Healthwatch Sandwell- Diabetes in Sandwell
In March 2024, Healthwatch Sandwell published its report into Diabetes in Sandwell, a priority project it had completed in partnership with Diabetes UK. Here is a summary of the project:
Healthwatch Sandwell is an independent organisation that champions the voice of Sandwell residents in their health and social care services. Experiences and insight gathered from engaging and listening to people is shared with health and social care providers and commissioners to help inform and improve services.
10.1% of Sandwell adult patients are recorded as having diabetes exceeding the West Midlands average of 8.2% and the national average of 7.3%.
Sandwell figures are projected to increase to 11.4% by 2030.
Successful management of living with diabetes and reducing associated health risks requires patient and health care services to work together. NHS healthcare services have a responsibility to ensure patients are offered diabetes management education, so that they are well informed and able to be involved in managing their condition and decisions about their care, including medications. The National Institute for Health and Care Excellence (NICE) guidance also recommends an individualised approach, is required to meet any patients’ needs and circumstances including dietary advice, culture and beliefs.
Diabetes UK research highlights concerns around diabetes complications and care in the older population, especially frail elderly.
Also that some ethnic groups are at higher risks of development of diabetes and at an earlier age than the White population including African, African Caribbean and South Asian communities (Indian, Bangladeshi and Pakistani).
Raising awareness of diabetes in communities and prevention work with patients diagnosed as prediabetic is key to minimizing risk of development of type 2 diabetes and reducing the percentage of patients with diabetes in Sandwell and consequent demand on diabetes health care services.
Healthwatch Sandwell worked in partnership with Diabetes UK, some Voluntary Community Organisations and NHS primary care services to engage with Sandwell residents affected by diabetes and pre-diabetes to gather the picture for Sandwell.
The key findings have informed the recommendations which include:
• Increased information promotion, awareness raising and education on diabetes and risks
• A holistic partnership approach to diabetes prevention and risk reduction services
• Improvements to health care services including staff diabetes awareness training
• A focus on meeting specific needs for groups at higher risk of developing diabetes or challenges with managing the condition
• Increases in support services for individuals and communities living with and managing diabetes
The main body of the report (pages 5-41) includes an overview of health care services for pre-diabetes and diabetes, patient experiences and feedback on services and of self-management of the condition.
Sandwell residents and patient voices and views are included in the main report.
Conclusions
“Prevention is better than cure!”
A focus on increasing awareness and education of diabetes risks within Sandwell communities, through targeted work, is key to reducing growth in the number of patients living with type 2 diabetes in Sandwell in the future and subsequent impact on health care resources.
Quality information about diabetes and risks, in a variety of formats, needs to be visible and accessible across Sandwell for all members of the population. Working in a holistic partnership approach can ensure this and tailor focused services to groups with higher risks of developing diabetes or those struggling to self-manage the condition for reasons highlighted within the report.
Findings in the report, capturing patient feedback and monitoring of diabetes health care checks performance, will help identify areas for improvement and gaps in services requiring development, for example dietary advice services and mental wellbeing support.
Health and wellbeing support services are available across Sandwell. This report highlights a need for continuing Sandwell Council public health community outreach services and to developing a strategic approach to help ensure individuals and communities in Sandwell feel connected, supported, enabled and empowered to be able to take appropriate levels of responsibility for their own health and wellbeing.
Through a preventative agenda focus it should be possible to reduce the percentage of new patients diagnosed with type 2 diabetes, and the current poor performance levels, compared to regional and national average across Sandwell. Healthwatch Sandwell hopes the patient voices and findings reflected within this report have helped to demonstrate that.
Recommendations
Healthwatch Sandwell request that Sandwell Health and Wellbeing Board, Sandwell Health and Care Partnership and Black Country Integrated Care Board:
Consider and formally acknowledge the Diabetes report findings and respond to the proposed recommendations including confirming responsibility and accountability procedure for any service improvements.
The report recommendations have been categorised and presented in the next pages. They have been identified and informed by the project findings and feedback from Sandwell residents and are included within the main body of the report in the relevant locations.
Sandwell Health and Wellbeing Board
1. Consider the diabetes report findings and with Sandwell Health and Care Partnership identify a partnership approach to developing improvements to diabetes services and holistic support for Sandwell residents and communities in managing the condition and risks.
Sandwell Health and Care Partnership
2. Consider the extent of diabetes risk and prevention information visibly available across Sandwell, including accessibility of formats to meet needs, and seek to increase supply, distribution, promotion and up-take of information.
3. Consider the feedback from pre-diabetes patients and explore opportunities and feasibility for development of a pre-diabetes support contact service.
4. Ensure that all patients diagnosed with diabetes receive the Diabetes UK booklets on “What care to expect” and are clear about the annual diabetes health checks appointment booking procedures.
5. Note the findings in this report, review the dietician and nutritionist service offer available in Sandwell for supporting people with diabetes, and identify and make improvements.
6. Consider the findings relating to elderly people and potential impacts on management of diabetes identifying any possible improvements to care and support services for patients and family carers.
7. Consider the initial findings in this report and plan to engage with patients during and post gestational diabetes to help inform and improve services and patient diabetes risk awareness and management.
8. Consider the feedback on support groups and identify opportunities for increasing the offer across Sandwell, ensuring all support groups are adequately trained and supported with diabetes resources.
9. Consider feedback from patients on mental wellbeing within the report and identify opportunities for increasing the support offer at diabetes diagnosis and during patient self-management of the condition.
10. Consider the insights relating to men managing diabetes and identify opportunities for targeted engagement and support for diabetes management.
11. Consider the findings in this report relating to ethnic communities at higher risk of diabetes and develop a collaborative action plan for improvements in diabetes health, care and support services offers, including targeted diabetes awareness raising, information provision and risk screening.
12. Enable and empower local communities at “grass roots” level on awareness raising of diabetes prevention and risk management and practically support initiatives for living healthily with diabetes.
Black Country Integrated Care Board
NHS health care service commissioners:
13. Review procedures for pre-diabetic patients who have not received at least an annual HbA1c blood test and address gaps.
14. Consider procedures to ensure all patients registered with diabetes are receiving the full range of diabetes checks.
15. Consider the patient feedback relating to diabetes health checks and identify opportunities for improvements to services, including a continuation of diabetes awareness raising and training within primary care services.
Service commissioners:
16. Consider outcomes monitoring for referral, uptake and patient satisfaction of diabetes prevention programmes, ensuring service delivery is personalised to meet needs.
17. Consider the report findings and extent of information provided to patients diagnosed with diabetes, identify and deliver improvements, ensuring individual needs are met.
18. Review process and extent of diabetes patient referral to structured education courses through NHS health care services including uptake and quality checking through patient satisfaction feedback.
19. Explore opportunities for development of a Diabetes Community Champion programme delivered through Diabetes UK, identifying target communities and delivery partners with Sandwell Health and Care Partnership.
Please click here to read the full report: https://www.healthwatchsandwell.co.uk/sites/healthwatchsandwell.co.uk/files/1.%20Diabetes%20in%20Sandwell%20Final%20Report%20PDF.pdf