A National Service A National Service Framework for People Framework for People with Diabetes with Diabetes Adrian Sieff December 2001
Mar 28, 2015
A National Service A National Service Framework for People with Framework for People with
DiabetesDiabetes
Adrian SieffDecember 2001
The Quality FrameworkThe Quality Framework
MONITOREDSTANDARDS
Prof self regulation
LifelongLearning
• National Performance Framework• Commission for Health Improvement
• National Patient and User Survey
• NationalService Frameworks• National Institute for
Clinical Excellence
Clinical Governance
Patient &Public
Involvement
CLEAR STANDARD
S OF SERVICE
DEPENDABLELOCAL
DELIVERY
Purpose of NSFsPurpose of NSFs
Drive up qualityReduce variationsHelp deliver The new NHS, Modernising
Social Services and Saving Lives: Our Healthier Nation.
National Service FrameworksNational Service Frameworks
Interventions
National Standards
Service Models
Milestones
Performance indicators
UNDERPINNING PROGRAMMESresearch & development; clinical decision support systems;
information; human resources; revenue and capital
NSF ProgrammeNSF Programme
PublishedMental Health, CHD, Older People and
Cancer PlanOlder People
Coming soonDiabetesRenal and children’sNeurological conditions
Why an NSF in Diabetes:Why an NSF in Diabetes:CostsCosts
Individual costsNHS costsSociety costs
Complications Increase NHS Costs by Complications Increase NHS Costs by Increasing In Patient Costs -TIncreasing In Patient Costs -T22ARDIS ARDIS
surveysurvey
0
1
2
3
4
5
6
None (n=904) Micro (n=382) Macro (n=184) Both (n=108)
Cos
t im
pact
fact
or
Primary Care Drugs Out patient In patient
2.5x2.7x
5.6 x
Why an NSF in Diabetes:Why an NSF in Diabetes:VariationsVariations
The National ServiceThe National ServiceFramework for DiabetesFramework for Diabetes
AimsDecrease the incidence of type 2 diabetesImprove health outcomes of people with diabetes
By:Improving the overall quality of diabetes servicesReducing unacceptable variations in the quality of these services
NSF: StandardsNSF: Standards
AimStandardRationale Interventions Implications for service planningSupporting evidenceService modelsPerformance indicators
NSF: Delivery StrategyNSF: Delivery Strategy
Underpinning programmesActions and milestonesService modelsPerformance management
By 2013By 2013
Fewer people develop diabetesEarlier identification of diabetesPeople with diabetes have greater controlFewer complicationsEarly treatment of complicationsEffective in-patient careHealthy pregnancies
What will the NSF become?What will the NSF become?
Pathways in DiabetesPathways in Diabetes
Diagnosis InitialManagement
ContinuingCare
PREVENTION
Pregnancy
EVENTSEVENTS
Non diabetes Related Hospital
Admissions
New
Protenuria
New
CHD
New stroke
New Erectile
Dysfunction
Institutional Care
At Risk
Foot
New Eye Complications
DKA
HONK
Severe Hypoglycaemia
Major Life Events
Major Treatment
Change e.g. Starting Insulin
Other new
complications
A Different A Different PerspectivePerspective
www.doh.gov.uk/nsf/diabeteswww.doh.gov.uk/nsf/diabetes
[email protected]@doh.gsi.gov.uk
Bulletin BoardBulletin Board
Involving practitioners Involving practitioners andand
people with diabetespeople with diabetes
ERG, topic work and cross-cutting areas Review of existing literature on user views Further analysis of existing data on user views:
Audit Commission, Bradford HAZ Focus groups and in-depth interviews Nottingham event Seeking good practice
Delivering the NSF for Delivering the NSF for DiabetesDiabetes
ambitious but realistic programmes which “pull all the levers simultaneously’
recognition that change requires time if it is to be sustainable
determined and effective approach to reshaping clinical and social work practice
a commitment to leadership - within and between agencies, local communities, patients, service users and their carers