Agenda item

Purpose: To present a report on diabetes prevention, diagnosis and treatment in West Berkshire.

Dr Heike Veldtman (GP, Joint Chair BOB Integrated Cardiac Delivery Network Manager and lead for CVD. Chair Berkshire West Long Term Conditions Programme Board) presented the report on Diabetes services.

During the presentation the following key points were raised:

·       It was highlighted that lifestyle was key in improving and even reversing Diabetes.

·       The prevalence of Diabetes increased due to Covid. Patients were less active, eating habits changed, there was a disruption in routine care and there was late presentation of symptoms. This affected all areas of the BOB ICB. Prevalence of diabetes in West Berkshire increased and needed better control.

·       It was highlighted that Berkshire West participated in the Prediabetes Locally Commissioned Service to monitor and support people at risk of developing Type 2 Diabetes.  They identified those at higher risk of developing Diabetes and asked them in for an annual review. They would agree a care plan with the patient. Part of this offer was a referral to the National Diabetes Prevention Programme and Berkshire West had a much higher referral rate than other parts of the BOB ICB.

·       The patient pathway was described, and the participation of the patient was highlighted. They carried out annual reviews with patients who were pre-diabetic, and this would be crucial in preventing Diabetes. At the reviews, tests were carried out and conversations were had around how the patient approached their Diabetes. These conversations were fundamental in how to live well with Diabetes. The care processes and treatment targets were described. Treatment targets were based on what was important to the patient.

·       The Diabetes Recovery Local Enhanced Service was described. This was to aid recovery post-Covid. This included upskilling clinicians, professional development, support from the Diabetes Clinical Lead and meeting targets of the Eight Care Processes to pre-pandemic levels.

The following points were noted during the Committee’s discussion:

·       If a patient was identified as being pre-diabetic, they were offered a referral to the National Diabetes Prevention Programme. This included lifestyle and healthy eating advice, and structured education events for the patient and their household. A full understanding of what was important to the patient was critical in ensuring that the patient stayed engaged.

·       As Berkshire West was signed up to the Local Enhanced Service, all practices could sign up to it and get support from the Clinical Diabetic Lead. This meant more diabetes was being prevented.

·       A Member asked if strategies were available to address socio-economic differences and whether there was data to identify any inequalities. It was confirmed that they had access to data on inequalities that helped them to address those more likely to be at risk of diabetes. It was highlighted that healthy eating was important and more needed to be done to promote healthy food choices. The West Berkshire Council health in all policies approach had been approved and so the Council would ensure health was considered in all policy decisions.

·       It was discussed that the concepts and messages regarding healthy eating should have been a national approach. It was National Diabetes Week at the time but awareness of that was low. They needed to align communications from the NHS, the Local Authority and nationally to address the issues. It should have been in schools.

·       It was highlighted that the approach with patients was individualised and sensitive to cultures. They could do more and reach out to different faith groups and do more promotion. Reducing health inequalities was a shared commitment across organisations. There would be a targeted NHS health checks outreach service to reach patients who were disproportionately impacted by Cardiovascular Disease and Type 2 Diabetes but who were underserved by the universal services.

·       It was confirmed that there was currently very little communications regarding Diabetes prevention and what was out there was very corporate and not relatable. Healthwatch offered to help with promoting any communications. The location of the communications was vital in reaching the target audience.

·       It was confirmed that point of care testing could highlight the risk of Diabetes and lead to a referral for more investigation.

·       Action: Diabetes update to be added to the work programme.

RESOLVED to note the report.