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Diabetes Week 2024: six months of insights from PPP 

For this year’s diabetes week, Public Policy Projects Content Executive Navodi Kuruppu provides an update on some of the key findings from PPP’s Diabetes Care Programme.
Diabetes Care

Diabetes Week 2024 is held from Monday 10 June to Sunday 16 June.  This year’s theme is health checks, which provides a strategic opportunity to discuss the importance of check-ups and their vital role in supporting the wellbeing of people with diabetes. This year’s theme also offers a chance to advocate for a more equitable and resilient healthcare system built upon patients’ needs. Health checks can often feel like an overload of tests for people living with diabetes, which can lead them to avoid going to appointments and, in some cases, cause diabetes distress and burnout

PPP’s Diabetes Care Programme 2024, chaired by Professor Partha Kar, explores unmet needs in diabetes care and examines the challenges and opportunities to improve diabetes outcomes locally and nationally. From four roundtables and a webinar, PPP gathered a series of insights on health checks and how the NHS can improve their services to support all diabetes patient groups.     

When patient needs go unanswered, it inevitably and rightly adds to growing dissatisfaction with diabetes care services. At our webinar “Prioritisation of diabetes care – bold conversations or more of the same?”, Nikki Joule, Policy Manager and Chair at Diabetes UK, explained that patients are increasingly seeking more integrated, joined-up care, with reduced duplication and fragmentation. This means patients receive fewer, but more impactful appointments and tests. Nikki suggested consolidating single appointments into a single contact, possibly at pharmacies or specialist clinics. Greater digital enablement and interoperable IT systems can help facilitate more joined up working between different care providers.  

“We hear from people that have too many appointments and tests, and then we hear from people who don’t have enough or don’t get access to care. And obviously that’s not good for them or the NHS or wider society.” 

Nikki Joule, Policy Manager and Chair at Diabetes UK 

This was further expanded by Dr Waqas Tahir, Diabetes Clinical Lead at Bradford System Programme Board, who discussed the innovative potential of automated booking processes. In this way, patients are sent personalised appointment links based on their specific needs, they have the autonomy to schedule their appointments for blood tests, ensuring convenience and flexibility while minimising the burden on clinical staff.     

“With an estimated population of around 48,000 individuals with diabetes spread across 13 Primary Care Networks, the projected reduction in podiatry appointments could potentially translate into saving about 2,000 to 3,000 appointments across the entire healthcare system.” 

Dr Waqas Tahir, Diabetes Clinical Lead at Bradford System Programme Board 

Appointments that individuals with diabetes are required to attend go beyond checking their glucose levels. This is because diabetes can affect numerous parts of the body, everything from a patient’s kidneys to their vision. PPP recently spoke with Dr Joep Hufman, Medical Director of Bayer UK and Ireland, who explained the important link between diabetes and ophthalmology. Those who develop diabetes are likely to develop eye conditions that can lead to blindness or cardiovascular complications.  

“Every year more than 1300 people with diabetes have sight loss, equivalent to 25 people a week.”

Diabetes UK

The NHS’s programme for diabetic eye screening (DES) offers everyone with diabetes, who is 12 years old or over, annual retinal screening to catch issues early on, with regular follow-ups depending on diagnosis. However, studies have shown that many eligible patients do not attend screening appointments.

“Understanding why people are not accessing this important programme and supporting attendance will be vital to improve the lives and preserve the sight of diabetics.” 

Dr Joep Huffman, Medical Director of Bayer UK and Ireland 

This year’s Diabetes Week allows us to reflect on the valuable role the healthcare system plays in supporting diabetes patients with their health checks.  Whether it is too many or too few appointments, these are challenges that cannot be solved individually. Progress in this area relies upon healthcare organisations coming together as a system to identify any underlying flaws that manifest in the delivery of care.   

Throughout PPP’s Diabetes Care policy series, key stakeholders have come together to enrich existing discourse on transforming diabetes care. Stakeholders have included integrated care system leadership, representatives from primary and secondary care, pharmacy as well as industry representatives.  Our focus has been on identifying challenges and opportunities in transforming diabetes care pathways, with particular focus placed on prevention, inequalities, and stigma.  

One key topic at Roundtable 1 was clinical inertia, which refers to the failure to start therapy or its intensification/non-intensification when appropriate. This issue has been slowing the adoption of effective medicines among healthcare professionals in diabetes care. This is particularly prevalent in paediatrics, geriatrics and primary care. Overcoming this inertia is crucial for improving diabetes care outcomes, so patients can be given the right medication at the right time to prevent disease progression and associated complications.  

At Roundtable 2, stakeholders highlighted significant stigma around certain parts of the diabetes care pathway, particularly due to the visibility of the CGM technology for those who do not wish to be identified as having type 2 diabetes. This is a barrier impacting the uptake of CGM technology, particularly among those with type 2 diabetes. Also, the colouration of sensor covers has previously been limited and designed for Caucasian skin tones, therefore presenting another barrier to people with diabetes from ethnic minorities.  Alongside stigma around wearing visible technologies, systemic barriers were identified that hinder the effective roll-out of certain devices in the NHS such as continuous glucose monitoring and hybrid closed loop systems. For instance, patients and their families have expressed concerns about the high costs of mobile phone data, issues with unreliable internet, limited access to data and phone incompatibility with the latest diabetes devices. Stigma also impacts type 2 diabetics who sometimes feel blamed for their condition due to lifestyle choices – a common misconception. 

 

In the last six months, PPP had the privilege to connect and speak with around 150 experts. If you would like to learn more about prevention, unmet needs of patients, inequalities and stigma in diabetes care, Diabetes Conference 2024 will have Panel 1 and Panel 3 dedicated to them. The PPP Diabetes Conference will be held on 27th June in London and interested parties can find out more using the link below.

Click here to find out more on PPP’s Diabetes Care Conference

 

With the end of this programme, we look forward to seeing national thought leaders at our Autumn Programme, which will focus on not just treating diabetes but treating patients across the entire care pathway. With four virtual 90 min invitation-only roundtables, the programme will bring in a broad range of health and care experts to elevate our understanding of challenges and opportunities for prevention of diabetes complications and improving outcomes for people with diabetes and other metabolic conditions to improve access and outcomes through better diabetes services. 

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