http://www.kirklees.nhs.uk/fileadmin/documents/your_health/Self_Care/JOINT_DIABETES_REFERENCE_GROUP_

Agenda Item

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

JOINT DIABETES REFERENCE GROUP MINUTES FROM 10th June 2009 (Huddersfield) and 25th June 2009 (Batley)

Dixon Room, Salvation Army, Batley Present:

National Childrens Centre, Huddersfield

Hayley Haycock

Present:

Valerie Wilson Pat Chapman Tony Chapman Apologies

Geoffrey Gibson Barbara Senior Margaret Kilbury John Lloyd Cynthia St Louis

Natalie Pinnock-Hamilton Apologies:

Agenda Item 1.

Dixon Room, Salvation Army, Batley

Denzil National Childrens Centre, Huddersfield

Hayley Haycock (Programme Manager for Stroke stood in for Sandra/Julie) Valerie gets 2 copies of minutes ? on distribution list twice?? Pat + Tony just get 1 – OK. NSF Standards sent out last time with minutes was too small to read – can we send a better quality copy with these minutes please. (action Anne)

Sandra Readman Catherine Harper – minute taker

Sandra had received 1 comment on these.

Julie Wood is looking into the possibility of printing details of support groups on the back of flyers to encourage awareness and hopefully increase membership.

Workstreams from the Diabetes HIT meeting. The standards which have to be met by 2013 were sent out with the previous minutes and all had received them.

Retinal Screening – still in process of developing service for Asked how they could get more members to group house bound patients. Gillian Longbottom putting back on the – wondered if Marilyn or Sue could help through steering group agenda.

EPP. Diabetic medication in hospital, if concerns take to PALS (Patient Still not ready to attend HIT at present but would and Liaison Service) on 01484 466129 or 466141. Catherine like list of future meetings. said this had been discussed in the Neurology HIT meeting, the /mnt/tmp/tmpTomCym Page 1 of 7

Agenda Item

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

point discussed was about medicines management training for nurses to enable patients to self-medicate and have a place where their medicines can be kept secure.

PALS (exercise) membership – in answer to the question raised at the last meeting, you receive 1 year free, 1 year at a subsidised rate then it goes to full price. If you had another illness diagnosed that would benefit from exercise you would start again from scratch.

2.

Patient hand held records The reference group members were asked to review several sets of patient hand held records used in other parts of the country. The aim is to develop hand held records for patients to use in Kirklees. The diabetic record may form part of a larger Long Term Conditions record, for use by patients with either diabetes, heart disease or stroke.

The record should provide information for the patient and carers and for the patient to write down their goals, progress or problems and to then share the record at diabetic review appointments.

There will also be the opportunity to write down recent blood results; blood pressure readings etc.

Group took some of the hand-held records home to digest!

All preferred the smaller size booklet with the ability to slot things in.

Liked A5 size / ring binder better than bound copy / also wanted a sleeve at the back to keep loose things in / wanted menu of information / contacts for sign-posting.

The patient held record could be handed out at the annual review.

Dietary advice: Not keen on how some core information was presented, eg page on healthy diet showed the plate model – this was felt to be too strict and doesn’t take into account individual preferences / lifestyles. Need page on ‘where are my dietary /mnt/tmp/tmpTomCym Page 2 of 7

Agenda Item 2. continued

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

boundaries’ – if having a good or bad day’ - eg wedding / party / Christmas (compensations).

More information re sweetners/aspermante. Diet reviews should also be kept in hand-held record.

Activity: ‘Being active’ not meaningful – needs fuller explanation and examples. Doesn’t take into account those who can’t partake, and also needs to tailor advice from those who are very active and to those who are housebound. Examples would be good here.

Footcare: Footcare needs to be emphasised, as very important and key to being active.

Difficult to get referrals to podiatry – need more information where to go to get help and accessing footcare.

Complications of diabetes: Tony wanted more information on other difficulties that diabetes can cause – eg stroke Home Blood Glucose Monitoring: Testing kits – confusing re number available and different types of devices available; need guidance re why, when and how often to test, which meter is better for adults, type 1, poor eyesight , children.

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Agenda Item 2. continued

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

Goal setting: Easy to set goals but achieving can be difficult.

Can some motivational advice and pointers be included, and where to get support. ? include some success stories. There needs to be acknowledgement of barriers to achieving goals, and where to make a start. Where to go for help and encouragement; positive techniques etc.

Need a section on ‘what are my habits?’ – help and support to break the cycles.

Support: There is a lack of continuation of support and peer group support. ? Include contact information re local support groups / health trainers.

Reviews: Results to be incorporated in record.

Medication : To be included in record. Also want basic realistic information about medications – not just ideal scenario (like drug company info). Clear, easy to understand info – eg could make you pass water more often , rather than ‘increased urination’.

Pharmacy: More information around role of pharmacy and how they can help and support.

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Agenda Item

Dixon Room, Salvation Army, Batley

3.

National Childrens Centre, Huddersfield

Reference Group information on NHS Kirklees Intranet: Information on diabetes and the reference group are now available via the internet. To access: Internet site – www.kirklees.nhs.uk Click: ‘Your Health’ From ‘Section Menu’ – click – ‘Self Care Programme’ From ‘Section Menu’ – click – ‘Diabetes’ Click – ‘Get Involved’, then click ‘How to shape local diabetes services’ You can forward any comments to the PCT regarding diabetes services from this web page.

Sandra is promoting this site with the Occupational Health Nurses

4.

Any Other Business

Any other business

Dietary Advice:

Diabetic Reference Group Event:

The role of dietician in community needs to be more visible and accessible and more holistic in their approach rather than purely focusing on diet – tailoring advice to the individual.

Speaker Dr Sue Roberts who worked at the Home Office came to the last Diabetes UK support group meeting and was excellent.

Could we invite her to the event later in the year?

We need to discuss this at the meeting in the north side and then come up with a date.

Reference Group : Val re-emphasised the need for more group members.

Pat mentioned cutting down on catering for next meeting (take sandwich bags)

Expert Patient and Desmond: In development is Desmond foundation which will be starting in small way from September.

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4. continued

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

This is to educate people about self management and includes a lot of group learning – 2 sessions, half a day, 1 week apart.

The Desmond team are happy to attend meetings to share the information. Could we do a joint meeting of the 2 reference groups and invite someone from Desmond to attend, we could also invite the press to highlight the reference groups. This needs to look at for later in the year.

Access to GP’s Problems with seeing your doctor were raised. All patients should be able to see the doctor if needed without being made to feel you are wasting his time. Sandra asked is the problem of getting an appointment or is it that if you are a controlled diabetic you are automatically slotted in to just seeing the nurse?

All patients need to be able to see the GP for some diabetic discussions, say at least once per year.

Redesign of diabetes services: There is a drive to get Diabetes care into GP practices by 2013 (NSF standards) but only if fits in with local service need. The PCT also needs to be clear on how we are meeting the NSF standards.

The PCT should have a clear strategy on how to they are providing diabetes care. Part of this is to have patient held records.

The proposed model for the diabetes service redesign is to get GP’s trained up to provide an enhanced service offering care for patients who are stable on insulin therapy, and those who need to start insulin, as well as newly diagnosed Type 2 patients and

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Agenda Item

Dixon Room, Salvation Army, Batley

National Childrens Centre, Huddersfield

4. continued

those taking tablets. All other patients will continue to be care for in secondary care. The business case is going in on 1 July.

The GP will identify those patients who may be suitable for discharge from secondary care, but the decision to move from secondary to primary care for diabetes reviews will be jointly made between the consultant and the patient. The specialist team (Consultant, diabetes specialist nurse and diabetes specialist dietitian) will be visiting GP practices periodically to support the practice and patients. The PCT is responsible for making sure that the practice is capable to take on enhanced care. It is expected that e-consultation will be available in a few years, that is sharing of the patient record between the GP and the consultant for treatment advice.

In the new model, if a patients needs to be referred into secondary care, it should be on a more of a revolving door system, that is see the consultant then refer back to GP with a treatment plan, then if problems occur back to consultant, rather than attending secondary care all the time. This should cut down on waiting times and the appointment system should work better for the patient. Basically, mix and match according to need.

Date of next meetings

5.

Huddersfield Meeting Dates

Batley Meeting Dates:

14 October 09

29th October 2009

All meetings to be held at the Brian Jackson Centre, 12.30 to 2.30 pm.

All meetings to be held at the Salvation Army Centre, Batley – Dixon Room.

12:30 – 14:00

PLEASE NOTE: As there is no meeting for the Batley group in August (was 12 August) the planned Huddersfield meeting has how been cancelled.

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