Winner
Barts Health Young Adult Diabetes (YAD) Service
by Barts Health
Executive Summary
Young people with diabetes are a high-risk group with poor clinical outcomes and are subject to significant health inequality. Through this pilot project we have implemented innovative initiatives to improve engagement and clinical outcomes.
Key Changes made:
- A cross site Young Adult Diabetes (YAD) team to work across all 4 Barts health sites
- High-Risk YAD pathway to find young people who are not engaging, understand their barriers and address their priorities.
- Peer support and education
- Supporting psychosocial factors- housing, financial resources, mental health
Lessons Learned:
Addressing psychosocial factors and personalising care improves engagement and outcomes
Judges’ comments:
“Barts Health Young Adult Diabetes Service’ is an impactful initiative targeting a hard-to-reach group with a large number of different demographics. The person-centred approach stood out to the panel, as well as the social prescribing element. The service directly addressed health inequalities and the clinical outcomes were impressive, even in the programme’s early stages. There was clear evidence of support from service users, and a demonstrable cost benefit. An excellent project with a model that could be applied to other long-term conditions.”
Highly Commended
HELENA (nortH East London prEconception iN diabetes) Project.
by North-East London Integrated Care Board
Executive Summary
Many women with type 2 diabetes in North-East London (NEL) are not well prepared for pregnancy. The PRIDE project was led by a multi-disciplinary group including diabetologists, GPs, practice nurses and commissioners. A standardised annual review template in EMIS for preconception across NEL and a practice level monthly dashboard were launched, with primary care network focused MDTs. The second phase involved a desktop primary care guide, leaflets for women in 11 languages, primary care education sessions, patient facing webpage/webinars, an ad campaign on bus shelters/supermarket billboards, standard GP text/letters and a local incentive scheme to increase folic acid prescription.
Judges’ comments:
“North-East London Integrated Care Board have created an important and well-executed programme aimed at a patient population that can be difficult to engage with. The project was a great example of collaborative working and its impact was well demonstrated, with positive user feedback and impressive advert reach. It was sustainable, replicable and could have a huge impact if rolled out widely. A brilliant programme that every surgery should have.”
Commended
Waiting Well Diabetes: A novel, dietetic-led approach to pre-surgical diabetes optimisation
by Collaboration between North East and North Cumbria (NENC) ICS, Newcastle upon Tyne Hospitals NHS Foundation Trust, Northumbria Healthcare NHS Foundation Trust
Executive Summary
Uncontrolled diabetes is the main reason surgical operations are currently being postponed. Surgery is delayed for considerable periods often without any optimisation services in place, placing immense strain on primary and secondary care services. Patients often end up on increasing medications without targeting the underlying issues.
Our new intervention combining specialist dietetic support along with new technologies allows patients to optimise their diabetes with feedback loops to the hospital teams, reducing workload and leading to better surgical outcomes for patients and also for their longer term health.
We present results from year one of a novel pre-surgical diabetes optimisation service.
Judges’ comments:
“Waiting Well Diabetes: A novel, dietetic-led approach to pre-surgical diabetes optimisation’ has created a simple but highly effective intervention addressing many aspects of diabetes care. The judges thought the approach was innovative, and liked that the team addressed diabetes distress, as well as types 2 and 3c. The impact of the programme was well evidenced, with great testimonials from patients and healthcare professionals. An excellent piece of work with impressive data outcomes.”
Commended
Diabetes and Frailty; Creating Holistic Care Using an MDT Approach to Integrate Primary, Community and Specialist care
by Joint project between the Community Frailty Team from the Jean Bishop Integrated Care Centre and Community Nursing , services within the City Health Care Partnership CIC, and the Diabetes Department of the Hull University Teaching Hospitals NHS Trust
Executive Summary
Diabetes, frailty and community nurse services in Hull have collaborated to establish a diabetes frailty MDT based in the Jean Bishop Integrated Care Centre (JBICC). The MDT has provided access for hard-to-reach service users to specialist advice without hospital visits. Thematic study data and stakeholder feedback indicates that transfer of skills and knowledge between services has changed the nature of referrals into the MDT and improved access to Continuous Glucose Monitoring.The learning from the diabetes frailty MDT has informed the development of other speciality MDT meetngs at the JBICC. No additional resources were required to fund this potentially transferable initiative.
Judges’ comments:
“Diabetes and Frailty’ has designed an innovative and sustainable service that addresses a major issue in a hard-to-reach population. The panel liked the all-encompassing approach taken by the team, as well as the cross-fertilisation of knowledge. The need was clearly identified and the user feedback was excellent. A really strong entry.”
Commended
A Novel Approach to Pre-operative Diabetes Optimisation in Cardiac Surgery to Improve HbA1c and Reduce Length of Stay in Hospital
by Royal Brompton and Harefield Hospitals/Guy’s and St Thomas’ NHS Trust
Executive Summary
Cardiac surgery outcomes are worse in patients with poorly controlled diabetes and an elevated HbA1c. Surgery may also be cancelled or delayed. This study assessed the effectiveness of a pharmacist led Diabetes Pre-operative Optimisation Service in reducing HbA1c and enhancing cardiovascular optimisation prior to cardiac surgery. Patient consultations focused on a holistic approach to diabetes management in the context of impending surgery. Results demonstrated improved HbA1c and subsequent reduction in hospital length of stay. Interventions also resulted in improved cholesterol and hypertension management plus provision of lifestyle and dietary advice associated with improved long term cardiovascular health.
Judges’ comments:
“Royal Brompton and Harefield Hospitals/Guy’s and St Thomas’ NHS Trust has produced an excellent programme that positively impacted patient care. The entry itself was concise and particularly well written. The need was clearly identified, the objectives and measurement tools were considered, and the areas of improvement were highlighted, which the judges appreciated. The team used feedback and different approaches to drive further improvements. A sustainable initiative that ticked all the boxes.”
Finalist
Diabetic Foot Emergency Early Triage Service (DFEET)
by Cardiff and Vale UHB Podiatry
Executive Summary
In 2018 Cardiff and Vale (CAV) UHB introduced a ‘Walk in clinic’ for patients with diabetes and a foot emergency. This service, whilst highly successful, needed to adapt to meet the demands of the health service.
An adapted ‘phone first’ service, diabetic foot emergency early triage (DFEET) , where patients living with diabetes with a ‘foot emergency’ can contact the department, speak to a triaging Podiatrist and be offered advice and an appropriate appointment has been piloted. The service provides a ‘one stop shop’ with access to interventions such as x-rays, microbiological sampling, independent prescribing and MDT access.
Judges’ comments:
“Diabetic Foot emergency early triage service (DFEET)’ is an important programme that has had a great impact on patient care. The need, context, aims and objectives were all clearly identified, and the cost savings were well demonstrated. The results were brilliant and the user feedback was really positive. An excellent project that should be widely disseminated.”
Finalist
Spotlight-AQ
by Spotlight Consultations Limited
Executive Summary
Spotlight-AQ, a disruptive shift in diabetes healthcare delivery, replaces ineffective, inefficient appointments with routine visits that focus on physical, mental and social wellbeing. Deliverable by any healthcare professional HCP), in any setting with any person with diabetes (PWD); Spotlight-AQ fits seamlessly within existing workflows and is time and cost saving. It results in significantly improved glycaemia and quality of life for PWD and increased efficiency and reduced burnout for HCPs. It works by sending a short holistic questionnaire to each patient prior to their routine visit, results are immediately visible and mapped to evidence-based resources supported by HCP discussion.
Judges’ comments:
“Spotlight-AQ’ is an interesting and promising programme with really good evidence of support from both healthcare professionals and service users. The programme is very scalable, and would be cost-effective and valuable going forward. A great example of co-design and a brilliant way to bring psychological care into consultations.”
