Proposed Integrated Diabetes Care Model

Tina Teague – Head of Locality CommissioningTrish Brown – Practice Nurse/Mid Devon Clinician

to Clinician (C2C) Diabetic LeadCatherine Argyle – Specialist Diabetic Nurse

Proposed Care Model• Aims for equity of capability & capacity • Recognises the need for invest to save• Proposes 4 tiers of care provision&

commissioning options• Identifies education (patient, community

nurses, GPs) • Formalises the role of community DSN• Identifies local commissioning groups as being

key to implementation

RD&E Diabetes Activity Trends – Mid Devon

0

5

10

15

20

25

30

35

2009/10 2010/11

New Outpatients

General

Obesity

Specialist

Month Q1 Q2 Q3 Q4 Q1 Q2 Total Total CostGeneral 25 28 25 29 33 32 172 £41,108Obesity 0 10 14 17 19 17 77 £18,403Specialist 16 18 16 20 22 21 113 £27,007

2009/10 2010/11

RD&E Diabetes Activity Trends – Mid Devon

020406080

100120140160180200

2009/10 2010/11

Follow Up Outpatients

General

Obesity

Specialist

Month Q1 Q2 Q3 Q4 Q1 Q2 Total Total CostGeneral 145 145 150 171 170 190 971 £89,332Obesity 0 23 37 43 43 48 194 £17,848Specialist 75 77 80 92 91 102 517 £47,564

2009/10 2010/11

£245/Consultation

£70

£130

Mid Devon DiabetesC 2 C and other Meetings

Trish Brown10/01/2011

Local Vision

• To provide a world Class service, in which Primary and Secondary care is integrated.

• Every patient will have access to the most appropriate team to provide care.

• Quality will be measured and services modified with a view to improvement.

Restructuring Diabetes Services

Entry Criteria Exit CriteriaEntry Criteria Exit Criteria

Initial management T1DM Self management - planComplications Management stableAtypical Diabetes Established diagnosis - PlanErectile Dysfunction Management PlanYoung People Up to age 21- ? Adult CareInsulin Pump Therapy Established managementAnte-natal No longer PregnantRetinal Screening Continue as beforeNew Referrals Stable / Management PlanPodiatry Integrated Foot service

Other Service Provision

• Community Specialist Nurse• Structured Patient Education-all new T2 DM• Community Consultant / DSN clinics DGH• All Annual Reviews in General Practice• Education Programmes for PNs and GPs (Survey)• Updated Diabetes Formulary – Treatment Pathway• Protocol and Pathway Development• Telephone and Email advice• Accessible updated website