Aims and objectives:
The aims of the service change was to give patients more choice to be seen at a local venue and to meet and share experiences with other people with the same long term illness.
General practitioners repeatedly requested education groups to give patients best care and choices and relieve time at the surgery.
This links in with West Lincolnshire’s strategic plan of people being seen in primary care, releasing time in general practice for more clinical work.
Support for the change:
The Primary Care Trust has provided funding for the new service. The hospital diabetes specialist nurses started spotlight at the hospital, evaluating each session. The general parishioners were sent a questionnaire after the sessions had been running for a year.
After the evaluation It was rolled out countywide across 3 primary care trusts within Lincolnshire.
The general practices still continue to refer their patients who are newly diagnosed with Type 2 diabetes.
Patient and public influence:
Every patient was requested to fill an evaluation form at the end of their education programme and from these observations we have fine-tuned the programme. Changes include overhead projector to PowerPoint and by giving prompts to the audience, making it more interactive.
Practice nurses have had a say in the format of the referral form and these have been changed to reflect their views, giving extra space for diagnostic test results, and adding the national health service number instead of the hospital number.
Dietician and podiatrist have been involved in discussion about the programme and the data to be recorded; the dietician has changed the diet programme to be more practical for the patients using food models.
Impact on the workforce:
Two full time equivalent community diabetes specialist nurses have been employed in West Lincolnshire Primary Care Trust and other trusts in Lincolnshire have also employed diabetes specialist nurses.
The package for the community services also included dietician and podiatry hours for their input into Spotlight.
Measuring the results:
A questionnaire given to the general parishioners showed a reduction in the amount of times a newly diagnosed person with Type 2 diabetes was seen, reducing the practices workload.
A further audit will be required at the end of one year to see if any further improvement has been achieved in the workload of general practice, after the extra spotlight sessions, this will be done county wide, to compare differences in other primary care trusts Also an audit will be required to see if the patients have retained knowledge.
Improved performance:
The evaluation forms written by the patients all give high marks and all patients have said they have at least 50 % more knowledge about their condition after the session.
Reflecting diversity:
On the referral form there is a place for staff to indicate if there is any learning disability or physical barrier i.e. hard of hearing.
From published evidence it has been proved that patients, carers and staff gain confidence from group work and interaction with diverse groups.
Within the Spotlight package, it enables staff to present the education in different ways but keeping the same message.
People learn at different paces and in different formats, therefore various methods of teaching are used. These may be overheads, PowerPoint, videos, quiz, question and answer, discussion and sharing experiences with the rest of the group.
Sharing the learning:
Taken to the Diabetes Practice Nurse Forum and shared with two other primary care trusts across Lincolnshire, via the countywide Education Sub Group.
Submitted to Lincolnshire NHS Health Community, Celebrating success in Lincolnshire
Outstanding features:
The integrated working of nurses, dieticians and podiatry all working to the same programme with different methods of delivery, make it an informative enjoyable way of providing education.
The change in patients’ outlook to their quality of life, living with a long-term illness after the programme. Many enter the programme feeling low in mood and as one person told me he was absolutely devastated, but after the programme people have a better understanding and more confidence in living a ''normal'' life.
