Friday, 5 April 2013

Doing Diabetes Differently

‘Doing Diabetes Differently’

We are proud to announce that we have been awarded a £75,000 Shine award from the Health Foundation to deliver the ‘Doing Diabetes Differently’ project, in association with Milton Keynes Hospital NHS Foundation Trust.

The project hopes to improve patient’s commitment to their diabetes treatment regimens by improving their mental wellbeing. It is envisaged that by offering psychological support patients will be able to make sense of their diabetes, fit it into their lives and will feel more empowered to manage their diabetes effectively.

We are one of 30 project teams from across the UK whose innovative idea to improve the quality of healthcare is being put to the test in 2013/14.

The innovations, selected for the Health Foundation’s Shine programme, are testing new approaches to delivering healthcare that will either support patients to be active partners in their own care, improve patient safety or improve quality while reducing costs.

Background to the project
At more than £2 billion per annum, diabetes represents one of the greatest, and growing, costs in healthcare, rising by 8.9% each year, and is predicted to ‘bankrupt the NHS’ by 2035. The incidence of mental health problems in people with diabetes is very high, and is linked with poor dietary control and treatment adherence. This leads to increased risk of poor health outcomes and premature mortality, doubling the cost of treatment.

However, despite NICE recommendations, there is a scarcity of readily accessible, appropriate, effective psychological support for diabetes patients throughout the UK. NHS trusts lack the finance to invest in new services, leading to the current stalemate.

Following a voluntary pilot of solution-focused psychotherapy, this project seeks to introduce psychological screening questionnaires as part of routine clinic appointments and to provide brief psychotherapeutic interventions to aid treatment adherence as an integrated part of medical treatment, for those who need it. It will use data from questionnaires, blood-test results and uptake of medical services to build a model of risk factors and evaluate which of these are improved by brief psychotherapeutic interventions.

The approach overcomes the funding challenge by using social enterprise employees to deliver the service through a Social Impact Bond model. This means that the service will receive payment in arrears, based on results at the end of each year of provision. This will enable the hospital to ‘save to spend’ rather than ‘spend to save’, breaking the funding deadlock.

The project will comprise a self-contained year-long evaluation of the improvement in patient care and reduction in costs. However, part of the project will be to establish the viability of outcome-based contracting for a Social Enterprise company within a health setting.
Dr Miriam Silver, Consultant Clinical Psychologist, who is managing the project said, “This is a very exciting collaboration which we hope will improve patient experience and quality of life. Our delivery model is unique and we hope to be successful in securing on-going funding in arrears according to the outcomes we achieve”.

Dr Asif Ali, Consultant and lead for diabetes at Milton Keynes Hospital said: “Milton Keynes has a growing and ageing population, and more people are being diagnosed with diabetes. We’re excited about this project: helping patients manage their diabetes will not only improve patients’ quality of life, but will help the hospital save money in the long-term due to having to treat fewer complications that can result from it not being effectively controlled.”

Dr Jane Jones, Assistant Director at the Health Foundation, said, ‘Innovative approaches are required to tackle the challenges that we are facing today in healthcare. We want to encourage innovators in the service to lead the way in thinking differently and to show how new approaches can deliver better healthcare.

This year we have chosen the 30 best innovative ideas, selected from a large number of applicants. The project teams will have the challenge of demonstrating the practicality of their ideas and show that they can improve quality and reduce costs with the potential to have high impact when scaled up across the UK. Our aim is to share and promote the most effective innovations to the clinical and managerial leaders of the UK healthcare system and policy-makers.’
This latest round of the Shine programme is the largest ever run by the Health Foundation. It has 30 project teams, selected from a high number of quality applications from across the health service.

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