The team developed a single structured diabetes education group programme specifically meeting the needs of people newly diagnosed with type 2 diabetes. This was put in place alongside a complementary referral process whereby all patients referred to the dietetic department at diagnosis of type 2 diabetes can access a group place on average within 28 days, and receive four times more dietetic input than previously. Patients take part in a single group session that lasts two hours, with two group sessions per month each with a capacity for 10 people. Patients are able to implement self-management changes prior to their review by the primary care team, which takes place at about three months after diagnosis.
An estimated 5% of the UK population has diabetes, with 90 % experiencing Type 2. Treating diabetes, including associated complications such as blindness, haemodialysis, amputation and cardiovascular events, accounted for approximately 10% of the 2012 NHS budget.
NICE Clinical Guidance 66 (2009), Type 2 diabetes, stated that SDE should be available at diagnosis, and ongoing, for patients and their partners/carers, to empower them to self-manage and prevent complications as much as possible. But in that same year, across the Betsi Cadwaladr University Health Board, patients waited up to 14 weeks after referral for a 30-minute dietetic consultation in a clinic. The service received approximately 150 adult out-patient referrals a month for newly diagnosed Type 2 diabetes (excluding people in care homes).
The initiative aimed to provide appropriate evidenced based education in groups, targeting the needs of most people at diagnosis of Type 2 diabetes.
Each group could be quality assured and audited to ensure consistently high quality teaching from suitably trained dieticians. Referrals and bookings were audited to ensure that patients waited less than 30 days for a place in a group, and that appropriate patients were referred. Alternative venues could be offered where necessary.
The group approach, involving up to 10 patients at a time, would immediately release the staff needed to lead the groups, and allow other services to be developed. It was anticipated that patients would become confident in accessing group education, and would accept this as a normal part of their diabetes self-management. They were also directed to the XPERT patient programme, for more detailed ongoing education.
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