CVD Prevention: Diabetes prevention, detection and treatment

CVD Prevention: Diabetes prevention, detection and treatment

Overview

About this resource

NICE: who we are and what we do

Local support from NICE

• Making the case for prevention

• Using NICE guidelines and quality standards

• Practical tools and resources

• Finding what you need

• The following slide set is a collation of key NICE resources to support STPs/ICSs looking to improve prevention, detection and treatment of diabetes

• It signposts to key NICE products to support improvements and savings; demonstrates how the products can be used and provides practical examples

• This resource pack is one of a suite of NICE resources aligned to the NHS England RightCare and Public Health England CVD Prevention Pathway (see next slide)

• Official Launch at NICE conference : STP resource pack to help achieve priorities

About this resource

NICE: Who we are and what we do

The National Institute for Health and Care

Excellence (NICE) is the independent

organisation responsible for providing national

guidance and advice to improve health and

social care

What is NICE?

Our portfolio in 2018 Based on the best

available evidence

of what works and

is value for money

Improve quality

and safety

Using your resources wisely

NICE

Clinical

practice

Public

health

Social care

Medicines

practice

MedicinesMedical

technologies

Indicators

Quality

standards

Information

services

Standardise

practice, reduce

unwarranted

variation, drive

quality

improvement

Find trustworthy,

high quality

evidence and best

practice information

Based on the best available evidence of what works and is cost effective, NICE resources can inform the development and implementation of STPs to:

• improve quality and safety by supporting standardisation to evidence-based best practice for your key clinical priorities

• improve productivity

• prevent ill health and promote wellbeing

• engage patients and communities

• drive and measure quality improvement

NICE support for your STP/ICS

Local support from NICE

Local support

Advise

• how NICE guidance, advice and quality standards can support the

implementation of your STP plan

• on the evidence base underpinning priority work stream action plans

• on the availability of metrics to support local evaluation

• which NICE resources can support community engagement and shared

decision making between patients and practitioners

Support

• quality planning, quality improvement and quality assurance

• development and evaluation of new models of care

• local discussions, events, shared learning and local education

Connect

• STPs to other teams and technical experts in NICE when specialist advice

is needed

• STPs with other organisations and networks working in areas of shared

interest

NORTH

Annie Coppel

Associate Director

annie.coppel@nice.org.uk

Angela Parkin

Medicines Implementation

Consultant

(and Northern Ireland)

angela.parkin@nice.org.uk

Rachel Reid

Implementation Facilitator

rachel.reid@nice.org.uk

MIDLANDS & EAST

Deborah O’Callaghan

Associate Director

deborah.ocallaghan@nice.org.uk

Gill Eddy

Medicines Implementation Consultant

(and Wales)

gill.eddy@nice.org.uk

James Jagroo

Implementation Facilitator (interim)

James.jagroo@nice.org.uk

Michelle Liddy

Meds Implementation Consultant

michelle.liddy@nice.org.uk

LONDON

Jane Moore

Associate Director

jane.moore@nice.org.uk

SOUTH

Chris Connell

Associate Director

chris.connell@nice.org.uk

Zoe Girdis

Medicines Implementation Consultant

(and Channel Islands)

zoe.girdis@nice.org.uk

Jade Fortune

Implementation Facilitator

(South East)

jade.fortune@nice.org.uk

Jane Jacobi

Implementation Facilitator

(South West)

jane.jacobi@nice.org.uk

NORTHERN IRELAND

Lesley Edgar

Implementation Facilitator

lesley.edgar@nice.org.uk

NICE Field Team and Medicines Implementation Consultants

Making the case for prevention

CVD primary care intelligence packs look at prevention, diagnosis, care and outcomes and allow for comparison between CCGs and between GP practices

Cardiovascular disease profiles for each CCG, looking at coronary heart disease, diabetes, kidney disease and stroke

RightCare ‘where to look packs’ include headline opportunities, improvement opportunity tables and pathways on a page showing how CCGs in each STP differ from their peers

Additional health intelligence resources

NICE guidelines

NICE Guidelines

• NICE guidelines are comprehensive sets of recommendations based on the best available evidence

• They describe what is effective (what will result in the best outcomes)

• And what is cost effective (best value for money)

• They are developed to guide decisions made about health and care (for practitioners, providers, commissioners, service planners and users)

• Developed by independent committees

• NICE consults on the scope and the draft of the guideline

“NICE guidance sets the standards for high quality healthcare and encourages healthy living.

Our guidance can be used by the NHS, local authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing”

• Provides a common language to unite services around a shared aim

• Helps with difficult local discussions about ‘what’ to deliver

• Supports evidence based pathway redesign

• Improve quality and safety of services by standardising practice

• Support local uptake of innovative technologies

• Reduce wasteful or inefficient practice

• Help engage local communities

Why use NICE guidance?

Guidelines:

• Type 2 diabetes: Prevention in people at high risk (September 2017)

• Type 2 diabetes prevention: population and community-level interventions (May 2011)

• Behaviour change: Individual Approaches (January 2014)

Key NICE guidelines: Type 2 diabetes preventative intervention

Guidelines

• Type 1 diabetes in adults: diagnosis and management (NG17)

• Type 2 diabetes in adults: management (NG28) December 2015

• Diabetic foot problems: prevention and management (NG19) (updated January 2016)

• Diabetes (type 1 and type 2) in children and young people: diagnosis and management (NG18) (August 2015)

Medical technologies guidance

• The Debrisoft monofilament debridement pad for use in acute or chronic wounds(MTG17)

• VibraTip for testing vibration perception to detect diabetic peripheral neuropathy(MTG22) (updated: March 2015)

Key NICE guidance: Diabetes detection and treatment

Diagnostic guidance

• Integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes (the MiniMed Paradigm Veo system and the Vibe and G4 PLATINUM CGM system) (DG21) February 2017 and adoption support resource

• Medtech innovation briefings

• Aptiva for painful diabetic neuropathy (MIB119) September 2017

• FreeStyle Libre for glucose monitoring (MIB110) July 2017

• MiniMed 640G system with SmartGuard for managing blood glucose levels in people with type 1 diabetes (MIB51) February 2016

• Key therapeutic topics

• Safer insulin prescribing (KTT20) January 2017

• Type 2 diabetes mellitus - Medicines optimisation priorities (KTT12) January 2015

Key NICE guidance: Diabetes detection and treatment (cont.)

NICE pathways

Type 2 diabetes preventative intervention

• Preventing type 2 diabetes

• Behaviour change

• Obesity

Diabetes detection and treatment

• Type 1 diabetes in adults

• Type 2 diabetes in adults

• Foot care for people with diabetes

• Diabetes in children and young people

Key NICE pathways

Using NICE Quality Standards to

achieve improvements

NICE guidance and quality standards

Evidence Guidance Quality

Standards

A NICE quality standard is a

concise set of statements

designed to drive and

measure priority quality

improvements.

A set of systematically developed

recommendations to guide decisions for

a particular area of care or health issue

Research studies - experimental

and observational, quantitative

and qualitative, process

evaluations, descriptions of

experience, case studies

Type 2 diabetes preventative intervention

• Diabetes in adults (QS6) statement 1 (August 2016)

• Obesity in adults: prevention and lifestyle weight management programmes (QS111) January 2016

• Obesity in children and young people: prevention and lifestyle weight management programmes (QS94) July 2015

Diabetes detection and treatment

• Diabetes in adults (August 2016)

• Diabetes in children and young people (July 2016)

Key NICE quality standards

Practical tools and resources

• NICE Fellowship project to facilitate the implementation of NICE guidance PH38 via the utilisation of Tier 2 and Tier 3 weight management and lifestyle-intervention programmes for the prevention of type 2 diabetes (November 2017)

• Prosiect Sir Gar - Workplace cardiovascular (Diabetes and CHD) health assessment and management programme (June 2012)

• An innovative approach to providing lifestyle education and behaviour change to prevent type 2 diabetes (June 2012)

• Walking Away from Type 2 Diabetes: implementation of a diabetes prevention programme (June 2012)

• Any Body Can (ABC) Cook! - Engaging and encouraging the public to acquire healthy-eating skills and habits (December 2013)

• Lincus Trial: YMCA Liverpool pilot study for individuals with multiple and complex needs (November 2013)

Shared learning case studies: Type 2 diabetes preventative intervention

• Young Adult Diabetes: Engaging to improve; outcomes of the young adult clinic restructure. April 2018.

• Supporting the management of type 2 diabetes with pharmacist-led reviews and implementing NICE recommended nine key care processes February 2018

• Implementing an active foot disease pathway for people with diabetes in South Tees July 2016

• Implementing multiple daily injection insulin regimens (MDI) with carbohydrate counting for children and young people at diagnosis of type 1 diabetes: education provided by the Children’s Diabetes Service for patients, families and staff April 2016

• Training non-podiatrists to assess foot risk as part of an integrated foot service for people with diabetes February 2016

• PITstop training and the use of NICE guidance and the Type 2 diabetes treatment pathway July 2014

Shared learning case studies: Diabetes detection and treatment

• NICE Guidance CG10 (2003) - Type 2 diabetes the prevention and management of foot problems: How top down implementation removed waiting times (up to 18 months waits) January 2013

• Evidence-based insulin prescribing in type 2 diabetes November 2012

• SADIE - a local education programme for people with Type 1 diabetes Dec 2011

Shared learning case studies: Diabetes detection and treatment (cont.)

NICE patient decision aid for type 2 diabetes

Endorsed resources

Tailored resources

• Patient decision aid (includes a user guide)

• Algorithm for blood glucose lowering therapy in adults with type 2 diabetes

Endorsed resources

• Introductory Certificate in Obesity, Malnutrition and Health RCGP has produced a learning package that supports NICE recommendations relating to identification and classification of overweight and obesity and assessment and advice on physical activity in the NICE guideline obesity, nutrition, physical activity and exercise referral schemes.

• Weight management: guidance for commissioners and providers (June 2017)

• Mapmydiabetes An online resource to enhance the self-management of diabetes. The objective of Mapmydiabetes® is to improve the uptake of diabetes self–management education (DSME) to patients with type 2 diabetes by providing high-quality online information and educational content.

• Optimising medicine for adults with type 2 diabetes This e-learning course is designed to support clinicians in implementing NICE guidelines and quality standards in relation to managing type 2 diabetes in adults. It's particularly focused on the optimisation of medicines to achieve the best outcomes for patients.

Finding what you need

• Website www.nice.org.uk

• NICE News monthly e-newsletter

• NICE in Social Care monthly bulletin

• 140,000 people follow us on Twitter @NICEcomms

• General enquiries nice@nice.org.uk

• Field Team: regional contact details on next slide

Staying up to date with NICE

• Associate Director Chris Connell

• Chris.connell@nice.org.uk

• Implementation Facilitator (South West)

• Jane.jacobi@nice.org.uk

• Medicines Implementation Consultant

• zoe.girdis@nice.org.uk

NICE Field Team and Medicines Implementation Consultant