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Prevention and inequalities in healthcare: Bayer’s vision for better health outcomes

Ahead of the Public Policy Projects (PPP) Diabetes Care Programme Conference on June 27th, 2024, Ameneh Saatchi, Director of Market Access and Policy at PPP, spoke with Joep Hufman, Medical Director UK & Ireland, of Bayer, who will join the Conference’s third panel, Using data to improve health Inequalities to produce better outcomes.

Bayer have provided sponsorship funding for this series and this article has been developed in collaboration between PPP and Bayer Plc.

Prevention

The conversation with Joep started off on the key role of prevention within diabetes care. To successfully provide preventative care, Joep discussed two key actions. Firstly, patients must be given the right treatment with a holistic approach, which is essential for both preventing diseases and identifying them in their early stage. Secondly, managing diabetes from its onset allows healthcare professionals to cope with the risks linked with diabetes and for patients to reduce high medication intake. “We’re looking at a systemic disease, not a disease of the pancreas, or only of the blood. It’s a disease that sits throughout your entire body,” Joep explained, emphasising the importance of holistic diabetes management.

Ophthalmology

Within the context of diabetes prevention, Joep explored the topic of ophthalmology, explaining how diabetes can lead patients to develop eye conditions. The combination of diabetes and eye conditions makes patients more vulnerable to developing cardiovascular disease (CVD). The scale of the issue is reflected in the data collected by Diabetes UK, which indicates that every year, more than 1,300 people with diabetes develop sight loss, equivalent to 25 people a week.1 These are cases where the condition could have been spotted and possibly prevented.2 In view of this, Joep suggested establishing a prevention strategy that links ophthalmology and diabetes pathways. The NHS has a programme in place for diabetic eye screening (DES), through which everyone aged 12 or over with diabetes is entitled to retinal screening annually to catch issues early on, with regular follow-ups depending on diagnosis.3

However, studies have revealed a concerning trend of eligible patients missing their screening appointments.4 Between 2021 and 2022, 10.4 per cent of individuals with diabetes did not attend their eye screening appointments within the previous three years.5Although this percentage is not alarmingly high, it remains a cause for concern. Similarly, in 2022, the Royal National Institute for the Blind (RNIB) reported that between 20 and 40 per cent of patients in Northern Ireland were not showing up for their appointments on any given day.6

“Understanding why people are not accessing this important programme and supporting attendance will be vital to improve the lives and preserve the sight of people with diabetes,” said Joep. He emphasised that it is imperative for people to have easy access to primary care and the screening services that can support them with this aspect of their health. Health inequalities across England remain a major issue, with people from the poorest areas struggling the most to access vital services. To put this into context, one in three people in the most deprived areas found it difficult to contact their diabetes healthcare team in 2022, compared to one in four in the least deprived areas.7

Recent national surveys have shown that many people face challenges accessing their GP. Around 1 in 4 patients (24.1 per cent) said they tried to contact an NHS service in the past 12 months when they wanted to see a GP, but their practice was closed.8 Surveys have also shown that ophthalmology has one of the largest backlogs for the NHS to tackle. The Royal College of Ophthalmologists has reported that ophthalmology sees the highest number of total outpatient appointments;in 2021/22 alone, there were more than 7.5 million ophthalmology outpatient appointments in England.9 Joep stressed that “there is clearly a need for ophthalmology centres to optimise their services in the presence of the backlogs. In this way people can lead a more fulfilling life, they can read for longer, they can drive for longer. Our team in the UK have been supporting some trusts with this work. An example of this is an NHS clinic in Somerset, where through collaborative working, the clinic can handle more patients more effectively and closer to home.”

Deprivation and inequalities

Joep stressed that health inequalities are one of the biggest challenges facing the health and care system and this is no different with respect to diabetes care. Diabetes is more prevalent in more deprived areas and access to diabetes is not equal across the country.10 “The goal is to support more people to stay healthier for longer, but there are barriers to achieving this. Funding of deprived areas can be an obstacle and it can be more challenging to recruit a skilled workforce in more deprived areas, whichthis can impact people’s access to local GP and dental services. Furthermore, investments in the system are not designed to fully address the additional workload and efforts required and therefore improve outcomes for people.” Instead, Joep believes the health system could take a more radical step towards diverting existing resources, prioritising, and supporting the workforce to improve outcomes in more deprived areas.

Patient empowerment

Joep also discussed the importance of patient empowerment in diabetes care. He pointed out that there is a need to ensure that information is tailored and simple to understand, ensuring that information on self-care, treatments and even appointment details is clear and understandable. For example, Diabetes UK has developed resources to support people better, including “Information Prescriptions.” These are personalised and accessible pieces of information, supported with clear images and tailored individual goals to help patients prevent diabetes health complications. They are designed to give people with diabetes the information that they need to understand, engage with, and improve on their health targets.11 Bayer has led various initiatives involving patient representatives and disease awareness campaigns. They have also worked with the NHS to optimise their services around the throughput of patients. “By helping people living with diabetes to better understand their condition and the types of treatment available, we are putting decision power back into their hands,” Joep added.

This insightful exchange between PPP and Bayer concluded by discussing the main opportunities for improving care for people with diabetes and their eye health. Joep put forward two key opportunities: the strategic use of resources and an open culture to help encourage collaboration between different providers and disciplines.

The insights from this discussion will be carried forward at Panel 3 at the PPP Diabetes Care Programme Conference on 27th June 2024. The aim of the conference is to break down professional silos by bringing together a diverse stakeholder group. Their objective is to analyse and shape better integration and collaboration across the diabetes patient pathway. This is an invaluable opportunity for our delegates and speakers to engage in a dynamic dialogue to deep dive into prevention strategies, leadership, explore ways for reducing inequalities and improving outcomes, and the priorities in diabetes care.

With the end of this programme, we look forward to seeing national thought leaders at our Autumn Programme, which will focus on treating the whole patient. 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.

Throughout the 2024 Diabetes Programme, PPP had the privilege to connect and speak with over 150 experts and explore themes of prevention, unmet needs of patients, inequalities, and stigma in diabetes care. 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 the whole patient. With four virtual 90-minute 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.

To find out more contact Ameneh Saatchi, Director of Market Access and Policy for the Diabetes programme, at Ameneh.Saatchi@PublicPolicyProjects.com.


References

1 https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/diabetic-eye-screening
2 https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/diabetic-eye-screening
3 https://www.gov.uk/guidance/diabetic-eye-screening-programme-overview
4 https://diabetesjournals.org/care/article/45/2/303/138992/Factors-Associated-With-Nonattendance-in-a
5 https://assets.publishing.service.gov.uk/media/6491c9425f7bb700127fad7a/Diabetic_eye_screening_annual_data_tables_2021_to_2022.xlsx
6 https://www.bbc.co.uk/news/uk-northern-ireland-61809945
7 https://www.diabetes.org.uk/about-us/news-and-views/too-many-people-diabetes-still-not-receiving-vital-care-our-new-report
8 https://www.england.nhs.uk/statistics/2023/07/13/gp-patient-survey-2023/
9 https://www.rcophth.ac.uk/wp-content/uploads/2022/11/RCOphth-response-to-Public-Accounts-Committee-inquiry-Managing-NHS-backlogs-and-waiting-times-Nov-2022.pdf
10 https://www.diabetes.org.uk/about-us/news-and-views/too-many-people-diabetes-still-not-receiving-vital-care-our-new-report
11 https://www.diabetes.org.uk/for-professionals/supporting-your-patients/information-prescriptions/information-prescriptions-qa

Job code: MAC-MACS-GB-0034

Date of preparation: June 2024 

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