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Lambeth Diabetes Learning Event Local and regional update

Lambeth Diabetes Learning Event Local and regional update. Dr Neel Basudev GP Lambeth Clinical Director Diabetes Health Innovation Network Clinical Lead Out of Hospital Care London Diabetes Network. Things to cover. Diabetes state of play Type 2 Diabetes Prevention.

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Lambeth Diabetes Learning Event Local and regional update

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  1. Lambeth Diabetes Learning Event Local and regional update Dr Neel Basudev GP Lambeth Clinical Director Diabetes Health Innovation Network Clinical Lead Out of Hospital Care London Diabetes Network

  2. Things to cover

  3. Diabetes state of play Type 2 Diabetes Prevention

  4. Overview of ICS programme

  5. Prioritisation Approach • HbA1c 44-47mmol/mol or Fasting Plasma Glucose (FPG) 6.5–6.9mmol/l • Healthier You, NHS diabetes prevention programme (NDPP), commissioned by NHS England • first line option • STEPs to prevent diabetes commissioned locally in Lambeth • second line option • NDPP • 42-43mM/M: 50 34 8 • 44-47mM/M: 131 87 38 • STEPS • 42- 43mM/M: 38 36 • 44-47mM/M: 19 30

  6. South London cumulative referrals 11,982 Referrals

  7. Eligible referrals received by CCG (June 2016-May 2018)

  8. South London cumulative Initial Assessments (IA) 7,548 Initial Assessments attended 63% conversion rate from referral

  9. No. of participants attending 1st session by CCG 3,219 1st sessions attended 43% conversion rate from IA to 1st session

  10. No. of participants who have completed the programme by CCG • 732 Finishers • Have to take into account time lag • 9 month programme and we received the majority of our referrals in the second year of the contract • Majority of people who have started on programmes will not yet have had a chance to complete

  11. Status of referrals Lots of participants currently active in the programme

  12. Drop outs and when they left the programme Drop-out rates once started on the programme are very low

  13. Mean weight change at 6 months for participants who had a valid weight at IA and 6 months by CCG Mean weight change at 6 months of -2.6kg

  14. Summary of achievements • 11,982 eligible referrals received • 7,548 Initial assessments attended • 63% conversion rate from referral to IA • 3,219 1st sessions attended • 43% conversion rate from IA to 1st session • 732 finishers (as of April 2017 data) • Mean weight change at 6 months of -2.6kg (as of April 2017 data)

  15. Diabetes state of play Book and Learn

  16. CDEP structured education module available

  17. Diabetes state of play Tier 3 weight management

  18. Overview of 2 year pilot • Pilot Tier 3 adult weight management service for patients with a GP in Southwark, Lambeth, Bromley, Bexley and Lewisham. • Run until 31st March 2020 and it is a 12 month multi-disciplinary programme of group based sessions • Delivered by Dietetics Dept. at Guy’s & St Thomas’ but the programme itself will be delivered in the community • The programme is for: • Over 18’s • BMI ≥40 or BMI ≥35 with Type 2 Diabetes • Motivated to lose weight • Willing to take part in a group based programme requiring regular attendance • The referral form can be found on DXS or EMIS and referrals must be sent via eRS

  19. What does the programme consists of? • A 1-1 initial assessment with a dietitian • A choice of two programmes: • BALANCE - Nutritional education alongside behaviour change, psychology and physical activity. 12 group sessions over the course of a 12 month period • FAST - Evidence-based total meal replacement programme for more substantive, rapid weight loss followed by food re-introduction, nutritional education, psychology and physical activity. 15 group sessions over the course of a 12 month period • Follow up at 18 and 24 months • Review by a clinically-led MDT within the medical obesity service • Integrated support from clinical psychologist with option for 1:1 support if required • Group programmes in each borough. Evening and weekday groups available. Participants can choose from any of the available locations in any borough.

  20. Diabetes state of play General roundup

  21. A few other reminders • 75%, of patients with non-diabetic hyperglycaemia (NDH) should be on the High Risk of Diabetes register using read code 14O80 • 8 care process and three treatment targets • Flash glucose monitoring

  22. Horizon scanning Technology

  23. How to improve self-management

  24. Personalised supportWhat Patient FE would be offered by our new model of care Habituation Care planning Recall Maintenance 12 3 6 2 1 Month Information gathering appointment Care planning appointment Support to access resources Annual review Booking process • Care planning preparation • Introduction to Healum platform • Video message with their results • Better understanding • Video via text message or e-mail explains why care planning is important and what to expect • Hyperlink included to make an appointment • Detailed care plan and results available in Healum • Video message with their care plan • Linked to education and social prescribing resources • Useful resources and information constantly updated in Healum • Nudging from app to keep focus on goals • Video message to keep up motivation at 6 months • Video message to prepare for annual care plan review • Link to Healum self assessment • Click to make appointment

  25. Learning today Programme

  26. This afternoon Diabetes Book and Learn Alison Meadows, Priority Digital Health Pregnancy in annual review for women with T2DM Dr Kate Hunt, Consultant in Diabetes and General Medicine, King’s College Hospital NHS Foundation Trust Monogenic and Mitochondrial Diabetes- ensuring the correct diagnosis Anna Reid, Diabetes Nurse Consultant, Guy’s and St Thomas’s NHS Foundation Trust

  27. Thanks for listening

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