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Diabetes Enhanced Service LES 73

2. Learning outcomes. Understand the criteria for the new LESAppreciate the work:financial reward' ratioBe able to deliver care planningBe able to integrate care plan into clinical systemKnow where to go for helpBe aware of supplementary education available and support. 3. LES 73 Diabetes Care

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Diabetes Enhanced Service LES 73

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    1. 1 Diabetes Enhanced Service LES 73 Enhancing diabetes care in the community Dr Dan Jenkinson

    2. 2 Learning outcomes Understand the criteria for the new LES Appreciate the ‘work:financial reward’ ratio Be able to deliver care planning Be able to integrate care plan into clinical system Know where to go for help Be aware of supplementary education available and support

    3. 3 LES 73 Diabetes Care LES 73 A Care planning Enhanced annual review Patient Survey Referral to DESMOND LES 73B Insulin Initiation

    4. 4 Why should I apply? What’s in it:- -for me? -for the practice? -for the patient? -for the PCT? £30 per patient on reg Better compliance Better understanding Strategic objective

    5. 5 Finances LES 73A Say 200 patients with diabetes -Revenue £6000 Additional costs extra 10min nurse for 40% of reviews= approx £300 per yr Backfill for training say £1000 Extra admin time negligible but allow £100 Profit £4600

    6. 6 No free lunch! Training New ways of working IT Audit Patient Questionnaire

    7. 7 What do I have to do to get the cash? LES 73A 30 out of 35 QOF points relating to HbA1c target Must do 2 day PCT course on diabetes OR have done diploma in diabetes+half day refresher Complete care plan (or code refusers) in 70% of eligible patients* Show evidence of lifestyle, diet, smoking, alcohol, diet, weight, exercise (template) Do survey Refer new T2DM to DESMOND (community team) *not 1st 6m

    8. 8 What do I have to do to get the cash? LES 73B All of above PLUS Insulin initiation on at least 10 patients per year* Attend Insulin for Life Course (instead of PCT led training) Have named diabetes contact Have a protocol for insulin initiation Extra £65 per patient initiated on insulin *not 1st 6m

    9. 9 What is ‘Care Planning’? Group work! Small group discuss: What is care planning? How would you go about setting it up for a patient attending a diabetes annual review? How will the care plan be shared with the patient?

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    14. 14 Pilot in Northumbria (DOH 2007)

    15. 15 Local proposal Engage patient before annual review see ‘Planning for annual review’ (PCT website) S- Specific M- Measurable A- Action to achieve goal R- Realistic T- Time-scale Patient sets the agenda

    16. 16 Annual review Agree/ modify goals Record goals Patient-held, patient-informed record Print out and save in notes Include in any referral

    17. 17 The ‘IT’ bit EMIS: integrated word processor Vision: SmartTags2- fully supported by VISION SystemOne: adaptation on intranet Other systems?

    18. 18 Annual review template

    19. 19 DESMOND New community diabetes team Structured education for T2DM Must refer at least 70% of all new Referral criteria on PCT Website

    20. 20 Patient Questionnaire Give out at annual review FREEPOST! Analysed by PCT At least 5% received ONLY!

    21. 21 Summary LES 73A 30 out of 35 QOF points relating to HbA1c target Must do 2 day PCT course on diabetes OR have done diploma in diabetes+half day refresher Complete care plan (or code refusers) in up t0 70% of eligible patients* Show evidence of lifestyle, diet, smoking, alcohol, diet, weight, exercise (template) Do survey Refer new T2DM to DESMOND (community team)

    22. 22 Where to get help PCT Website DOH website Diabetes UK Dan.jenkinson@nhs.net NICE

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