Diabetes in Wandsworth

1. Diabetes in Wandsworth Review of Diabetes National Audit, Local Health Needs Assessment and Proposals for Service Redesign

2. NHS Diabetes Data Audit – Audit based on QOF measures for 2009-2010. Report compiled from data submitted by practices and in the public domain

3. Examinations are being done but treatment is not to target?

4. Analysis of efficiency and cost pressures Prescribing data from EPACT July 2010ogramme budgeting data relating to endocrine dysfunction, Wandsworth 2007/8 Programme budgeting data relating to endocrine dysfunction, Wandsworth 2007/8 From Health Needs Assessment

5. Key Recommendations from Health Needs Assessment An integrated diabetes prevention strategy is required to ensure that a comprehensive approach to the prevention of diabetes is adopted within the PCT. (Diabetes NSF Standards 1 & 2) As diabetes incidence is increasing and programmes like the NHS health checks begin to identify increasing numbers of people with diabetes, commissioners need to ensure that increased capacity within the health service to cater for these patients is available. Further analysis of QoF data and other data sources is required to assess the reasons for … variation, and practices that are underperforming need to be performance managed via commissioning The impact of these changes on patient outcomes needs to be prospectively evaluated within a monitoring and evaluation framework. Community specialist nurses should be given the necessary IT support to enable an assessment of their effectiveness and impact on patient outcomes. The development of this service is important to the expansion of care for diabetics in the community and the service may need to be expanded in the future to respond to increasing demand and changes in the service organisation.

8. Conclusion and Discussion • Diabetes is an expensive area with many strands. We need to continually review how we are providing care for our patients with diabetes, adopting newer care models, identifying areas of best practice and of inefficiency. • Using IT has obvious advantages but depends on a smooth transition to EMIS web and concerns about data sharing need to be resolved. We also need managers who understand this area and work to head off areas of poor reporting or performance as identified in the National Diabetes Audit • Professional and patient education is important, not only in the core diabetes area but also in renal disease, cardiology, foot care, information technology and referral management. • Putting the patient at the centre of diabetes care has been the aim throughout, but this needs to be done while understanding the whole network and where the pinch points are. Neil Bamford. Dec 2011