Issue - meetings

Susan Lloyd, LBBD Consultant in Public Health, presented the report and explained the difference between the different types of diabetes and the actions needed to identify and treat diabetes and to reduce the secondary complications and issues which it causes. 

There had been significant improvements in diabetes care in the community over the past year and the report provided details of the progress to-date and the future partnership working that would be needed to achieve the desired continued improvements.  The prevention of diabetes was becoming a significant driver to reduce pressures on care and health services and the community and to improve the wellbeing of those that are, or could become affected by the condition.  Next year a preventative programme would be started to identify and check individuals that had the risk factors for developing the disease and to encourage lifestyle changes that can reduce or remove their risk.  A mixed commissioning approach would also encourage closer working between primary and secondary health care.  The Board was advised that the levels of type 1 were quite low compared to the national average, however, type 2 had a higher than national incidence rate with around 13,300 individuals currently being treated.  In addition, there was an estimated 10,000 residents at pre-condition stage and potentially at risk of going on to develop diabetes type 2.  The Borough also had significantly higher ethnic / demographic risks than the national average.  Sue explained that £4.3m is spent on diabetes medication alone, which is 15% of the total prescription medication costs for the Borough, and there are also significant and indirect costs, e.g. social care and lost work attendance.  Susan also clarified that an average of 10% was used as it was not possible to attribute costs because many individuals had multiple conditions.  However, what was clear was that the prevention of developing diabetes and reduction of complications, such as foot amputations, would produce significant financial savings: but more importantly the life style and of individuals would be positively enhanced.

The Board noted that 27 GP Practices had been approached but so far only two had responded to the on-line services trial.  Dr Waseem Mohi, Barking and Dagenham Clinical Commissioning Group (CG) stressed that the changes undertaken in one year were considerable, and were more than had been achieved in 10 years or more in other boroughs.  A cohort of some 20,000 individuals with potentially controllable and pre-diabetes were being targeted.

The results of the changes would be seen in five to ten years, when amputations, blindness and hospital admissions and care costs were reduced. 

In response to a question from Anne Bristow as to why we were only getting half of the eight processes and what the barriers were, Dr Mohi explained that we needed incentives to push change and that was now starting to have an impact, however, it needed to be noted that GPs in the Borough have on average 1,000 more patients that national average.  There was clearly a spend to save  ...  view the full minutes text for item 36