TRAINING & EDUCATION
Whydiabeteseducation isn’t one-size-fits-all
Nadine Miles, director of market development at Spirit Health explores how to increase the uptake of structured diabetes education programmes among Type 2 Diabetes (T2D) patients.
Structured diabetes education programmes are key to empowering people with diabetes to take control of their condition, and reduce the risk of developing complications, which is why they should be 'fit-for-purpose' to help educate the growing number of people diagnosed with T2D.
Structured diabetes education works. Evidence increasingly shows that timely, relevant and accessible educational programmes can play a significant role in helping type 2 diabetes (T2D) patients manage their condition more effectively. When education is delivered well,
everybody wins; patients report a better quality of life, health outcomes improve and healthcare costs reduce. Not all programmes measure the health outcomes, but where they do, some achieve relative reductions in a person’s HbA1c of over 10% in 6 months, alongside weight loss and lifestyle improvement. It’s this kind of sustained behaviour change that NHS organisations need to achieve if they’re to move the dial of diabetes care. To get there,
Diabetes
prescriptions Diabetes prescriptions are costing the NHS in England more than £1 billion a year, according to figures from NHS Digital. l The total cost of the prescriptions has risen by more than £422 million - in the last 10 years
l Almost one in 20 prescriptions written by GPs are now for diabetes treatment
l The biggest increases are seen in treatments for type 2 diabetes, which affects around 90% of diabetes patients
l Drug costs have not risen significantly during this period, and the increase in prescribing costs is largely a result of the rise in prevalence of type 2 diabetes.
however, many CCGs may need to rethink their diabetes education strategies to offer greater choice, extending delivery beyond a common reliance on a single provider. As the annual cost of diabetes in England climbs towards £10 billion,1
the NHS’ ability
to remodel the lifestyle behaviours of people living with T2D will be a key determinant in reducing the burgeoning burden of disease. Structured diabetes education (SDE) will undoubtedly form part of the solution. But a one-size-fits-all approach to delivering it simply will not work.
Poor patient uptake
There are a growing number of high-quality education programmes available, provided in a face to face setting or as a digital offering and, with the revised Long Term Plan reinforcing NHS England’s commitment to education pathways, more innovation is likely to emerge in the future. However, despite the obvious knock-on benefits of SDE – and despite clear NICE guidance to encourage it – patient uptake remains poor. Last year, a summary of the 2016/17 National Diabetes Audit (NDA) suggested that the NHS still ‘underestimates’ or ‘undervalues’ the provision of SDE. The numbers tell the story. In 2016, while three quarters (74.5%) of T2D patients were offered SDE within 12 months of diagnosis, only 8% actually attended a course within the same timeframe.2 Poor record-keeping is cited as a potential
factor in low attendance rates, with the number of attendees apparently higher than recorded figures suggest. The 2017/18 NDA reports an incremental increase in the timely offer of education over the past three years, but patient attendance remains stubbornly low. The NDA has recently revised its policy on data capture, with GP practices and specialist services now legally required to supply the data for their practice or clinic. This, on paper at least, is likely to drive an upturn in performance in the coming years – we await the results. But SDE is not a tick-box exercise – it needs to be measured in outcomes as well as uptake. If more patients are to reap the genuine benefits of SDE, the way NHS organisations manage and deliver diabetes education must evolve to capture a wider audience.
There are a growing number of high-quality education programmes available, provided in a face to face setting or as a digital offering and, with the revised Long Term Plan reinforcing NHS England’s commitment to education pathways, more innovation is likely to emerge in the future.
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WWW.CLINICALSERVICESJOURNAL.COM NOVEMBER 2019
Nadine Miles, director of market development at Spirit Health
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