Working with PCN Teams to Optimise Management of Type-2 Diabetes.
20-Feb-2020: Diabetes costs account for approximately one-tenth of the total NHS budget. There are 3.8 million people living with a diagnosis of diabetes in the UK, and 90% of those with Type 2. There are almost 1 million more people living with Type 2 diabetes, who don’t know they have it because they haven’t been diagnosed, bringing the total number up to 4.7 million. By 2030 it is predicted this number will rise to 5.5 million. The NHS has systems in place to monitor and manage the quality of Diabetes Care in England, but care is still variable. GPs are paid to bring as many of their Type-2 diabetes patient cohort into control as possible. This is measured using three treatment targets for glycaemic control (HbA1c), blood pressure and lipids (cholesterol). In addition, there eight care processes that are contracted and expected to be delivered to Type-2 diabetes patients, universally including foot and eye checks. In spite of this the quality of care for people with Type-2 Diabetes in England is variable with avoidable secondary care costs amounting to £3.8bn. Because of this, Res Consortium and The University of Manchester undertook a regression analysis to identify treatment factors that have the greatest impact on glycaemic control. These factors, when understood at GP Practice and PCN level, can provide some simple rules that GP Practices can use to make the greatest positive impact on the quality of care they provide. In order to test this hypothesis, Res Consortium has launched two pilots using an industry grant, one in Newcastle Gateshead and one in Cheshire. This week, the Res-Events Team hosted the launch meeting of the Cheshire pilot. The meeting was attended by senior decision makers for the local CCG, Local GP Diabetes Leads, GP Federation / PCN Lead GPs, Practice Nurses and local Diabetes Consultants. During the meeting, key decision-makers agreed the first steps of the Cheshire pilot to optimise patients care with a practice opt-in at PCN-level. The trial sites will make simple changes to management of the care of patients on the Diabetes register according to recommendations of the regression analysis. They will then be re-audited following QOF reporting during the 2020-21 period.