attendee said: I need a grup t advice me n what I need and what yu need t d if yu have diabetes. Expert patients culd share and prvide supprtive infrmatin, teach self-management and prvide peer supprt. Talking t thers abut the cnditin, dispelling the myths believed an attendee. There was ptential, expressed sme attendees, t frm their wn diabetes assciatin with supprt frm LBN/Third Sectr a G fr it grant fr cmmunity grups is a financial grant that culd be given t supprt grups in the brugh t cver the cst f rm hire and tea/cffee. There als ught t be a push t drive diabetes up the agenda f PPG meetings and GP centres. 2. Accessible, layman, plain English, infrmatin n diabetes, infrmatin n linked health issues t diabetes advice. There were a lt f cmments abut educatin n exercise and curses, with mre rbust GP advice. A resurce centre t prvide supprt fr thse with diabetes. It was understd that there are leaflets and the internet but smetimes it can be t much infrmatin r nt enugh, there was nt yet the interactive infrmatin sharing. Eye test, ft clinic infrmatin as well as hw t inject prperly webpages was an example. Infrmatin needs t be n DVD, audi and in ther languages. 3. Self-mnitring, and infrmed self-management: prviding training fr the usage f technlgy, supprt with mnitring tests, the checks, learning hw t use bld testing medicine prperly, and keeping a recrd. Patients require mre supprt with understanding their diabetes and its cmplicatins, ne patient said: It s the Dctr s respnsibility t give results t patients and make sure they understand them. Anther felt, and many agreed the time between being diagnsed as a diabetic and getting n the system was t lng. Anther stated that it shuld be a patient-led cnsultatin where the patient is able t speak freely. 4. Specialist care: a sense f urgency was fed back in that mre GPs need t be specialising in diabetes and an increased recruitment f Diabetes Specialist Nurses. Specialist care and supprt is needed fr the deaf cmmunity where there are high rates f diabetes. Time needs t taken t explain diabetes, understanding diabetes and which fds are suitable; training days and supprt frm Dietician/Nurse shuld be frequent. 3

4 After diagnsis, a Dietician can really lk at a diet with each persn; ne Wrkshp grup thugh, nted that Dietician advice seems t vary and was nt always useful. An example f best practice was Cmmunity Prescriptin: NACRE referred t by Wrdswrth Practice. It was stated that unfrtunately nt all Practices have a Diabetes Specialist Nurse and patients are nt seen by the same Clinician. Diabetes awareness/preventin Suggestins made thrugh Wrkshp 2 in terms f what Newham culd d t raise awareness and prevent mre peple getting diabetes included: 1. Preventin/awareness prgrammes f diabetes thrugh crdinatin at varius husing grups in the brugh; East Ham Husing Grup was particularly mentined. Cmmunity centres, libraries and sheltered husing are all avenues fr prviding educatin n healthy eating/living and giving infrmatin n the risk and dangers f diabetes. Husing grups, sme nted, have gd utreach capabilities and there needs t be investment in awareness activities as a nrm. East Thames Husing prvide husing t peple with different disabilities and ught t have a Diabetes Awareness mnth, inviting NHS staff and Diabetes UK staff t give advice. A substantive diabetes preventin/awareness prgramme, culd be enacted, hlding regular sessins acrss the brugh that cver infrmatin, advice, educatin, interactive wrkshps and supprt at venues, such as day centres, cmmunity centres, Churches, and Msques. 2. Parents and children require rbust educatin, healthy eating in schls, and infrmatin n hw t avid fast fds/bargain fds. Catering in schls was mentined by sme as a significant way f raising awareness and preventing diabetes. Again a Diabetes Awareness week in schls shuld be the nrm. Teenagers, ne thught, shuld nt just get the image f a sprty r thin persn but have healthy living advice and discussins. Further suggestins included: Giving yung peple, a Frum, run thrugh Newham s Yung Mayr. Family advice thrugh the GP culd ptentially reach the seldm heard grups that d nt access cmmunity services. 15 minutes is nt lng enugh fr that advice. GP can shw vides in the receptin area and must prvide healthy living vides t deaf cmmunity withut diabetes. Health checks ught t be in schls and lessns n cking meals rather than eating junk fd. 3. Public health warnings n TV adverts and billbards, n the internet. Health prgrammes during ppular prgrammes and children s TV shws. Psters in shpping centres, n buses and in undergrund statins. A campaign t highlight 4

5 cnversatins and cncerns abut the debilitating cnsequences f diabetes similar t the successful HIV campaign in the 80s. Raising awareness there are 3 millin peple with diabetes in the UK, and it is predicted 1 millin are walking arund with diabetes withut being diagnsed. 4. Health prmtin by Active Newham. Supermarkets shuld prmte fds that are gd fr diabetes with suitable labels n fds. A few attendees agreed that supermarkets shuld prmte healthy fd; there shuld be a diabetic area in supermarkets. 5. Diabetes Friends des nt necessarily have t be a Friend with diabetes but they can visit seldm-heard peple, such as thse with disabilities r the elderly, and take them fr walk and discuss healthy eating. Exercise shuld cntinue t be n prescriptin. Diabetes Friends can meet and liaise thrugh scial media. Alternative rganisatins t the NHS, LBN and Diabetes UK such as deaf and visually impaired charities and Age UK culd run the prgrammes that wuld address the diabetes epidemic. Cnclusins Over 35 peple attended the Wrkshps and many were in agreement abut the lack f educatin and awareness acrss the brugh n diabetes. One r tw attendees believed it was the Health Service s respnsibility t frequently check n whether a Newham resident has diabetes r nt, a cmmunity-led awareness and educatin that individuals and parents need t take respnsibility fr their well-being taking up available exercise and learning t eat smaller prtins and healthy fd. Overall there is a need fr services nt t slely respnd with medicatins fr Type 2 but, encurage peple t adapt their habits and lifestyle t reverse the Type 2 cnditin, it is never t late attitude. Sme service users may need much mre supervisin than thers hence persn-centred treatment such as a Diabetic Friend r Supprt Grup r Cmmunity Prescriptin. Mechanisms are already in place they just need mre emphasis and made accessible t thse vulnerable t the cnditin r accelerating it. Diabetes UK has a natinal reputatin hwever very little presence in Newham, run by vlunteers; the slutins t the diabetes prblem needs mre than a little presence t be addressed. In the lng-term, investment in research and technlgy is required t adapt the invasive bld checking fr thse with Type 1 and imprve self-management mnitring. Reprt cmpleted: 5 th August

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