AQW 25870/17-22

Ms Paula Bradshaw
Alliance Party
South Belfast

Tabled Date: 16/11/2021
Answered On Date: 27/01/2022
Priority Written: No

Question:
To ask the Minister of Health for an update on work to reform services for people with diabetes as part of the overall Transformation of Health and Social Care.

Answer:

My Department published a Strategic Framework for Diabetes in Northern Ireland in 2016. The Framework, which was developed in partnership with a range of stakeholders, including Diabetes UK and people living with diabetes, included a 3-year action plan which aimed to improve outcomes and services for people living with diabetes or at risk of developing diabetes.

The Diabetes Network supports the implementation of the Diabetes Strategic Framework and action plan and provides strategic direction for diabetes treatment and care in Northern Ireland. It brings together people living with diabetes, carers, and health and social care professionals working in partnership with Diabetes UK. The Network is based on an ethos of collective leadership and aims to enable people living with diabetes and frontline experts in diabetes care to work in partnership to co-design services for future diabetes care and improvements in the long term health for people living with the condition.

Key achievements and initiatives taken forward by the Diabetes Network to support prevention, diagnosis and treatment of diabetes include:

 Development of a regional integrated foot-care pathway, launched in November 2019. The pathway is based on a multi-disciplinary approach that operates across primary care, community and acute hospital services. It is focussed on the prevention of amputations and includes foot assessment and risk assignment, regular review for those with foot complications, delivery of foot health education as part of a structured education programme, acute phase management and specialist investigations for new episodes of diabetic foot disease, and management of acute diabetic foot disease and diabetic foot emergencies, including the care of patients pre- and post-amputation;

 On 11 January 2022, the launch of a new regional insulin pumps service, developed in partnership alongside Diabetes UK and people living with diabetes. The new model has been supported by £2million funding from my Department and aims to ensure equitable access to pumps and support across Northern Ireland for people with Type 1 diabetes. The pathway, ethos and approach for the service have been agreed and this will be developed over the next 3 years. When in place the service will help support people to get the best outcomes from their pump therapy and ensure that diabetes teams across the region can share good practice and optimise care;

 The development of standardised protocols for the management of diabetes in inpatient settings. Progress was made using Transformation funding to establish specialist diabetes teams and case finding to identify and support patients in hospital at higher risk and to improve insulin prescribing for patients in hospital. Further work continues to improve inpatient care and on the development of a new regional inpatient model;

 Support for women in pregnancy - screening is available for all women for gestational diabetes and uniform protocols of care have been developed to support standardised care;

 Prevention of Type 2 diabetes was one of the key areas in the Diabetes Strategic Framework. Diabetes prevention and the reduction of the number of people developing diabetes is supported through the Diabetes Prevention Programme, with implementation through the Public Health Agency and in partnership with Health and Social Care Trusts. The Programme aims to support people to reduce their risk of developing Type 2 diabetes through weight reduction, healthy food choices and increased physical activity. My Department has a stated aim to align outcomes of the new obesity strategy with the diabetes prevention agenda;

 The South-Eastern Health and Social Care Trust has worked with NHS England, Diabetes UK and researchers from the Diabetes Remission Clinical Trial (DiRECT) research study to develop Northern Ireland’s first Diabetes Reversal programme for Type 2 diabetes patients. The first Diabetes Reversal pilot programme commenced in May 2021. Learning from this pilot will inform consideration on the potential for developing a regional programme;

 The Diabetes Network’s ‘New models of care’ work stream is undertaking work to develop a standardised pathway for Type 2 diabetes in Northern Ireland and ensure that Type 2 treatment matches best practice;

 The Diabetes Network is working with my Department to inform a Programme of Care Workforce Review for Diabetes. A working group is considering the preliminary work required before such a review can be undertaken. It is anticipated that the Workforce Review will commence in the next financial year, subject to the provision of the required preparatory work.