Diabetes Newsletter – March 2017

www.berkshirewestdiabetes.org.uk March 2017
Monthly diabetes news for healthcare professionals and
others in Berkshire West

  Insulin Optimisation Programme – 15mmol/mol reduction in HbA1c at six months  
This intervention is focused on people with Type 2 diabetes who are using insulin but still have poor control with HbA1cs >75mmol/mol, aged <75. Practices gather a group of up to six patients and arrange a DSN to visit and facilitate a two hour session, with the practice nurse also present.

Results show a mean reduction in HbA1c of 15.1mmol/mol at six months – a really impressive result. The programme has been extended for a further six months from April. To book this, call the DSN hotline (number at foot of this newsletter).
  National Diabetes Audit results 2015/16  
Results from last year’s NDA are available here on the diabetes website, broken down to CCG and practice level. You can see that there is the usual wide variation in achievement of practices across CCGs. Here are a few reflections:
  • Some practices do very well at getting the eight care processes done – but are not so good at achieving target levels for HbA1c, BP and cholesterol. Look at specific practices doing well for eight care processes and see how they do on the 3 treatment targets.
    In one CCG, one practice is top for one and bottom for the other! This means they are getting the patients through the door, boxes ticked, but then losing focus on target achievement.
  • The key metric is the ‘3 treatment targets’. This is the % of patients who achieve all 3 treatment targets: HbA1C<58, BP<140/80, Cholesterol<5. These patients are at lowest risk for complications of diabetes. In all cases, people with Type 1 are worse off than Type 2 with huge variation.
    There is one stand-out practice that I will name: Abbey Medical Centre in South Reading CCG, achieving 50%. It can be done! 
  • If your results are good, think about why that is and whether you can improve. If they are not so good, think about why. Here are some questions to ask:
    • Have you got a good recall system for annual review?
    • Are all your patients getting a care planning consultation? 
    • Are you referring making good use of patient education: in particular,
      X-PERT and CHOICE?
  • Set a target for the coming year. There is a regional target of achieving at least 40% of patients getting the 3 treatment targets within the next year, and 45-50% by 2020. 
  Changing faces!  
Some of you will know that I, Richard Croft, am retiring at the end of March. My successor as diabetes lead for Berkshire West is Dr Paul Westcar. Paul has been diabetes lead for Newbury and District CCG for many years and has wide experience both in diabetes and in leadership. He will be an excellent overall lead for the CCGs.

​It has been an enormous privilege for me to hold the baton for the last five years, and to see diabetes care come a long way. I wish Paul all the best as he takes over. 
        Dr Richard Croft         Dr Paul Westcar
Richard croft web   Paul Westcarr web

  Diabetes leads by CCG  
Diabetes Specialist Nurse Hotline: 07879 814922 (Monday to Friday 10am – 4pm) Consultant Hotline: 07717 867448. Email: virtualdiabetes@royalberkshire.nhs.uk
Visit our website: www.berkshirewestdiabetes.org.uk
Click here to read this update online