A Patient - Centred NHS
- How MCN’s Do It
Carole Morrison, Diabetes MCN Manager
Caroline Craig, Diabetes Specialist Nurse
SHIFTING THE
BALANCE OF CARE
INFORMING THE DEVELOPMENT
OF AN INTERMEDIATE MODEL OF
DIABETES CARE – A NEEDS
ANALYSIS
Structured
Patient
Education
Patient
Held
Records/Self
Management
DIABETES MCN
Referrals back
to
Primary Care/Stable
Patients
DSN
Posts
Complex
Therapies
NEEDS ANALYSIS
AIMS
• To determine the current diabetes service provision/standard
within General Practices in order to determine how DSN’s
can best support the needs of General Practices in order to
enhance services to patients with diabetes
• To obtain views from General Practices on how future
diabetes services should be provided locally in order to shape
and shift the balance of care in the most appropriate way
RESULTS AND
RECOMMENDATIONS
OF NEEDS ANALYSIS
Informed our understanding of the level of service provision
Highlighted specific reasons for referral to secondary care and how
this can be better managed
Identified a number of barriers within general practices which impinge
on their aspirations and ability to provide quality diabetes care
Contributed to how DSN’S can effectively support general practices
and work effectively in partnership with them
Education and training needs of general practices identified
RECOMMENDATIONS: FURTHER ENHANCE INTEGRATED INTERMEDIATE
MODEL OF DIABETES CARE TO DELIVER IMPROVED SERVICES FOR PEOPLE
WITH DIABETES.
ACHIEVING
THE SHIFT
•
•
•
•
•
MCN objectives and priorities now
better aligned to planning group
agendas – BOC/Service
Redesign/LTC
Performance Management – clear
objectives /timescales/reporting
format required of MCN
Need for Quantitative data as well as
Qualitative data to provide evidence
of shift
Influencing change within MCN
through appropriate representation
Influencing change at CHP level
through
MCN
Management
representation on CHP groups
•
•
•
Involvement of MCN patient focus
group members in service re-design
and priority setting – listening and
responding to what is important to
them
Effective relationships / team
working and clinical leadership
Improved recognition of the role and
skills of the DSN and other members
of the MDT and their contribution to
the work of the MCN