Sarah Woodman

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• Sarah Woodman
• Diabetes Lead Dietitian
• Southampton

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Objectives

• What is Diabetes4Life?
• Why has it been created?
• The future for Diabetes4Life

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Diabetes4Life

• Carbohydrate Counting Groups
• Intensive Type 1 Education Programme
• Weight Management Programme
• Newly diagnosed Type 2 Groups

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Diabetes4Life

• Carbohydrate Counting
• Intensive Type 1 Education Programme
• Weight Management Programme
• Newly diagnosed Type 2 Groups

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National Programmes

• Are available
• E.g. DESMOND, X-PERT
• Southampton decided against
• 10 years local experience
• Kept relevant to local population
• Will meet NICE criteria
• Hard to justify at times! Everyone has heard of
  DESMOND and DAFNE!

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NICE Guidelines

• Technology Appraisal 60 (April 2003)
• Direction reinstated from Jan 2006
• Structured Education is made available to all
  people with diabetes at the time of diagnosis and
  then as required

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Diabetes UK and DH Report

• Support and guidance to meet recommendations
• Key Criteria
• Written curriculum
• Trained educators
• Quality assured
• Audit

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Type 2 Programme

• Full internal review
• Team restructured whole programme
• Now 30 programmes/year - can accommodate 90 of
  estimated newly diagnosed Type 2s each year
  (SCPCT)
• 15 people per session
• Wide range of venues and times
• Designed for those diagnosed in last 12 months

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Type 2 Programme

• 3 x 2 hour sessions
• Session 1 Getting Started (DSN and dietitian)
• Session 2 Eating and Exercising with Diabetes
  (Dietitian)
• Session 3 Stepping out to Stay Healthy
  (Podiatrist and DSN)

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Summary of content

• The disease process
• Treatments
• Psychological issues
• Adopting a healthy diet and lifestyle
• Goal setting to promote health and resolve issues
  for daily living

• Detecting, treating and reducing risk of
  complications
• Legal issues e.g. driving
• Special occasions
• Other sources of help
• What diabetes care to expect

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Venues

• Weekdays only currently
• Mornings and afternoons
• New early-evening programmes
• Health centres and GP surgeries health
  education rooms
• Local podiatry centre
• NOT hospitals

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Who Attends?

• Average age 55yrs (range 32 83)
• 48 male 52 female
• Majority diagnosed 3-5 months
• 82 estimated newly diagnosed population booked
  to attend
• Consistent 20 DNA rate
• 30 of GP surgeries not referring

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Meeting NICE Criteria

• Curriculum
• Completed, but a working document
• Distributed to all trainers
• 50 pages!
• Contents
• Meeting the Criteria
• Programme structure
• Referral process
• Appendices and references

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Trained Educators

• Currently run by professionals
• Each with own professional qualifications
• Before delivering programme
• Observe current trainers
• Deliver whilst being observed
• Go from there!

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Quality Assurance

• Being completed annually
• Internally currently
• Plan to work with local centres for external QA
• Informal feedback to individuals
• Report provided to all trainers and PCT

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Audit

• Ongoing
• Attendance
• Individuals sessions 1, 2, 3
• Practices referral trends
• Patient satisfaction content, venue, times
• Pre- and post-knowledge scores and evaluation
• Changes made as a result of the programme
• Biochemical outcomes HbA1c, cholesterol
• Six-monthly reports to PCT

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What do Patients think?

• 99 convenient venue
• 94 convenient time
• 100 enjoyable
• 100 useful (diet and feet most useful)
• 100 easy to understand
• Average knowledge scores increased from 6/10 to
  7.75/10

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What changes will result?
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Where are we going?

• Addressing the local population Black and
  Ethnic Minority programmes?
• Training other health professionals/lay people to
  be part of delivering the programmes
• Support from retinal screening and psychology?
• Refresher sessions
• Web-based/computer education

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• Sarah Woodman
• Diabetes Lead Dietitian
• Royal South Hants Hospital
• 023 8082 5442/5922
• Sarah.woodman_at_suht.swest.nhs.uk