Mapping Diabetes against
the needs for London
Leena Sevak: National Improvement Lead, NHS
Improving Quality – Delivery Team
Challenge:
National reduction in amputations by
50% in 5 years
Overall objective:
To see diabetic foot care pathway
included in the Joint Strategic Needs
Assessment on the Health and
Wellbeing Board
Nationally agreed outcomes 2012
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Implementation of integrated foot care pathway
MDT/FPT group established in each district, including
commissioners and service users
Ensure competencies in HCPs including ulcer
awareness, patients education on diagnosis, patients
know risk status
Engage commissioners in the network
24/7 facility for receiving foot care patients by a
competent member of MDT team and seen within 24
hours by the foot care specialist team.
Map foot care services in primary, community and
acute sectors to identify gaps
Participate in foot care audits
Root cause analysis for minor & major amputations
Domain
Indicators
Preventing people from dying prematurely
Domain 1
1a Potential Years of Life Lost
(PYLL) from causes considered Reduce diabetes related amputation rates by 50%.
amenable to healthcare
Prevention and early detection of foot ulcers in primary
care & support of people with diabetes to self- care.
Increase GP & CCG participation in NDA and National
Foot Audits.
Reduce emergency admissions for diabetic foot
problems.
Footcare Educational and Training Programme in Care
Homes
Better footcare and risk factor awareness
ii.Potential years of life lost
(children and young people)
Prevention and early detection of foot ulcers in primary
care & support of people with diabetes to self- care.
1b Life expectancy at 75
i males
ii Females
Reduce diabetes related amputation rates by 50%.
Increase GP & CCG participation in NDA and National
Foot Audits.
Footcare Educational and Training Programme in Care
Homes
Increase GP & CCG participation in NDA and National
Foot Audits.
Increase GP & CCG participation in NDA and National
Foot Audits.
Treating and caring for people in a safe environment
and
protecting them
from avoidable harm
Domain 5
5a. Patient safety incidents
reported
Reduce diabetes related amputation rates by 50%.
Prevention and early detection of foot ulcers in primary care
& support of people with diabetes to self- care.
Increase GP & CCG participation in NDA and National Foot
Audits.
Increase foot examination in people with diabetes admitted in
hospitals to more than 70% of patients admitted with
diabetes (currently 26%) & implement inpatient foot care
pathway.
Reduce emergency admissions for diabetic foot problems.
5b Safety incidents involving Footcare Educational and Training Programme in Care
serious harm or death
Homes
Increase GP & CCG participation in NDA and National Foot
Audits.
5c. Hospital deaths
attributable to problems in
care
Reduce emergency admissions for diabetic foot problems.
5.3 Incidence of newly
Implementing effective foot risk surveillance
acquired category 2,3,4
Footcare e-learning module
pressure ulcers
Opportunities
• Alignment between Public Health, NHS & Adult
Social Care Outcome Frameworks
• Prevention & early detection NHS England
priority
• Integration of health & social care
• Public health integrated in LA with reach in
local communities – opportunity for self-care
• Health & Wellbeing Boards driving health
improvement – influence CCGs & primary care
Recent Developments & foot care
• Strategic Clinical Networks – setting
local priorities
• CVD Outcome Strategy – driver for
integration of heart, diabetes, stroke
and renal
• Academic Health Science Networks
• NHS England & NHS IQ - Integrated
care pioneer sites
Resources
www.diabetes.nhs.uk http://webarchive.nationalarchives.gov.uk/2
0130513172055/http://www.diabetes.nhs.uk
www.kidneycare.nhs.uk http://webarchive.nationalarchives.gov.uk/2
0130504185629/http://kidneycare.nhs.uk