Audit shows big improvement in care for people living with diabetes

Two years after the launch of a pioneering new diabetes service in North East Essex, there has been a dramatic improvement in the level of diabetes care in the region, with over 4,000 more patients receiving eight recommended health checks from their GP.

According to figures from the 2014/2015 independent National Diabetes Audit (NDA), 50.5% of people with type 1 diabetes and 67.9% of people with type 2 diabetes in the Colchester and Tendring areas are now receiving all eight health checks, greatly exceeding the national averages of 39.6% and 59% respectively.

In particular, the North East Essex Clinical Commissioning Group (CCG), which commissioned NEEDS (North East Essex Diabetes Service), is now ranked in the top 15% of CCGs nationally for delivering the eight essential care processes for people living with type 2 diabetes. The annual checks, which are recommended by the National Institute for Health and Care Excellence (NICE), include blood glucose levels, Body Mass Index (BMI) and foot health.

Sam Hepplewhite, Chief Officer at North East Essex Clinical Commissioning Group, said:

“We welcome the news that the service we commissioned in 2013 to improve Diabetes care for patients in the North East Essex area has delivered such excellent results. The move to a streamlined service including a community based team has made a substantial improvement in how patients receive treatment. The service is providing excellent care and we look forward to the continued success of the service with further improvements in care for the patients of North East Essex”.

The NEEDS service, which is delivered by the Suffolk GP Federation, has also increased the number of patients with blood pressure, cholesterol and blood glucose levels within a recommended range. Additionally, a focus on improving patient education and involvement has resulted in 95% of patients newly diagnosed with Type 1 diabetes and 96% of patients newly diagnosed with Type 2 diabetes being offered structured education.

A priority for the NEEDS service going forward is to ensure that all patients with diabetes continue to receive the eight recommended health checks, particularly a urine test for albumin which can help spot the early signs of kidney disease meaning any problems can be treated more successfully.

Dr Karunakaran Vithian, Community Diabetologist for NEEDS and Clinical Lead for Diabetes at Colchester Hospital University Foundation Trust, said: “Ensuring patients receive all eight care processes is one of the most important measures of a diabetes service. We’re delighted with these independent audit results and look forward to delivering further improvement which will benefit people living with diabetes in North East Essex.”

Clair Carpenter, a GP at Mill Road Surgery in Colchester, said: “I have very much enjoyed working with NEEDS over the last two years as a local GP. They have provided good training to staff about a new approach to diabetes care and quarterly meetings with practice staff and the specialist NEEDS team ensure everyone is listening to each other, sharing experiences and ideas. There appears to be a genuine practice-wide enthusiasm not just to improve care within the practices but as a larger locality. Everyone involved has put a lot of work into making this successful but it is great to see the improvement in patient care locally.”

The Suffolk GP Federation was commissioned by the North East Essex Clinical Commissioning Group (CCG) in 2013. Where the previous diabetes service was often fragmented with a number of different providers, the NEEDS integrated model of care brings together the majority of diabetes care under the umbrella of one service. The service has a community-based diabetes specialist team which has made it easier for patients to access higher level care locally to where they live and has reduced the need for hospital visits.

In 2015 the NEEDS service was a finalist in the East of England NHS Leadership Recognition Awards for ‘Outstanding Collaborative Leadership’ and shortlisted for ‘Provider of the Year’ by the National Association for Primary Care (NAPC).

Top line findings

  • An increase in the percentage of diabetes patients receiving all eight care processes from 39.1% in April 2014 to 60.3% in March 2015 (an extra 4,000 patients)
  • 38 out of 41 GP practices in North East Essex (92.7%) participated in the 2014/2015 National Diabetes (NDA) audit
  • The NDA banding for the North East Essex CCG changed from ‘as expected’ to ‘higher than expected’ for performance in delivering all eight care processes to diabetes patients
  • The North East Essex CCG is ranked 30th out of 206 (in the top 15%) of CCGs in the UK for providing the eight care processes to patients with type 2 diabetes (up 95 places from the previous NDA audit)
  • 74.2% of patients with a cholesterol level measurement within a recommended range
  • 70.3% of patients with blood pressure within target levels (up from 67.4% in April 2014)
  • 95% of patients newly diagnosed with Type 1 diabetes and 96% of patients newly diagnosed with Type 2 diabetes offered structured education