Peer review of diabetes foot services in the South West
by South West Cardiovascular Clinical Network
Read the case study
Reduction of lower limb amputations as a result of diabetes has been a main priority of the South West (SW) Cardiovascular (CV) Strategic Clinical Network (SCN). A standardised Peer Review of foot care services for diabetes patients across all 14 acute trusts and 11 Clinical Commissioning Groups (CCGs) within the South West SWSCN has evolved over 4 years. Its aim was to understand the variation in practice, establish compliance with NICE standards, identify and share good practice and make recommendations for change and improvement. Provisional data shows a significant reduction in the number of major amputations across the South West in 2015.
"This demonstrated a good investment in staffing and it was excellent to see patient involvement via in depth interviews to give the patient perspective. There have been amazing changes in services since the audit, which has resulted in reduced amputations. Peer review of service is something to actively encourage."
Screening for new onset diabetes following Acute Coronary Syndrome – the way forward?
by Sandwell & West Birmingham Hospitals NHS Trust
Read the case study
Disturbances of glucose metabolism and diabetes are widely prevalent in acute coronary syndrome (ACS) and relate to adverse outcomes. The City Hospital (SWBHT) team developed a protocol incorporating a random, post-admission HbA1c diagnostic blood test for patient with ACS. All HbA1c results were sent directly through to Diabetes Department via the Think Glucose (TG) electronic system on iCM and patients were subsequently invited for a repeat HbA1c at two weeks. As a result of this simple and inexpensive tweaking of an electronic system, the team accurately estimated new onset diabetes in high-risk post ACS patients, who would otherwise have been missed.
"Screening for high risk individuals is important. This is a good project and has been done well, especially picking up people with undiagnosed diabetes, or those with poor glycaemic control. Wider recognition of this simple intervention should be encouraged.