FOR INFORMATION ONLY
BOURNEMOUTH AND POOLE PRIMARY CARE TRUST
PAPER FOR HEALTH AND SCRUTINY PANEL APRIL 2007
1.Diabetes Services within The Borough of Poole
1.1There are well established diabetes services across primary and secondary care within the Borough of Poole.
1.2The primary care services are located within GP practices.
1.3The secondary care services for adults are located at Poole General Hospital within the Phillip Arnold Centre. The diabetes services for children from across East Dorset are also located at Poole General Hospital within the paediatric department.
2.Diabetes Prevalance within The Borough of Poole
2.1The national estimated incidence of diabetes in the adult population is 4.3%.
2.2A tool has been developed by the Yorkshire and Humber Public Health Observatory to estimate the prevalence of diabetes within any given population. This tool takes into account the age, sex and ethnic group profile of each population with an adjustment for geographical variations in socio-economic deprivation.
2.3The Primary Care Trust has used this tool to calculate the estimated prevalence of adults with diabetes within the Poole GP practice population. Within Poole practices the estimated prevalence of diabetes ranges from 3.5% to 6.2% of the GP practice populations. When the variations in individual practice prevalence were looked at by the Local Implementation Team, with a view to identifying poor practice, it was discovered that the variations were largely due to patient demographics. For example low prevalence equated to a practice list which had a high number of young patients and high prevalence equated to a practice list which had a high number of elderly patients.
2.4A screening tool to identify those people with undiagnosed diabetes is being piloted in several practices and it is planned that this tool will be used across all practices to identify people with undiagnosed diabetes.
3.DIABETES CARE WITHIN POOLE
3.1There are two types of Diabetes known as Type 1 and Type 2 Diabetes. All are managed by primary care; some are jointly or mainly looked after in secondary care. The latter are predominantly children and insulin dependent patients.
3.2Patients diagnosed with Type1 Diabetes require regular Insulin injections to maintain good control of their diabetes. The education and on-going care of patients with Type 1 Diabetes is usually provided by Diabetes Specialist Teams from within Poole General Hospital. Patients with Type 1 Diabetes are seen regularly in the hospital and progress is regularly shared with the patients GP.
3.3Patients diagnosed with Type 2 Diabetes require speedy access to an education programme about their diabetes. These education sessions are provided in a range of community and hospital settings by a team of specialist staff. They provide diabetes specific education, dietetic and life style advice and promote self care. Following the education sessions outcome data is collected for all patients participating in the education programme. The education programme is delivered over several weeks.
3.4Patients with Type 2 Diabetes following their initial education are managed in primary care by their GPs. These patients have regular annual reviews of their disease with their GP. A range of clinical outcomes are recorded at these reviews. These are monitored through the GP contract and show that patients with Diabetes are well cared for by the Poole practices.
3.5All patients with Diabetes require a regular eye screening test to monitor for Diabetic eye disease. There is a national standard required for this eye screening service. The Dorset wide Diabetic Eye screening service is sited in the Philip Arnold Centre at Poole General Hospital.
3.6Local optometrists, in their practice, use a Camera to take a digital image of the patient`s eyes and send this to the Eye Screening Service for grading and checking. There are robust mechanisms for fast tracking patients to ophthalmology services if there any risk to an individuals sight.
3.7There is joint work across primary and secondary care to provide on-going education and training to GPs and practice staff to enable them to effectively manage their patients with diabetes. There are a range of study days for practice nurses, one to one sessions with GPs tailored to their training needs and joint clinical reviews for the management of patients whose diabetes care is very complex.
3.8Overall standards of care are now easily monitored by reviews of individual practices Quality and Outcome Data. In the past this method has identified small areas where care could be improved and this has occurred by use of a unique PCT-employed diabetes nurse specialist who has a hands-on educational role for health care professionals.
Name Anna Doherty
Job Title Chronic Disease Management Commissioning Manager
Date 26 March 2007
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