Newham, east London is the youngest borough in the UK with 40%
of the population under 25 years old and more than 60% from
ethnic groups. This leads to a high prevalence of type 2 diabetes, in
young people. As a national pilot site for You're Welcome (DH 2010),
Barts Health obtained feedback from patients and carers through
focus groups and found that the three contributors to poor self-management were: poor/inflexible access
to care; need for peer support; and lack of patient champions. To address this, the team pioneered the
use of online diabetes follow-up via Skype, developed a local peer-support group funded by UCLPartners
to provide a social platform for young people to discuss issues affecting self-management, and obtained
funding for a youth champion to facilitate the peer-groups and help redesign the clinical service.
The prevalence of diabetes in Newham is around 5-6 times the national average, due largely to the
local BME population. It is also the youngest borough in the UK and the sixth most deprived in the UK.
A paediatric diabetes service had provided excellent diabetes care for children in Newham since 1986.
However, transition to adult services was poor. The complex needs of adolescents and young adults with
a chronic illness like diabetes was difficult to address in routine clinics. Non-attendance rates were high
with increasing levels of patient and staff dissatisfaction. Even after the establishment of a monthly
diabetes clinic in 2005, DNA rates continued to remain high (33-50%) with poor clinical outcomes.
To make the transition from paediatric care more user-centred by improving access to
services, developing a more holistic model of care that addresses the complex needs of
young people and strengthening young people's ability to manage their diabetes.
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