- Embedding self-management support through the three strands of the Co-creating Health programme.
- Focused on working with people with type 2 diabetes.
- Ran from September 2007 until November 2012.
- Relied heavily on collaborative working between teams, including between the three provider organisations Whittington Hospital, NHS Islington and NHS Haringey
The team wanted to bring about a fundamental change in local diabetes care. They wanted to make relationships between people and their clinicians more collaborative, and redesign diabetes services to better support self-management. To achieve this they rolled out the three elements of the Co-creating Health programme:
- Self-management Programme (SMP) for people with long-term conditions
- Advanced Development Programme (ADP) for clinicians
- Service Improvement Programme (SIP) to redesign services.
Feedback was extremely positive from the SMP. Evaluations found the course helped with problem solving, goal setting and peer support and gave people a better understanding of their condition. Audits of blood tests before and after attending also showed significant improvements in HbA1c.
The team found it slightly harder to engage with clinicians who were initially sceptical about the ADP. However when asked, 97% said the ADP had provided them with new skills to use and 91% said they had implemented parts of the ADP into their daily professional practice.
The team found learning was most sustained when knowledge was shared (eg GP and practice nurse together) or when the whole team attended. To further embed and sustain skills they developed tools including peer support, refresher sessions and individual coaching.
The diabetes team shared learning with the local respiratory medicine team, clinicians specialising in pain and haematology were also trained and the ADP was adapted for hospital specialist nurses.
Training in improvement models was also highly valued and used to redesign and improve the quality of services. A number of teams were involved in quality improvement exercises such as developing an agenda/goal setting tool for patient consultations; designing a ruler measuring patient confidence; and adapting the diabetes template on the electronic patient record.