The overall aims of the scheme were to improve collaborative care between clinical staff and patients, systems and processes of care and biological outcomes for people living with diabetes by reducing variation between practices and improving the performance of all practices. Practical tools and guidelines supported the scheme. Over the last two years, during a period of unprecedented change in the NHS, care for people with diabetes in Lambeth and Southwark improved significantly.
Lambeth and Southwark’s population presents with diabetes at an earlier age and at a more advanced stage than elsewhere in England. Prevalence is lower but people are living longer with diabetes.
In 2011/12, NHS Lambeth and NHS Southwark Clinical commissioning Groups (CCGs) achieved population control for HbA1c < 64mmol/mol of 67.7% and 67.8%, respectively. Despite improvements, both remained in the bottom quartile in England, and variation between practices ranged from 44% to 85%.
The Diabetes Modernisation Initiative (DMI) is a charity-funded initiative to improve diabetes-related health outcomes in Lambeth and Southwark. In early 2012, it developed a focused programme of work in primary care.
In 2012, the DMI developed and launched a scheme in partnership with Lambeth and Southwark CCGs. Achievement was linked to a small financial reward equivalent to a maximum of £200k across both CCGs. The overall aim was to improve collaborative care between clinical staff and patients, systems and processes of care and biological outcomes for people living with diabetes, by reducing variation between practices and improving the performance of all practices.
The scheme had the following objectives: to improve patient experience; to develop and improve sustainable systems and processes; and to improve biological outcomes. It was also designed to improve effectiveness of care, reduce the burden on healthcare resources and engage and support primary care staff.
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