AQW 521/22-27
Ms Claire Sugden
Independent
East Londonderry
Tabled Date: 25/05/2022
Answered On Date: 07/06/2022
Priority Written: No
Question:
To ask the Minister of Health (i) for his assessment of the current levels of diabetes; (ii) to outline the current policy on prevention and treatment; and (iii) to detail what new treatment options are being considered.
Answer:
I recognise that diabetes is one of the most challenging chronic conditions facing people in Northern Ireland and impacts both at a population and individual level. Raw disease prevalence information for Northern Ireland 2021/22, recently published by my Department, indicates that, at 31st March 2022, there were 108,223 patients recorded on the General Practice Quality and Outcomes Framework diabetes register, which is a register of the number of patients aged 17 years and over with diabetes mellitus (specified as type 1 or type 2 diabetes). 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 by the Diabetes Network to support prevention and treatment of diabetes include: Development of a regional integrated foot-care pathway. 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; In 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 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. The Diabetes Prevention Programme, implemented through the Public Health Agency in partnership with Health and Social Care Trusts, 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. On an ongoing basis, treatment and care for people living with diabetes is provided in line with National Institute for Health and Care Excellence guidelines. The Diabetes Network work programme aims to ensure that opportunities for innovation in prevention, treatment and care are identified, including increasing the use of technology. For example, the Network has made access to insulin pumps a high priority and through the development of the new regional insulin pump model aims to ensure equitable access to pumps and support across Northern Ireland for people with Type 1 diabetes. In terms of Type 2 diabetes, the South-Eastern Health and Social Care Trust has worked closely with NHS England, Diabetes UK and Diabetes Remission Clinical Trial (DiRECT) researchers to develop and pilot Northern Ireland’s first Diabetes Remission Programme for Type 2 diabetes patients. This is an intensive structured low calorie diet treatment for people who are overweight and living with Type 2 diabetes to support weight loss and weight loss maintenance. Learning from this pilot is being shared regionally to inform broader consideration for developing a service Northern-Ireland wide. Work has also commenced to develop a regional pathway for diabetes across Northern Ireland. This model will consider primary and secondary care alignment as a new model of care to best support people living with diabetes.
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