Swindon Joint Strategic Needs Assessment Bulletin

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1 Swindn Jint Strategic Needs Assessment Bulletin Swindn Diabetes 2017 Key Pints: This JSNA gives health facts abut peple with diabetes r peple wh might get diabetes in Swindn. This helps us t plan fr medical and scial care in the future. It als helps us t think abut hw we can prevent diabetes. Diabetes causes high levels f sugar (glucse) in the bld. Over time this can lead t prblems such as heart disease, blindness and ft ulcers. Gd bld sugar cntrl can reduce the chances f getting these prblems and the need fr health and scial care. 12,924 peple in Swindn had diabetes in 2015/16 (nly includes peple aged 17 years and ver). Apprximately 9 in 10 f these will have type 2 diabetes. 18,535 peple are thught t be at high risk f getting diabetes (nly includes peple aged 16 years and ver). Type 1 diabetes is caused by damage f the cells that nrmally make insulin. This leads t high bld sugar levels. Type 1 diabetes usually appears befre the age f 40. Type 2 diabetes develps when the bdy can still make sme insulin, but nt enugh, r when the insulin that is made des nt wrk prperly. It tends t start in adulthd. The reasn mst peple get type 2 diabetes is that they are verweight r bese (als called excess weight). Older peple, peple frm sme minrity ethnic grups and peple wh have a family member with type 2 diabetes are als at increased risk f getting diabetes. The number f peple with diabetes in Swindn is frecasted t increase. There are several reasns fr this. This is because in the future we expect: mre peple will have excess weight there will be mre peple living in Swindn peple t live lnger mre peple frm different ethnic cmmunities In Swindn there are sme very gd services fr diabetes but there is als rm fr imprvement. The JSNA makes seven recmmendatins these are n page 6. What is a Jint Strategic Needs Assessment (JSNA)? JSNA helps us t understand: the current health and wellbeing needs f lcal peple; hw their needs are being met; what we think their future needs are likely t be; and hw their needs can be best met. We want t understand Swindn s changing ppulatin, what is ging n in Swindn and what makes a difference t peple s health and wellbeing s that we can plan fr the best care in future. Many different peple frm a range f rganisatins help t write a JSNA. The Swindn s Health and Wellbeing Bard is a grup that leads the develpment f JSNAs. Page 1

2 Number f peple with diabetes Intrductin Diabetes in the UK is a majr public health prblem that needs urgent actin. Mre peple are getting diabetes acrss the UK and in Swindn. In the UK in 2014 almst 3.5 millin adults had diabetes. It is thught that there are 549,000 peple in the UK wh have diabetes but have nt been diagnsed. Type 1 diabetes affects ver 370,000 adults in the UK. Type 1 diabetes is caused by damage f the cells that nrmally make insulin. This leads t high bld sugar levels and ther changes which have shrt-term and lng-term negative effects n health. Type 1 diabetes usually appears befre the age f 40, ften in childhd. Type 2 diabetes accunts fr abut 9 in 10 cases f diabetes (arund 3.1 millin adults in the UK). It tends t start in adulthd. Hwever the Natinal Paediatric Diabetes Audit in 2014/15 shwed that 2 in 100 f children and yung peple (up t the age f 24 years) with diabetes had type 2 diabetes. Type 2 diabetes develps when: the bdy can still make sme insulin, but nt enugh, Or when the insulin that is made des nt wrk prperly (knwn as insulin resistance). Peple with type 2 diabetes are usually advised t adpt a healthier lifestyle; with exercise, a gd diet and weight-reductin. Then, if necessary, peple are treated with glucse-lwering medicatin and smetimes insulin. Prblems caused by diabetes include: Blindness (type 2 diabetes is a leading cause f preventable sight lss in peple f wrking age), Kidney failure, Ft ulcers leading t amputatin, Gum disease, Heart disease, Strke. The prblems that can be caused by diabetes mean peple are much mre likely t need health and scial care. Nearly 1 in 10 peple with diabetes have clinical depressin which is nearly twice as many as in thse withut diabetes. Fr peple wh have diabetes alngside anxiety and/r depressin having gd bld sugar cntrl can be mre difficult and health care csts increase. Accrding t the Natinal Diabetes Audit reprt n cmplicatins and mrtality, abut 24,000 peple with diabetes in England and Wales die early frm causes that culd have been avided thrugh better management f their cnditin. Figure 1. Number f peple with diabetes in England by type f diabetes and age, 2014/15. These numbers are nly fr GP practices which sent data int the Natinal Diabetes Audit f General Practice which in 2014/15 was abut half f practices Age unknwn Aged 80 and ver Aged 65 t 79 Aged 40 t 64 Aged under Type 1 Type 2 Page 2

3 Hw many peple in Swindn have diabetes? There are a higher percentage f peple with diabetes in Swindn than in England. There are als a higher percentage f peple wh are verweight r bese which is ne f the biggest risk factrs fr develping type 2 diabetes. 12,924 peple in Swindn in 2015/16 had diabetes, f which arund 11,600 have type 2 diabetes. This nly includes peple aged 17 years and ver. This means that 7 in 100 peple in Swindn aged 17 years and ver had diabetes. It is thught that there may be nearly 1,000 peple wh have diabetes but have nt been diagnsed. Reasns fr getting type 2 diabetes Excess weight: 7 in every 10 adults were verweight r bese in Swindn in in 10 f 4 t 5 year lds were verweight r bese in 2015/16. 3 in 10 f 10 t 11 year lds were verweight r bese in 2015/16. Adults wh are bese are five times mre likely t have diabetes than an adult f a healthy weight. Ethnicity: 15 in 100 f the Swindn ppulatin in 2011 were frm Black Minrity Ethnic grups (everyne except peple wh reprt themselves as being White British) and 6 in 100 f these were Asian/Asian British. Depending n ethnicity and gender, peple in certain BME grups can be 3 t 5 times mre likely t develp diabetes and develp diabetes yunger. Children and yung peple with diabetes 175 children and yung peple (peple aged up t 24 years) were treated fr diabetes in Great Western Hspital NHS Fundatin Trust in 2015/16. Mst f these children and yung peple had type 1 diabetes. Other grups affected by diabetes 220 t 250 wmen wh have diabetes (type 1, type 2 r pregnancy related) give birth in Swindn each year. Diabetes increases the risk t the mther and baby but gd bld sugar management during pregnancy can decrease these. In Swindn nearly 1 in 10 f peple with diabetes may als have depressin and nearly 16 in 100 f peple with dementia culd have diabetes. Peple at a high chance f getting diabetes Peple with nn-diabetic hyperglycaemia (high bld sugar but nt yet diabetes) are mre likely t get diabetes. It is thught that in Swindn 1 in 10 peple wh are 16 years and lder may have nn-diabetic hyperglycaemia, (18,535 peple). Figure 2. Percentage f peple with diabetes (as measured by percentage f general practice list n Quality Outcme Framewrk diabetes register aged 17+). *Swindn PCT 2011/12 and 2010/11 Page 3

4 What services d peple use? There are a wide range f services fr diabetes available in Swindn. Mst peple with diabetes receive their care in primary care (mstly thrugh their general practice). In primary care there are differences in the care and management ffered. There are sme places in Swindn where imprvement is required and ther areas which are perfrming very well. Making sure that everyne with diabetes is able t have the same pprtunities is crucial t imprving utcmes fr peple with diabetes in Swindn. Preventin and self-management There are a wide range f services available in Swindn fr the prmtin f a healthy weight and active lifestyle. There are als a number f ptins t aid peple with diabetes t selfmanage their diabetes. Primary care and cmmunity care Less than 4 in 10 peple with type 1 diabetes and arund 6 in 10 peple with 2 diabetes had all eight care prcesses (rutine tests such as bld pressure being measured) (2014/15, data cllected in the Natinal Diabetic Audit (NDA)). Yunger peple and thse with Asian r Black ethnicity were less likely t receive all eight care prcesses. Less than 4 in 10 peple with newly diagnsed type 1 diabetes and arund 7 in 10 peple with newly diagnsed type 2 diabetes were ffered structured educatin sessins (2014/15, NDA). Hwever, f thse referred nly a very small number attended the sessins. Many ther areas f the cuntry get better uptake and we need t cnsider what they are ding that we culd learn frm and als cnsult with patients abut what they want. 15 in 100 f peple with type 1 diabetes achieved all three treatment targets. 4 in 10 peple with type 2 diabetes achieved all three treatment targets (2014/15, NDA). The treatment targets are; gd bld sugar cntrl (HbA1c less than 58mml/ml), gd bld pressure cntrl (bld pressure less than 140/80) and gd chlesterl cntrl (serum chlesterl less than 5mml/L). Yunger peple were less likely t achieve treatment targets. Achieving gd bld pressure cntrl, gd chlesterl cntrl and gd bld sugar cntrl is wrse in Swindn than natinally (see figure 3). The Swindn Cmmunity Diabetes Service ffers: Educatin fr healthcare prfessinals, Advice fr healthcare prfessinals including jint clinics, Clinics fr peple with mre cmplex diabetes. Peple with diabetes als use scial care services if their need increases with the prblems caused frm diabetes. Secndary care (hspital care) Hspital utpatient clinic data shws that there may be unequal access t this service fr different ethnic grups. Hwever, there are a large number f peple with unknwn ethnicity status which may be affecting the data. There are a number f ther elements within the diabetes pathway such as transitins (when children mve t adult clinics), ft care and maternity which are imprtant t imprve utcmes fr specific grups f peple with diabetes. Figure 3. NHS Swindn CCG diabetes care, 2014/15. Page 4

5 Estimated ttal number f peple with diabetes (diagnsed and undiagnsed) What culd the future lk like? It is thught that fr Swindn the percentage f peple with diabetes will increase t 9 in 100 by This means pssibly 2,711 mre peple with diabetes by 2025 and 5,250 mre peple with diabetes by 2035 (see figure 4). These numbers include peple with diagnsed diabetes and undiagnsed diabetes. Figure 4. Estimated ttal number f peple with diabetes (diagnsed and undiagnsed) in Swindn. CCG registered ppulatin Lcal authrity 25,000 20,000 15,000 10,000 5,000 0 Page 5

6 Recmmendatins 1. Stpping peple frm getting type 2 diabetes is crucial. If this is nt achieved almst 9 ut f every 100 peple (15,931 peple r 8.5% f the ppulatin) in Swindn may have diabetes by a. Make sure peple knw hw t prevent diabetes, by prmting an active lifestyle, watching their weight and eating a healthy diet. This can be thrugh wrking with cmmunities and health and scial care thrugh apprpriate campaigns. b. Prmte the preventin services we prvide e.g. the new Swindn Cmmunity Health and Wellbeing Hub. c. Supprt a natinal prgramme, called the NHS Diabetes Preventin Plan, t help lcal peple with a high chance f getting diabetes t reduce their risk f develping diabetes. 2. Make sure peple at high risk f diabetes and peple wh have just develped diabetes are diagnsed quickly, s that they can get the best care. This will be dne thrugh educatin f patients and healthcare prfessinals. Health prfessinals are advised t use risk assessments t aid early diagnsis. Cntinued educatin arund this area by the Swindn Cmmunity Diabetes team is required. 3. Prvide better care in Swindn fr peple with diabetes t reduce cmplicatins and, therefre, reduce need fr health and scial care. Actin is required t reduce the differences in care fr peple with diabetes that ccurs between GP practices. a. Wrk with the cmmunity, CCG and the Great Western Hspital NHS Fundatin Trust n a cmmunity mdel f care. b. Increase the percentage f peple with diabetes receiving all eight care prcesses. We will especially target yung peple, and thse frm minrity ethnic grups. This culd be achieved by raising the prfile f the annual review fr peple with diabetes and taking up natinal pprtunities fr imprving diabetes care. c. Increase the percentage f peple with diabetes meeting all three treatment targets. We will especially target yung peple and thse in deprived areas. T achieve this annual reviews are required, primary care educatin and awareness f referrals and patient engagement. d. Increase referrals and attendance t structured educatin sessins. T ensure this, primary care needs t be aware f and understand these curses, refer apprpriately as part f the care plan, ffer a variety f curse times and dates t suit patients and engage with patients t understand in mre detail why peple d nt attend. e. Cntinue imprvements in ft care prcesses including amputatin rates by nging review f the service, especially availability f pdiatry services in the cmmunity and secndary care. f. Cntinue t increase participatin in Natinal Diabetes Audit t get cmplete infrmatin f diabetes care in primary care, including n ethnicity. g. Cntinued educatin fr peple with diabetes and healthcare prfessinals n the increased risk f depressin with diabetes is required t ensure peple with diabetes and depressin receive apprpriate care. 4. Make sure there is cntinued patient and public invlvement in cmmunicatin f key messages, diabetes care and any changes t care. Specific wrk t find ut if there are any barriers t peple frm BME grups using diabetes services r being diagnsed with diabetes is needed t understand the pssible differences in service use. 5. Make sure that there is cntinued cmmunicatin between areas where peple with diabetes attend fr ther reasns (such as maternity, pdiatry and chirpdy) and specialist diabetes services. We will carry n with the prgramme f change within diabetes transitins which aims t imprve the service fr children with diabetes as they mve int adult services. 6. Aim t make ethnicity recrding mre cmplete in hspital utpatient clinics s we are able t understand differences in access t diabetes specialist services. 7. These recmmendatins shuld be taken t the established multi-agency Swindn Diabetes Transfrmatin Bard fr actin. Page 6

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