3TT Diabetic Pilot Programme

Quotes on Diabetes achievement

“…top five in London from bottom – In 3 years this is really impressive. Huge turnaround.”

“All of South East London ahead of the England mean for 3 treatment targets.What a turnaround for London in general, and well done Lewisham and OHL.”

“Ahead of Bexley for the first time ever!”

Our 3 Treatments Targets Pilot programme to improve care of diabetic patients has been a tremendous success, lifting Lewisham from the lowest ranking to secong-highest ranking in diabetes care in South East London, where we have been rated as ‘outstanding’ by the STP. The OHL project was the Winner of the nationally recognised HSJ Patient Safety Award 2019 in recognition of our significant improvement in clinical outcomes.

 

Working with key stakeholders (e.g. NHS England, Public Health etc.) Lewisham CCG identified that locally, Diabetes is a major public health problem that affects approx. 6.0% of the population. Acknowledging that most people with diabetes will have their care delivered in a community or General Practice setting, the CCG wanted to upskill and support of primary care clinicians to deliver a higher quality service.

A service specification was produced setting out Lewisham’s local implementation with One Health Lewisham to improve the achievement of the NICE recommended treatment targets (HbA1c, cholesterol and blood pressure) and driving down variation between Lewisham’s GP populations. Lewisham CCG were keen to demonstrate that:
• Achievement of the treatment targets leads to better patient outcomes.
• Better treatment target control reduces the risk, and delays the onset, of expensive
complications.
• There is variation in achievement of the treatment targets between CCGs and between GP practices that cannot purely be explained by differences in the populations.

OHL collected feedback on the service which was largely positive with some areas identified for further improvement as explained below:
• The project has been helpful to help focus practices on their diabetes care and achievement;
• The DSN and Pharmacist have been helpful;
• IG issue at one practice when the Pharmacist logged in as a GP instead of herself;
• Some PCNs / Practices have employed their own DSN and therefore do not want this service,
although in some cases their performance would still suggest needing OHL DSN involvement;
• Overall it has been felt that the bimonthly meetings were too much, with so many other
meetings and pressures on practice;
• The meetings when a practice has a specific clinical case to discuss have been helpful, however other avenues could fulfil this requirement for clinical discussion and support;
• It was felt that the meetings when the consultant endocrinologist attended were helpful;
• Practices would like a more focused involvement from OHL, with practice visits and support
when needed.

The 3TT Project was nominated for and won the nationally recognised Health Service Journal Patient Safety Award 2019. Lewisham is now a top performer in the area of diabetes care.