The North Devon Integrated Diabetes Service is being co-produced by patients, primary care, secondary care and commissioners. Individual interviews with a sample of 8 GPs took place over December and January 2017 and these informed the project brief that was brought to the North Devon GP Forum on 17 January 2017 for approval. At this meeting, it was agreed that Dr James Szymankiewicz and Dr Glen Allaway would be the GP representatives on the project team.
The project launched in March 2017 when the project team began 6 months of engagement with these four stakeholder groups.
Dr Alastair Watt and Andrea Beacham, clinical lead and programme manager, interviewed members of 4 GP practices:
|Lynton||14 February 2017|
|Holsworthy||20 March 2017|
|Litchdon||4 April 2017|
|Northam||6 April 2017|
The patient engagement took place concurrently and the results were reported to the clinical community as they were published.
As a result of the clinical engagement, the need for better specialist support for primary care was identified. This was to address some broad themes that were raised:
- More responsive support from specialists
- More support for complex patients
- More advice on new diabetes drugs
- Opportunity to discuss patients we’re ‘just not sure’ about
- Better understanding of referral pathways & assessments
- QOF targets not necessarily improving patient care
- Better understanding of own practice outcomes
As a result, the project team created a programme of work encompassing 8 projects:
- Specialist support to primary care
- Improving access to the multi-disciplinary footcare team
- Improving access and timely referral to community podiatry services
- Improving access to other NHS and public health support
- Making every consultation count/personalising care
- Ensuring same standard of diabetes care at home
- Creating place-based offers of support such as peer support and wellbeing clubs
- Ensuring patient access to appropriate, quality education resources
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Specialist support to primary care – design and test visits
In order to understand what support is required and how this might be provided, 4 primary care workshops were held (7 June, 30 June, 2 August, 5 September) with 72 members of staff from 13 GP practices in attendance. As a result, a primary care diabetes support service was proposed with specialist support visits and access to advice. Dr Watt and Andrea Beacham attended the Cluster Primary Care Development & Sustainability meeting on 9 May 2017 and asked if any practices would like to help design and test these visits.
6 practices offered to test out Practice Support Visits as part of the service. Unfortunately, due to circumstances, we were delayed and therefore have only been able to visit 4 practices as part of the design phase. These were:
|Brannams||10 November 2017|
|Combe Coastal||23 November 2017|
|Bideford||7 December 2017|
As a result of these visits the North Devon Integrated Diabetes Practice Support Service was co-designed and the following proposal agreed by the North Devon GP Forum on 20 March 2018.
Proposal to implement North Devon Integrated Diabetes Service (IDS)