Rotherham PPG Network 10 th September 2019 Welcome

Rotherham PPG Network 10 th September 2019 Welcome! 1

Updates – Car parking at Rotherham Hospital • Ralph, Doug, Helen and Tony (TRFT) did a walk round • This helped to dispel some of the misunderstanding about access • The details of the walk round are on tables • Tony would like to get a parking user group established, perhaps we can support recruitment and information to this 2

• We identified 3 other entrances to the hospital that patient and the public can use if the main entrance is difficult for them • We felt the volunteer driver scheme needs to be better promoted, as this can drop people just outside the main entrance • There was plenty of space in the drop off, and empty blue badge bays • We were very satisfied by what Tony and his team are doing to manage a complex and difficult system Additional details on the circulated sheets 3

Updates - ophthalmology • A proposal to move ophthalmology outpatients from the TRFT site to the community health centre is going to Rotherham Hospital Board in October • We have spent some time in clinics talking to people, most people are supportive of the idea • We need to offer assurance that the staff and department will stay the same. 4

Update – Respiratory Pathway • With staff from TRFT we are developing proposals to improve the pathway for people with a range of respiratory conditions • During September we will be contacting patients with these conditions and seeking their views, this will include a survey and drop in sessions • We also want to recruit people for workshop discussions; anyone interested to contact Helen 5

Diabetes – a wider look Lynda Astbury Lead Diabetes Specialist Nurse Claire Keighley Diabetes Centre Manager Tara Ramakrishnan Medicines Management 6

What we know • 17, 000 people with Diabetes in Rotherham • Around 10% have type 1 diabetes • GP services- see most of the patients who have diabetes 7

Diagnosed Type 2 diabetes • Referred to DESMOND – Around 1/3 patients attend • Referral to Dietitian and/or BETTY course – lifestyle interventions/weight management • Regular follow up reviews at GP practice (practice nurse), covering checks for medication review blood pressure retinal screening results foot check cholesterol blood glucose 8

Why do we need to provide regular follow up and review for patients with diabetes? • Type 2 diabetes is a progressive condition and eventually you may be referred to the specialist team 9

Rotherham Specialist Diabetes Team • See patients who require more complex management – patients who need treatment with insulin • Includes – Consultants, – Diabetes Specialist Nurses, – Diabetes Inpatient Specialist Nurses, – Diabetes Specialist Nurse Obstetrics, – Diabetes Specialist Dietitians – Diabetes Podiatrist 10

The specialist team provide: • Specialist education to patients with Type 1 (DAFNE) and Type 2 (DESMOND) • support for patients who wear insulin pumps • specialist education for other health and care staff • Support to patients to gain the skills to selfmanage their diabetes Patients are seen for a short period of time, then referred back to GP practice (Practice Nurse) for routine follow up 11

So – what are the problems? • ? ? 12

Cost of Diabetes medication in Rotherham compared to the rest of South Yorkshire

Cost and achievement of Hb. A 1 c recommended by NICE in Rotherham compared to the rest of South Yorkshire

If we have all these services why are diabetes • • • outcomes poor? Seen regularly in GPs Oral medication gradually increased to max Referred for insulin 1 year ago Self management – testing and control ‘Tom’, diagnosed 5 years ago with type 2 diabetes Management plan Back to GP for routine follow up 15

6 months later Tom was re-referred to the Diabetes Specialist Nurse by his GP practice as his diabetes control had not improved - Why? 16

Questions and discussion • How seriously do people treat diabetes? • What are people’s experiences like? – In their GP practice – In other services – At the centre • What barriers do people experience – Appointments, reviews, check-ups - why do people DNA – Take up of education/courses/information – In managing their diabetes and their health in general • What would an ideal service look like? 17