New diabetes model helps hospital admissions drop

Jack Woodfield
Tue, 22 Nov 2016
New diabetes model helps hospital admissions drop
The introduction of a new approach to diabetes care has shown a significant decrease in hospital admissions related to the condition, according to new figures.

In five years the Super Six model of care has lowered diabetic ketoacidosis (DKA) admissions by 29.5 per cent in South East Hampshire and Portsmouth.

Hospital admissions for hypoglycemic events have dropped by 42 per cent drop and there have been 30 per cent less hyperosmolar hyperglycemic state (HHS) admissions.

The new way of caring for people with diabetes was developed to streamline services produced by Clinical Commissioning Groups (CCG) and to improve the health of people in the area in the long run.

In Portsmouth and the surrounding areas, the care of a group of people with diabetes, who were previously managed at Portsmouth Hospitals NHS Trust, was shifted to general practice.

The model defined six patient groups which became known as the 'super six', whose care would continue to be managed in hospital.

Those services with a high level of diabetes expertise required are:
  • People on insulin pumps
  • People with diabetes in antenatal care
  • People requiring diabetes foot care
  • People at a later stage of kidney disease
  • Uncontrolled type 1 diabetes and teenagers
  • Inpatients with diabetes
The ongoing care of everyone else with diabetes in the area was moved to primary care (centred around the care of GPs).

In order to measure how effective the project has been, a survey was compiled and patients and healthcare professionals from the participating practices were asked to complete it.

The average satisfaction rating of patients was 9.5 and 96.6 of practices were pleased with the progress so far.

Dr Partha Kar of Portsmouth Hospitals NHS Trust, who helped pioneer the Super Six model, said: "This model of care looks at how differently we can approach diabetes care and the initial idea was really very simple.

"It was based on specialists using the hospitals for high-end care, with the rest of the services being managed in primary care.

Dr Kar, who is based at the Queen Alexandra Hospital and is also associate national clinical director for diabetes for NHS England, added: "We, as a community, are working to get this right. We don't believe it's the perfect model of care, but it's held its own and is bound by a core strategy - which uses the same group of specialists working in both community and acute settings.

"The term 'community diabetologist' is archaic and irrelevant in an era where patients are seen across the system. A hospital is only part of the community - and this is what our model of care has tried to reflect."
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