Tuesday, March 7, 2017

Hope…(And an Update)

Update from Diabetes UK….

Arrived on Tuesday in Manchester- as mentioned with hope…and wasn't it such a fabulous experience!! Meeting the trainees to begin with, a catch up with old compadres…it was as ever, fun. The next generation-as ever- never fails to energise me- and I saw plenty to fill me with that that twinkly word…hope.
The next 3 days went in a blur- keeping to ones promise to make NHS England accessible had to take its toll. Back to back meetings, explaining whats coming, plenty of handshakes, talks, taking questions, interviews….exhausting yet satisfying indeed. In an atmosphere of darkness, where lack of funding or morale within the NHS has been all pervading, it was lovely to see what a bit of extra injection of funds- along with ensuring your next generation feels valued can do. The conference bristled with positivity- apart from anticipation as the results of the transformation funds await to be announced over the next few weeks.

A big step forward was perhaps finally agreeing the priorities in diabetes as per the Right Care pathway- and hopefully the importance and recognition of Type 1 diabetes as a priority area for improving care. Again- due out shortly- but it felt good to close all the multiple discussions after months of discussions with many organisations and parties. Factor in the soon to be announced type 1 digital / self management platform that is being planned- and it feels we are finally making progress indeed. Or at least trying.

Highlights? The positivity was certainly one- as was meeting all the patients who had attended the event. It was good to hear their feedback too- and encouragement to carry on the work we are doing at the NHSE Diabetes team. Evening fun with the "home away from home" (Portsmouth diabetes team-of course!) as ever were special- as was hearing some of the positive findings from the national diabetes inpatient audit. It was heartwarming to see the drop in severe hypos in hospitals- even without much change in staffing levels.
However, a personal stand out moment was hearing some warm words from Prof Steph Amiel. Last year, we had a blistering discussion- and she challenged me to step up. It was nice to hear what she said one year later…a very personal moment indeed. If Steph thinks I am on the right track- it buries any other negativity pretty quickly -at least to me.

Downsides? 1 in 25 patients go into DKA while in hospitals (as per the audit)- a sobering fact-and we must change that…factor that in- and then think of rates when people are outside hospital. Let that sink in a bit in 2017. That must- and will- change.

Finally,a personal social experiment. I am well known to be dressed casually at most events- for this event, on day 1, I had a 3 piece suit; day 2 was a suit and day 3 was T-shirt & jeans. It was fascinating to see and hear peoples reactions- both from those who know me- and those who don't. Is it about personality, quality- and how much bearing has what you wear and the impression you create? A fascinating personal exercise for me- one to be continued more I reckon. How much in the era of showbiz do we actually live in? 



To finish, much kudos to the organising committee and Chris Askew for hosting such a great event. I enjoyed it- I enjoyed the atmosphere and fed off the belief too. 
Hope to be back next year- with further good news- but I also have a request for all those who came. Take that positivity away- and believe in what you can do. We are here to support, to help and do what we can. It is also down to you to have the belief to convince your local colleagues and take diabetes care forward. 

If stuck, you know how to get hold of us…till then x
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A week in Manchester- and to be honest, have been looking forward to this for some time. It's the annual conference for Diabetes UK where many colleagues mingle, share ideas, have a collective moan...and this year potentially bristles with the air of possibility. 

You don't need to be e recluse to know that the NHS is struggling. Any media outlet worth their salt is covering it and quite rightly too. You have to work in a hospital to know how "tough days" as regards the emergency pathway have become more of a norm, rather than a rarity. A "Black" status which even a few years back used to mean something is now on the verge of being normalised. It's not an unknown fact- we are struggling. Full stop. 

In the midst of that, there have been some good news for diabetes care. NHS England are on the verge of declaring which areas have won the transformation bids- about 40 million £ worth. Factor in the roll out of the National Diabetes Prevention programme and a few digital tools to help in education and self manahgement (on its way) and there just maybe something there for the diabetes community. The zeal is there amongst many organisations to work together...tough times have brought previously fractured parties together - and from the NHS England diabetes team, a willing desire to make use of the money- but with realisation that more of the same won't deliver much. The landscape of delivery is changing...if it passed you by, do take note of the 1st Consultant Pharmacist in Diabetes...Mr Phil Newland-Jones (Take a bow, laddie!!) 

The money is welcome and hopefully will help to improve basics such as safety in hospitals but this also does involve working...differently.

In the background is work with ABPI as well as all the technology companies to improve access, outcome based commissioning as well as a realisation that more needs to be done for populace at high risk such as South East Asian population. Watch this space...the game is indeed afoot. We are keen to focus on areas of high impact- while making sure primary care is squarely involved in any discussion regards QoF or indeed any models of care. Let's be categorical about this...asking primary care to take on more without resource, support or training is not something that works- it's time to stop that.

So I travel to Manchester with hope, optimism albeit,as ever, mixed with caution. I look forward to meeting our generation next, colleagues, patients as well as enjoying the evenings with my family away from home- the Portsmouth Diabetes team. If you have a question, come and ask. Yes, I work for NHS England, but I also do a full time job, am educational supervisor to many trainees- so always happy to take any queries- as long as done with a degree of respect. I don't think there has been any organisation involved with diabetes care we haven't tried to engage with- if there is, apologies- but come and say hello. I am always enthused to meet colleagues who are energetic, keen to make a difference - we need more of you indeed!

Let's see what this week brings. I travel with hope

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