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26
WQ.454/2019
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY M.R. LE HEGARAT OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 22nd OCTOBER 2019
Question
Given that the Health and Community Services Department is currently working on the formulation of an Island-wide Diabetes Strategy, will the Minister explain what reviews (both external and internal), if any, are being undertaken (or have been undertaken) as part of this initiative to ensure that the Diabetes Service within secondary care is fit for purpose; and if no external review has been, or is being, completed to help formulate the Strategy, will the Minister commit to such a review and the publication of its findings?
Answer
Internal reviews of the Diabetes Service were undertaken in 2010, 2012 and December 2017. Following both the 2010 and 2012 reviews, funding was granted to increase the nursing establishment. Following the 2017 internal review, it was recommended that an external review should take place. This external review was commissioned in March 2018. Based on the external review, a number of initiatives have been implemented. These include: the implementation of an in-patient diabetes service; restructuring of outpatient clinics; and recruitment of a paediatric nurse specialising in diabetes, a dietician and a podiatrist. In addition, diabetes ancillaries are moving out of the Diabetes Centre and into the community.
The lead nurse for specialist medicine (of which diabetes was a service within that division) joined the service in June 2018 and after discussion with the team it was identified that there was no Island-wide diabetes strategy. The initial need for a strategy was discussed with the Deputy Director Primary & Community Pathways and the Divisional Lead for Medical Specialities who agreed to create a small working party.
In August 2018, the working party was set up and included representatives from FNHC, the primary care Medical Director, GPs, diabetes consultant, lead nurse, diabetic specialist nurse team and a dietician. At this time, a version of the strategy was drafted focusing on the vision /key areas of performance and enablers.
Throughout the development of the draft Diabetes Strategy, HCS has worked closely with GPs, pharmacists, Diabetes Jersey and other stakeholders, such as Jersey Sport, as well as gaining the valuable views of Islanders with lived experience. This has enabled the group to review current provision and identify where improvements are required. Clinicians are developing pathways, and issues such as prevention and equipment are being discussed.
Through this process, a number of themes have emerged, namely:
• Improved equitable access to technology is essential
• Education for patients with diabetes is an important issue
• Diabetes Jersey is funding key essential services
• There is a need for clinical psychological support
• The Diabetes Centre sees a significantly greater proportion of patients with diabetes compared to its UK counterparts.
Health and Community Services will continue to work with all stakeholders to improve services for Islanders and is grateful to Diabetes Jersey for its recent support to provide ancillary products in the community, which launches in November. This is an example of where a gap was identified and, through working in partnership, a solution identified and put in place.