Diabetes Patient Education – A moral imperative?

The NICE Diabetes Quality Standards, “defines clinical best practice”.   Statement 2 of the 15 NICE Diabetes Quality Standards says:

“People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme.”  The guidance goes into detail about what “structured” means.

On average people with diabetes spend only 3 hours with a healthcare professional per year.  The rest of the 8,757 hours per year (or 8,781 hours per leap year) people are managing their condition for themselves.

Diabetes prevalence has increased by nearly 60% in the past 10 years and potentially this trend will continue at an alarming rate. I can only imagine that the time that people spend with a health care professional will go down?

Are we missing a trick?  At a time when resources are stretched it is a crashing shame not to harness our most under used and powerful resource – the person or carer themselves.

There are 57 new indicators in the CCG Improvement and Assessment Framework

One of the 57 reads: “Number of people with diabetes diagnosed less than a year who attend a structured education course”

Look again.  It says “attend”.  That’s a big deal. 

It’s not a coincidence that, with the introduction of 11 QOF points to refer patients to education, there was an enormous leap in referrals from 15.9% in 2012/13 to 75.8% in 2014/15.  However, despite a dramatic upturn in referrals, only 5.9% of people with Type 2 diabetes and 1.9% of people with Type 1 diabetes “attended” patient education. (National Diabetes Audit 2014-2015)

That’s a bit dispiriting for providers working hard to run courses.  We know that more people attend education than is being reported.  So what’s going on?  I’ll tell you where I think we should start.  Look at how we get data on “attendance” into GP clinical systems.  If that data isn’t being captured; then it is not being submitted annually to the National Diabetes Audit and your CCG IAF is indicator is not going to improve.

However, even if we get the data capture right and we double or treble recorded attendance at structured education we still have a mountain to climb.  Having this as a CCG IAF indicator will certainly focus the mind.

But more importantly, we know that people with diabetes are likely to spend less time with a healthcare professional in the future.  Surely we should be ensuring that we tool people with diabetes and their carers with quality education and information to support themselves.  I would go as far to say it may be a moral imperative.