Agenda item

Ian Ayres (Accountable Officer, NHS West Kent CCG), Dr Sanjay Singh (Chief GP Commissioner, NHS West Kent CCG) and Naz Chauhan (Commissioning Manager – Long Term Conditions, NHS West Kent CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the meeting. Dr Singh began by outlining the case for change. He explained that diabetes services had been identified as an area to improve quality and increase capacity in order to cope with a rising demand and prevalence. He noted that the current pathway was fragmented between primary and secondary care; a new integrated pathway had been developed as part of the review to enable a larger proportion of care to be delivered in the community with increased access to multidisciplinary services such as podiatry and psychological support. A proposed model of care had been developed based on the outcome of patient and stakeholder engagement. Mr Ayres advised that NHS West Kent CCG was seeking the Committee’s views and comments on the proposed model of care. Once a service specification had been developed, the CCG would return to the Committee to ask for a determination on whether it constituted a substantial variation of service.

(2)       A Member enquired about the community based spokes. Dr Singh explained that a spoke would cater for a cluster population of 30,000. The spoke would provide multidisciplinary clinics providing access to consultants, specialist practice nurses and dietetics which could move between surgeries in the cluster population.

(3)       A number of comments were made about referral, early intervention and workforce.  Dr Singh explained that patients would continue to be referred to level two and three community based services by their GP. He explained that it was important to identify diabetes at an early stage to prevent patients developing complex needs and requiring secondary care interventions such as amputations. He stressed the important of caring for level three patients in a community setting in order to release capacity inside the acute hospital for the treatment of complex level 4 patients. Dr Singh reported that it was expensive to provide specialist diabetic services within an acute setting and there were workforce shortages in secondary care. He noted that the primary care workforce could be upskilled to provide specialist support in the community to reach a larger population at a more sustainable cost. 

(4)       Mr Inett enquired about the figures provided by NHS West Kent CCG regarding the prevalence of diabetes; he noted a variation with the National Diabetes Audit. Dr Singh confirmed that the figures had been provided and verified by Public Health. Mr Inett also enquired about the promotion of self-management. Ms Chauhan acknowledged that more work needed to be done around self-help and intervention. Dr Singh noted thatthere was a focus on patient education as part of the review, the CCG was developing a Preventing and Obesity Strategy with Public Health and the CCG was part of a first wave national prevention pilot.        

(5)       RESOLVED that the report be noted and NHS West Kent CCG be requested to present the service specification to the Committee at the appropriate time.