There are over 19,000 people with diabetes in North East Essex, with prevalence 5.6% higher than the national average. The traditional hospital model was unsustainable. Multiple providers created a confusing system and duplication of care led to rising costs and increased pressure. Suffolk GP Federation won a competitive tender to deliver a new, clinically led integrated model of care under the North East Essex Diabetes Service (NEEDS). Launched in 2014, the aim was to improve diabetes outcomes, moving the region from the bottom to the top quartile within five years. The contract was to be delivered under the 2012 spend of £2 million, with 25% of the value subject to meeting key performance indicators. Suffolk GP Federation implemented a framework acceptable to GPs which led to full dissemination. The model has seen diabetes care transferred away from hospitals into a community setting, including a new role for consultants, supporting GP practices and providing governance. Services are now easier to access and understand for patients, which has led to better outcomes and improved self-management.
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