Brief for Susan Heyman, Executive Sponsor, Diabetes Clinical Stream
July 2013
Background
The Diabetes Clinical Stream was established in October 2008, currently sitting within the
Chronic Disease Network. The Diabetes Stream Leadership Group progresses the shared
vision and strategy for diabetes across the HNELHD area. The HNE Diabetes Services
Plan 2008-2012 has supported the management of diabetes in adults across all care
settings and both the current Diabetes Integrated Adult Framework and an updated
Diabetes Services Plan drives new Stream initiatives.
The current Stream Leadership group membership comprises people from all disciplines
and geographical areas and has representation from primary care.
Recent Achievements
 The Chronic Disease Management System, with diabetes services as the forerunner, is
utilised in the Diabetes Young Peoples’ Clinic.
 Diabetes pathways are included in Health Pathways in collaboration with Hunter
Medicare Local (HML).
 The Diabetes Stream collaborative space (portal) contains accessible, up-to-date
information about diabetes care and services in the area
 The Stream newsletter, Dialogue, provides information about diabetes issues and
Stream activities District-wide.
 District-wide Clinical Practice Guidelines (CPG) for treating hypoglycaemia, treating
diabetic ketoacidosis, blood glucose monitor use, and HbA1c point of care testing have
been developed with a peri-operative guideline currently in development.
 Health Professional Clinical Forums are offered - forums in Tamworth in 2012 and 2013
and a forum in Newcastle, jointly organised with the Hunter Post Graduate Medical
Institute (HPMI), were well attended by general practice staff in October 2012 in
Newcastle. Another HPMI collaborative forum is planned for October 2013 and an
update day is also planned for acute sector clinicians in Newcastle.
 The ComDIAB training program, developed by the Australian Diabetes Council has
been attended by a number of staff across the area, training them to offer group
diabetes education in areas of need.
 The Diabetes Stream is committed to enhancing the provision of diabetes services for
Aboriginal people across the District, with representation at a Network/Stream coordinators meeting to facilitate better alignment between the streams and networks and
Aboriginal health services.
 Linkages have been developed with the Agency for Clinical Innovation to establish a
pathway at state level for diabetes and endocrine issues.
 The Stream is continuing its links with the YOuR Diabetes research project.
Barriers
 The scope of the Diabetes Stream is strategic rather than operational, due to the lack of
a working budget and designated resourcing. All contributions to Stream initiatives,
including attendance at meetings and actions arising from them, are additional to their
substantive job demands. These contributions are possible only of course with the
approval of their line managers and executive sponsorship.
 The Stream Leadership Group has identified a number of gaps in service delivery and
standards of care that it feels are a apriority to address. New initiatives, including a
district-wide standard of care, are envisaged, with a first step being the recognition of
triage criteria that will apply in all services to diabetes patients. Work on this has just
commenced, and will be supported by the Health Pathways project. A number of
medical clinics targeting particular clients have been established or expanded in recent
times, but ongoing resourcing and support is needed. Other initiatives such as
establishing designated Diabetes Educators in major hospitals across the district are
also resource dependent.