Diabetes in London. Dr Jane Fryer. Date

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1 Diabetes in London Date Dr Jane Fryer Diabetes Senior Responsible Officer, NHE England - London Region Medical Director, South London, NHS England London Region December 2017

2 London Regional Diabetes Event Next Steps on the NHS Five Year Forward View Urgent and emergency care: 24 hours a day, 7 days a week Investment in primary care Addressing service gaps between mental and physical health care Helping frail and older people stay healthy and independent Leverage the potential of technology and innovation

3 London Regional Diabetes Event Government s Mandate to NHS England Objective 4: to lead a step change in preventing ill health and supporting people to live healthier lives Specific deliverables by 2020: 100,00 people through the NDPP Measurable reduction in variation in the management and care for people with diabetes Specific deliverables for : At least 60,000 people referred to the NDPP

4 London Diabetes Context Date Gemma Snell Regional Diabetes Lead Vicky Parker Quality & Improvement Manager December 2017

5 London Diabetes Team Elizabeth Pang Senior Project Manager Onome Okonji Senior Project Manager Tarita Turtiainen Project Manager Gemma Snell Regional Diabetes Lead Grace Coombs Project Support Officer Paul Trevatt London CVD Lead Stasha Jan Senior Project Manager Umar Majid Project Manager Vicky Parker Quality & Improvement Manager 6

6 What is the NDA? National Diabetes Core Audit (NDA): This annual audit of primary care and specialist diabetes services covers care processes, treatment targets, complications and mortality. National Diabetes Inpatient Audit (NaDIA): This is a snapshot audit of every hospital covering inpatient care of people with diabetes. National Diabetes Footcare Audit (NDFA): This audit collects data about specialist foot care services for people with diabetes. Continuous data collection, services can commence participation at any time National Pregnancy in Diabetes (NPID) Audit: This audit examines antenatal services for women with pre-gestational diabetes. Continuous data collection however submission deadline to be included in August 2016 annual report was 10 th February

7 National Diabetes Audit 2016/17 NDA participation has increased from 83% to 96% 8

8 Why participate in the NDA Comparative data to support planning and improvement activity CCG accountability and assessment High participation ensures high quality data across all diabetes audits 9

9 Why participate in the NDA 1. Monitor 2. Compare 3. Identify trends 4. Identify priorities 5. Link to long term outcomes 6. Find omissions 7. Learn from others 8. Demonstrate excellence in care 9. Improve care 10.Save money 10

10 Why participate in the NDA 1. Monitor 2. Compare 3. Identify trends 4. Identify priorities 5. Link to long term outcomes 6. Provides data for other diabetes audits 7. Learn from others 8. Demonstrate excellence in care 9. Improve care 10.Use money wisely 11

11 Type 1 & Type 2 care Type 1 patients have lower attainment of 8 care processes and 3 treatment targets compared to Type 2 patients. 12

12 Type 2 management London Treatment Target (HbA1c, BP, Cholesterol) attainment increased from 40% to 41.1% Wide variation across CCGs in completion of 8 care processes 88.8% to 21.7% 13

13 Structured Education Type % are offered structured education with 6.7% uptake Type 1 45% are offered structured education with 7.7% uptake N.B. it is acknowledged that locally services can report c.30% uptake rates All numbers are rounded to the nearest 5, unless the number is 1 to 7, in which case it is rounded to 5. Rounded numbers are used to calculate percentages. 14

14 London DESP 2016/17 437,896 people with Diabetes were invited to the Diabetic Eye Screening Programme in 2016/17 15

15 London Transformation Board Aim System leadership and oversight of Diabetes transformation in London Membership Senior Responsible Officer for Diabetes in each STP, Clinical Directors for Clinical Network and Academic Health Science Networks, NHS England and Public Health England, Diabetes UK, Patient representative 16

16 London Clinical Leadership Group 17

17 Treatment and Care Transformation Projects STP CCG 3 Treatment targets North Central London North East London North West London South East London South West London NHS Camden CCG NHS Haringey CCG NHS Islington CCG NHS Barnet CCG NHS Enfield CCG NHS City and Hackney CCG NHS Newham CCG NHS Tower Hamlets CCG NHS Waltham Forest CCG NHS Barking & Dagenham CCG NHS Havering CCG NHS Redbridge CCG NHS Hounslow CCG NHS Ealing CCG NHS Central London (Westminster) CCG NHS Hammersmith and Fulham CCG NHS West London (K&C & QPP) CCG NHS Hillingdon CCG NHS Harrow CCG NHS Brent CCG NHS Bexley CCG NHS Bromley CCG NHS Greenwich CCG NHS Lewisham CCG NHS Lambeth CCG NHS Southwark CCG NHS Croydon CCG NHS Kingston CCG NHS Richmond CCG NHS Merton CCG NHS Sutton CCG NHS Wandsworth CCG DTCL16 - Islington DTCL02 - Newham Structured Education DTCL01 MDfT DTCL16 - Islington DTCL09 - H&F DTCL09 - H&F DTCL09 - H&F DTCL07 - Southwark from Lewisham DTCL05 - Southwark DTCL08 - Southwark DTCL04 - Southwark DTCL17 - Wandsworth DISN DTCL16 - Islington DTCL14 - Wandsworth from Kingston excl. Merton 18

18 NHS Diabetes Prevention Programme From 18/19 1 provider per STP (excl. NCL) Provider selection process in Jan-Mar 2018 From 19/20 NCL STP will have a single contract London NDPP Delivery Group 19

19 NHS Diabetes Prevention Programme Digital NDPP Pilots - Barking & Dagenham, Havering and Redbridge are one site referring eligible individuals to the product on offer - CWHHE are referring individuals who have declined the face to face service More detail later on the agenda! 20

20 Clinical Network portfolio Treatment & Care Programme Foot Network and Type 1 Network Patient Engagement Plan Freestyle Libre London implementation guidance 21

21 Diabetes Team contact details Team inbox: Elizabeth Pang Senior Project Manager - elizabeth.pang1@nhs.net Gemma Snell Regional Diabetes Lead - gemma.snell@nhs.net Grace Coombs Project Support Officer - grace.coombs@nhs.net Onome Okonji Senior Project Manager - onome.okonji@nhs.net Paul Trevatt London CVD Lead - paul.trevatt@nhs.net Stasha Jan Senior Project Manager - stasha.jan1@nhs.net Tarita Turtiainen Project Manager - tarita.turtiainen@nhs.net Umar Majid Project Manager - umar.majid@nhs.net Vicky Parker Quality & Improvement Manager - v.parker@nhs.net 22

22 Useful websites