ABCD T1DCC-UK Newsletter - September 2017

Welcome back after the summer holidays and conference season.  I hope you all have managed to get some time away, and are suitably refreshed for the winter pressures!

As you can see the collaborative now has its own very stylish logo that won the vote by a clear majority.  My thanks to Ben Hayward of thirtytwotrees who provided the designs free of charge.

Although the website is a basic offering at the moment we will develop it to act as a repository of all manner of useful information, and to host forums on hot topics.

Patient representatives

I am delighted to announce that we have three brilliant patient reps to keep us on our toes.  Welcome to Joanna Mullineaux, Liam McMorrow and Mike Kendall, who will each take a particular interest in a couple of the work streams, as well as the collaborative as a whole.  We were overwhelmed with high quality applications via Diabetes UK’s Patient Voices.  Thanks to Dan Howarth and Emma Wilmot who contributed to the recruitment process.

Announcing the collaborative

I took the opportunity to announce the launch of the collaborative at the ABCD Clinical & Commissioning News-Live event on 6th July, after a wonderful State of the Art lecture on Type 1 diabetes by Simon Heller to delegates in London, Bristol, Leeds and Manchester.  ABCD's corporate supporters expressed their interest in and support for the collaborative after our committee meeting on 6th September.  We now have  144 people registered, including the clinical leads for 59 departments.

Healthcare Professional Education and Training

Session at Diabetes UK Professional Conference -Thanks to the organising committee of the Diabetes UK Professional Conference 2018 for giving us a session in the programme (day to be confirmed, but conference 14-16 March at London ExCel).   I have been invited to chair this, but will be relying on some of you to present your work in progress, and share examples of innovative care.  Since this conference is designed for multi-professional teams, and Diabetes UK is a partner in the collaborative I hope we can look forward to an annual session.

Type 1 Webinars - The conference calendar is very congested and it is hard to see where we could squeeze in a conference for the collaborative, so I propose a series of educational webinars on various aspects of Type 1 diabetes.  We are looking to start in early November with a webinar on the subject of Flash and Continuous Glucose Monitoring.  Some Type 1 teams may choose to log in for the live event, while others will prefer to access the recorded version on the website at their leisure.  Watch this space for more details.  Suggestions for future topics and volunteers to present are most welcome.

Pumps and Technology

News Flash: Flash Glucose Monitoring to be available in the NHS UK-wide 

The NHS Business Services Authority has approved the listing of the FreeStyle Libre® flash glucose monitoring system in the Drug Tariff (under section 9A: Detection Sensor, interstitial fluid for glucose).   This means, subject to local health economy approval, it will be available for reimbursement via the NHS across England and Wales, NHS Scotland and Health and Social Care in Northern Ireland from 1st November 2017.  This announcement follows the NICE MIB110 - see HERE, published on 1st July, and more recently the Diabetes UK Consensus Statement  - see HERE.   We would encourage Type 1 Clinical Leads to engage with the purchasers of health services in their localities to agree clinically sensible access policies.  The consensus statement might be a good starting point, and Gerry, Fiona, Dan and Emma contributed to it.  IPN-UK members are working on a statement /template that the collaborative can offer as a resource for discussions, as we know that patients rightly expect us to be prepared for this.  We hope to place examples of local agreements on the website as they become available.  Please consider signing up to ABCD’s Nationwide Audit of Freestyle Libre as a convenient way of collecting and analysing your data, while contributing to a UK-wide real world audit.

During the discussions it is clear that we need also to produce guidance about the place of continuous glucose monitoring, which is not covered by the announcement about flash glucose monitoring.

Pump guidelines - Finishing touches are being put to a series of guidelines for insulin pump teams about various aspects of pump therapy.  I am certain they will prove extremely useful.

Quality Improvement

T1 Diabetes Service Level Audit  - Thanks to everyone who gave feedback on the T1 service metrics developed by Emma Wilmot and Anne Kilvert.  This will now be sent out as a pilot audit, possibly via Survey Monkey, before being offered for adoption by the National Diabetes Audit in 2019.  I would urge the clinical leads to complete it for their departments.

Whole of Life   The topic areas that seem to be priorities are:

  • Transitional Care (from paediatric to adult services) and I have had lots of volunteers to keep up the momentum of recent months.
  • Frailty  Alan Sinclair is doing some important work on frailty and diabetes.  We will have the opportunity to comment on this from the perspective of the person with type 1 diabetes.
  • End-of-life  June James has agreed to lead an update of the current Diabetes UK recommendations for diabetes care at the end of life, and there will be an opportunity to contribute to this.

Enabling Success

University students - I am aware that Diabetes UK is highlighting the challenges faced by people with type 1 diabetes going off to university.  Dr Khin Swe Myint has led a project supported by DUK and JDRF that has produced a toolkit that looks very useful.  Swe has offered to share this experience with and disseminate it via the collaborative.

Driving and T1 diabetes - Partner organisations have responded in various ways to the proposed changes to the driving legislation in England and Wales from January 2018.  The ABCD response is on its website. We need to ensure the changes to legislation and the implications of those changes are communicated to clinical teams in timely fashion.

Patient Education

Simon Heller has been involved producing a proposed framework for the accreditation of courses on behalf of NHS England.  In parallel with this innovative digital resources are being produced and evaluated.   I am very grateful to Sam Rice for giving the collaborative access to the videos produced in Wales on type 1 diabetes.  They have been well received by the collaborative committee and hopefully we will be able to make them more widely available.  It would be marvellous if the work done by Sophie Harris to establish T1Resources could be continued with the support of the collaborative.

In conclusion

I hope this bulletin will have demonstrated the important developments that the collaborative is already engaged with, and some projects already going on that are relevant to us.  Although we can and will do lots of things, a major role for the collaborative is to disseminate good work that is going on around the UK and further afield that will improve care for people with Type 1 Diabetes.  Do let me know what is going on in your area and I will do my best to share it via the website.

I will circulate suggested dates ASAP for a meeting of the core group, probably late November.  

 

Rob Gregory
Leicester