TRAINING & EDUCATION
education services that respond to evolving patient expectations, diverse patient demographics and changing needs. This default to a single provider, can lead to inflexible or inaccessible programmes that cater for ‘the many’ but isolate hard-to-reach communities. Models are often configured to accommodate ‘low hanging fruit’ but don’t address the lifestyle and socio-economic challenges of diverse populations – all of which are known to influence behaviour change and human decision-making. The repercussions are reflected in attendance: if a course is at the wrong time of day, in the wrong location or the wrong language, patients won’t turn up. And if they do, they won’t get an experience that delivers optimal value. Similarly, some CCGs set up services to comply with NICE recommendations, focusing entirely on newly diagnosed patients. This typically means that long-standing diabetes patients miss out on valuable education and local health economies pay the price in avoidable hospital admissions, costly prescribing and the ‘expensive complications’ associated with diabetes. The focus on new diagnoses is understandable – it makes
sense to catch people early – but it minimises the value and impact of SDE and its ability to influence lifestyle behaviours in existing patients. And many people take a while to settle into the reality of what diabetes means for them, and may be more receptive to education programmes a year or so after diagnosis.
Fit-for-purpose not one-size-fits-all
As the cost of diabetes escalates and the impact on health services intensifies, CCGs must overcome a number of challenges if they’re to reap the rewards of SDE. Fundamentally, they must review their current approach and design an infrastructure that enables deserving patients to access programmes that meet their needs.
The considerations are many: if only 20% of the UK’s diabetes patients have had diabetes education, how do you get it to the patients that you’ve missed? How do you ensure your programmes suit the ‘needs of the person’ and get to hard-to- reach communities? And, ultimately, how can you ensure that education isn’t just being ‘commissioned’ but is being
The most effective CCGs treat diabetes education as an ongoing endeavour, systematically reviewing and adjusting their SDE strategies to ensure services are tailored to population needs.
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‘implemented effectively’? If the NHS is to improve diabetes outcomes, the huge gap between the ‘offer’ of education and the health outcomes after attendance must be closed. But the conventional approach – relying on standardised models and potentially inflexible single providers – won’t close it.
The answer is all about agility and choice. The most effective CCGs treat diabetes education as an ongoing endeavour, systematically reviewing and adjusting their SDE strategies to ensure services are tailored to population needs. Success requires working with a range of providers to offer patients choice. The best providers will take a
partnership-based approach and work closely with customers to design flexible programmes that respond to identifiable needs. Moreover, they’ll provide end-to-end support – from the offer of education right through to implementation and outcomes – to drive attendance and inspire sustained behaviour change. Ultimately, diabetes education isn’t one-size-fits-all. It’s time for CCGs to broaden the scope of SDE provision to deliver programmes that improve T2D care not just for the few, but for everyone.
References
1
https://www.bbc.co.uk/news/health-46139595 2 National Diabetes Audit Report 1 Care Processes and Treatment Targets 2017-18 https://
digital.nhs.uk/data-and information/ publications/statistical/national-diabetes- audit/report-1-care-processes-and-treatment- targets-2017-18-short-report
NOVEMBER 2019
CSJ
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