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PROCEED Preconception Care for Diabetes in Derby/ Derbyshire:

PROCEED Preconception Care for Diabetes in Derby/ Derbyshire:. Paru King, Consultant Physician On behalf of the PROCEED team. The national picture. Women with diabetes are: 2-4 times as likely to have a baby with a congenital abnormality. Five times as likely to experience a stillbirth

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PROCEED Preconception Care for Diabetes in Derby/ Derbyshire:

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  1. PROCEED Preconception Care for Diabetes in Derby/ Derbyshire: Paru King, Consultant Physician On behalf of the PROCEED team

  2. The national picture • Women with diabetes are: • 2-4 times as likely to have a baby with a congenital abnormality. • Five times as likely to experience a stillbirth • The risks can be reduced by preconception care • Only 34% access preconception care • 8 000 pregnancies affected in 2011 in the UK • Preconception is a NICE Quality standard 2011

  3. The local scenario: Derby and Southern Derbyshire %

  4. Gave us the opportunity to pilot PROCEED, the first integrated preconception service for diabetes.

  5. Raising preconception awareness

  6. Referral by paper, NHS email or telephone Telephone contact by coordinator Hospital clinic (South Derby) Community clinics (Central Derby) Community clinic (North Derby) Flexibility depending on clinical need and user choice

  7. PROCEED : Efficiency and productivity

  8. Impact of PCC P<0.01 P<0.05

  9. PROCEED : outcomes  PROCEED

  10. PROCEED : light and dark green dollar savings

  11. PROCEED: Finance • Total annual savings from changes= £61,000 • Recurrent cost of service =£17, 000 • Overall savings Year 1 =£44,000 / year • Could save £14 Million if rolled out nationally

  12. PROCEED: Summary • Preconception Care reduces abnormalities and improves outcomes in pregnancies complicated by diabetes. • We demonstrated a case for change and piloted PROCEED. • PROCEED a user centred integrated preconception service for diabetes, which is integrated not only vertically across specialities but for the first time horizontally across traditional primary and secondary care boundaries. • It improves productivity, efficiency, PCC rates, pregnancy outcomes as well as responding to user needs. • This model has a recurrent cost of £17, 000, but in the first year has resulted in savings of over £60, 000 locally, as is now commissioned.

  13. PROCEED: Learning • PROCEED’S success was as much about building relationships to work across boundaries as it was the service redesign. • Listening to users is important in providing a service that meets their needs. • The importance of a solid financial evaluation should not be underestimated. • The support from the Health Foundation and Springfield was fantastic!

  14. Thank You

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