scholarly journals Integrated diabetes care: The Association of British Clinical Diabetologists (ABCD) national survey report

2021 ◽  
Vol 21 (2) ◽  
pp. 272-280
Author(s):  
Dinesh Kumar Nagi ◽  
Susannah Rowles ◽  
Andrew Macklin ◽  
Umesh Dashora ◽  
Heather Oliver ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetes Care ◽  
Annual Review ◽  
Clinical Integration ◽  
Current State ◽  
Survey Report ◽  
It Systems ◽  
It Integration ◽  
One Stop ◽  
The Uk

Executive Summary A national survey on integrated diabetes services was carried out by the Association of British Clinical Diabetologists (ABCD) during the COVID-19 pandemic and has provided some very useful insights into the current state of integration to deliver a joined-up diabetes service in the UK. This survey was carried out during the second half of 2020 and explored three main areas: (1) current state of clinical integration between primary and secondary (specialist) diabetes services; (2) the state of IT integration among the diabetes IT systems and hospital-based electronic patient records (EPR) and between hospital and primary care; (3) to ascertain the membership of their views on a ‘one-stop service’ for collecting annual review data for diabetes and the potential barriers to achieve this. The results presented are a summary of the survey, while the full unedited survey report, especially on the qualitative aspects, is available to ABCD members. The survey was mailed to 518 individuals, of which 431 (83.2%) were consultants and 53 (10.2%) were specialist registrars. Of the 83 replies received, 98% were from consultants and the responses represented a total of 73 hospital diabetes services. The findings of this survey revealed that full integration of clinical services among primary care and specialist diabetes teams is uncommon, although there are good examples of clinical integration in different formats. In a number of areas, primary care and specialist diabetes services continue to work in silos despite a universal recognition that integrated services are desirable and are likely to improve quality of care. Clinical leadership, resources and buy-in from those who commission services were deemed important factors to help improve the development of integrated care systems. In hospitals with dedicated diabetes IT systems the information flow from these diabetes systems to the EPR was not universal, raising concerns that vital information about an individual’s diabetes may not be available to other hospital clinical specialities at the time of delivery of care, posing a significant clinical risk. IT integration among primary and specialist diabetes teams in England was only available in certain areas and was mostly based around the use of SystmOne. The survey also identified a diversity of opinions regarding the current arrangements of the Quality Outcome Framework (QOF), where GPs are incentivised to collect data for annual review of routine diabetes care. Many were of the opinion that annual review processes should be performed by clinical teams who are tasked to deliver diabetes care to the individual, while others felt that the status quo should continue with primary care GPs being responsible. A one-stop service for eye screening for diabetes and other annual measurements nearer to people’s homes was identified as an improvement, but several logistic barriers were identified. We recognise the limitations of any survey which expresses opinions of participants. However, we believe the present survey represents a significant proportion of diabetes units in the UK and provides insights into the current state of integrated services in diabetes. There are significant learnings for diabetes communities, and the information can be used to improve and galvanise delivery of integrated diabetes care in the UK.

Type 2 diabetes in primary care

2017 ◽  
Vol 10 (12) ◽  
pp. 705-712
Author(s):  
Hermione Price
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Care ◽  
Cost Savings ◽  
Patients With Diabetes ◽  
The Uk

Type 2 diabetes is common, and its prevalence is increasing. Most patients with type 2 diabetes are managed entirely in primary care. The National Diabetes Audit has provided evidence of large variations across the UK in the standard of available care in the community for patients with diabetes. Good diabetes care can prevent or delay complications and, as well as cost savings, this results in a better quality of life for patients. This article provides an overview of type 2 diabetes and the National Institute for Health and Care Excellence guidance for treatment proposed in 2015.

The Mass Knee Clinic: a new NHS outpatient care model showing clinically led transformation in practice

2020 ◽  
Vol 7 (1) ◽  
pp. 117-122
Author(s):  
Lily Li ◽  
Sam Nahas ◽  
Rajan Jandoo ◽  
Sarah Williams ◽  
Haddon Paul Lionel Ganippa ◽  
...  
Keyword(s):  
Primary Care ◽  
Waiting Times ◽  
Cost Savings ◽  
Improve Patient Care ◽  
Wait Times ◽  
Junior Doctors ◽  
One Stop ◽  
The Uk ◽  
Training Opportunities ◽  
Improve Patient

BackgroundThe Mass Knee Clinic is an innovative, patient-focused and efficient clinic introduced into our hospital in April 2017. The UK Government has mandated referral-to-treatment (RTT) time for patients to be within 18 weeks to improve patient care. The new clinic involves seeing high numbers of patients by amalgamating all new non-traumatic knee disorders (up to 200) from primary care into one clinic day every 6 weeks. The premise and success of the clinic is multifactorial and involves focused multidisciplinary consultant-led care in every case, training opportunities for junior doctors, a ‘one-stop shop’ for patients allowing them to be seen by a consultant, physiotherapist and receive a date for surgery all in 1 day, and subspeciality consultant presence, preventing multiple reattendances.MethodsWe present the results of prospectively collected data on wait times to clinic, time-to-treatment and outsourcing of new referrals, 1 year after the initiation of the new clinic model (n=56). This data was compared with data 1 year prior to the Mass Clinic being introduced (n=56).ResultsTime from primary care referral to first Orthopaedic review was reduced from median 13.5 weeks to 11 weeks (statistically significant (p=0.00512)). RTT was reduced from median 30.5 weeks to 15.5 weeks (p<0.01), allowing a significant reduction in waiting times for the patient. Outsourcing was eliminated, and the number of appointments per patient also halved.ConclusionsThe new Mass Clinic with focused consultant-led care and multidisciplinary approach has led to significant reductions in patient wait times and cost savings for the hospital.

scholarly journals Identifying People with Dementia in Electronic Primary Care Records in the UK

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Kang ◽  
S Lewis ◽  
J Gladman ◽  
V Wardt ◽  
J Gibson
Keyword(s):  
Primary Care ◽  
Incidence Rates ◽  
Health Improvement ◽  
Annual Review ◽  
Presenile Dementia ◽  
Broad Definition ◽  
Diagnostic Codes ◽  
People With Dementia ◽  
Definition Of ◽  
The Uk

Abstract Background Many epidemiological questions need to be answered regarding dementia, including the causes, prognosis, comorbidities, and treatment of the condition and complications. A routine electronic primary care dataset provides a way of investigating some of the complicated factors with rich information. However, there has been concern regarding whether dementia is recorded well enough. Methods This study has therefore explored this by conducting a systematic review to understand how dementia has been identified previously in primary care databases in the UK, and added to this by exploring additional terms and symptoms, and medications that might be helpful in identifying people with dementia. The study estimated the prevalence and incidence rates of dementia in The Health Improvement Network (THIN) database and compared with other longitudinal studies using the comprehensive list of diagnostic codes. Results The estimated incidence rates per 1,000 person-years for the 60+ age group who had any of the first diagnosis among the Quality Outcomes Framework (QOF) defined codes, Other diagnoses, Dementia symptoms and Prescribed medications were 2.5, 4.7, and 15.9 in 1995, 2004, and 2015 respectively. The estimated prevalence were 2.8, 3.2, and 10.2 in 1995, 2004, and 2015 respectively. Conclusions The codes related to dementia symptoms (represented by mini-mental state examination, the six item cognitive impairment test, referral to memory clinic and behaviour assessment) seem to cover a broad definition of dementia or pre-existing dementia population in the UK primary care records. At least, using of the Other diagnoses (represented by dementia annual review, senile/presenile dementia and dementia monitoring) in addition to the QOF defined codes, and Prescribed medications were evidenced that will not missing out a number of people with dementia. Key messages The codes related to dementia symptoms seem to cover a broad definition of dementia or pre-existing dementia population in electronic primary care records in the UK. Nevertheless, the codes about non-specific or temporary symptoms may need to be used carefully as it is possible for memory or cognitive function to be impaired temporarily due to other factors.

French and Spanish Queer Film

2016 ◽  
Author(s):  
Chris Perriam ◽  
Darren Waldron
Keyword(s):  
Focus Groups ◽  
Sense Of Community ◽  
National Identities ◽  
Audience Research ◽  
Large Sample ◽  
Current State ◽  
Trans People ◽  
Screening Questionnaires ◽  
On Line ◽  
The Uk

This book advances the current state of film audience research and of our knowledge of sexuality in transnational contexts, by analysing how French LGBTQ films are seen in Spain and Spanish ones in France, as well as how these films are seen in the UK. It studies films from various genres and examines their reception across four languages (Spanish, French, Catalan, English) and engages with participants across a range of digital and physical audience locations. A focus on LGBTQ festivals and on issues relating to LGBTQ experience in both countries allows for the consideration of issues such as ageing, sense of community and isolation, affiliation and investment, and the representation of issues affecting trans people. The book examines films that chronicle the local, national and sub-national identities while also addressing foreign audiences. It draws on a large sample of individual responses through post-screening questionnaires and focus groups as well as on the work of professional film critics and on-line commentators.

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