North-East London Type 1 Diabetes Transformation (NATALIE) Project
by North-East London (NEL) Sustainability and Transformation Project (STP)/Barts Health NHS Trust/Homerton University Hospital/Clinical Effectiveness Group
The NATALIE project aimed to reduce variation in access, outcomes and experience for people with Type 1 diabetes (T1D) and improve outcomes. The initiative encompassed North-East London (NEL) Sustainability and Transformation Project (STP), Barts Health NHS Trust and Homerton University Hospital’s Clinical Effectiveness Group. A region-wide, cross-sectional audit of where people with T1D accessed care was undertaken, resulting in the NEL T1D Primary Care Toolkit, a High-Risk register, a T1D cluster primary/secondary MDT and the use of a novel T1D app. The Toolkit improved the accuracy of coding, increased structured education uptake, and secondary care access, plus improved outcomes.
"This entry was the overwhelming favourite for the patient care pathway category. The judges were impressed with the patient-centricity, alongside the data-driven and evidence-based approach employed by creators of this entry. It used multiple initiatives with an excellent steer on quality improvement which continued during the COVID-19 pandemic. They were pleased to see the impact the app made when it was used. In addition to this, the judges noted the excellent focus on innovation, DE&I and dissemination. A very well-executed and comprehensively written submission."
Pharmacist Led GLP-1RA Initiation Clinic in a GP Practice
NHSAAA diabetes care was improved by a diabetes specialist pharmacist, who began initiating Glucagon-like peptide 1 receptor agonists (GLP-1 RA) at her weekly diabetes clinic in a GP practice. The aim was to reduce inequalities in access to medicine and poor patient outcomes as a result of delayed treatment. This innovative service was offered to patients who fulfilled the criteria of the Scottish Intercollegiate Guidelines Network (SIGN). They were initiated on GLP-1 RA within 2-3 weeks of first being offered this treatment.
"The judges all agreed on the excellent use of resources for this entry, specifically mentioning the use of pharmacists, especially during COVID-19. The judges also commented on the variety of languages used and mentioned the diversity and equality angles, showing how to get people onto medication when they needed and highlighted how preventative support with primary and specialist can help patients avoid having to seek secondary care. Moreover, the judges said that entry felt powerful in terms of legacy as a lone agent of change."
Improving Cardiovascular Outcomes for People with Diabetes in North East Essex
by North East Essex Diabetes Service (NEEDS)
North East Essex Diabetes Service (NEEDS) reviewed the National Diabetes Audit data to identify areas requiring further attention to benefit the local population. It was found that primary and secondary cardiovascular prevention needed improvement. A multidisciplinary team 'think tank' was set up to review current data, plus plan and implement changes to the local service to positively impact cardiovascular data for people with diabetes. The group created numerous resources, training updates for HCPs/service users and embedded local service alterations. These improved local data for 28 of the 32 (mean change) GP practices in the area.
"The judges agreed that this entry demonstrated well considered data and population stratification, with excellent examples of teams working together. They also commented that it deserved recognition for being so comprehensively integrated into the pathway, and were impressed by the evaluations that were carried out, looking at multiple areas of impact."