Diabetes Education Review

There are over 21,000 people with diabetes in Wirral. Their long-term condition means that they will all have an increased risk of heart attacks, stroke, cancer, sight loss, nerve damage, kidney problems and other complications. Many of these risks can be reduced and managed with the right self-care and support. For people to be able to keep themselves as healthy as possible they need accessible information that meets their needs. According to Diabetes UK, “Diabetes education is key to successful day-to-day diabetes management and can be life-changing for people with diabetes”.

Structured education programmes can help adults with type 2 diabetes to improve their knowledge and skills and increase patient activation to self-manage effectively, and it’s also recommended for it to be utilised by family members and carers of adults with type 2 diabetes, if appropriate. The Integrated Care Board (ICB) wants to see an increase in referrals to structured education for diabetes and to support the uptake of structured education across our Place. Therefore, it’s key that gaps in local services are reviewed and ensure there is both a face-to-face and digital offer for Type 1 and Type 2.

Cheshire & Merseyside ICB asked Wirral Place to focus on the Long Term Plan programme ambition of supporting people who are newly diagnosed to manage their own health. A key component of that ambition is improving access and uptake in diabetes education.

We were commissioned by Wirral Place to review the structured education available to people with Type 1 & 2 diabetes in Wirral. We focused on understanding the referral and attendance data available, current referral processes and the barriers and solutions to increasing uptake in diabetes education.

How did we do it?

We contacted people who had attended diabetes education and those who had a recent diabetes diagnosis, but had not attended any structured education. We had conversations with community groups and held workshops with people who are most likely to experience health inequalities, people from our most socially deprived communities, people with a learning disability and people who come from a diverse ethnic background.

Our team spoke to GPs and nurses in Primary Care as well as hospital and community diabetes specialists who refer their patients to structured education in diabetes. We sought the views of other professionals who support people with their diabetes care in community pharmacy, optometry and podiatry.

Once complete, the team brought all this information together alongside the various data sources to get a system view of the challenges and articulate solutions to improve people’s knowledge, skills and confidence in managing their diabetes.

Our Findings

The research found that there is a clear, local need for a co-ordinated and consistent marketing campaign to ensure every opportunity for people with diabetes to be encouraged to access diabetes education is maximised. We need to make every contact count, engaging with Primary Care in the widest possible sense, community pharmacy, community optometry, podiatry and the whole general practice team.

The Core20plus5 framework needs to be utilised to effectively identify priority communities and inform engagement activity towards those localities where residents experience the most health inequalities and correspondingly the poorest health outcomes.

Our review has also highlighted that diabetes education needs to be more flexible to improve choice and increase the conversion rates from referred to attended. Offering courses across Wirral, more courses outside core working hours and in community settings are all solutions suggested by people with diabetes and the clinicians who support them. An asset-based approach, utilising specialist community organisations to engage key audiences and deliver sessions within underserved communities would be a very positive step forward.