So these pages recently have been all about
pumping and more specifically the 640G. Whilst I know this interests many, I’m
keen to keep a more general feel to the blog now and again and a few hours last
night gives me the perfect chance to do this.
The event I attended at my local hospital
was about a proposed new diabetes centre for the surrounding area. The ‘Patient
Conversation’ was billed as an opportunity for patients to put across what the
team currently do well and what can be improved upon. Along with a few others
from a local diabetes group I attend, I went along to really try and make a
difference. This should be an opportunity for local diabetes care to step back
and look at everything they do to see what they do well, what they do badly and
what they don’t do at all.
Being the good boy scout that I am I made a
few notes beforehand and went along to see what was being proposed.
We were grouped into tables of roughly five
to eight and together we put our thoughts down on to paper and answered the
four questions of the night. The
questioning was good and open about what we’d like to see from the centre and
also what can be improved with current treatment.
Overall a common theme was coming through
the evening as we answered the questions and fed back table by table. The
healthcare professionals we meet with at every appointment are fantastic
(except Barney obviously!) and their hard work and dedication will be what
makes any new centre work even better. On the flip of this process and
organization needs improving along with taking this opportunity to make some
relatively simple changes to improve the lives of people with diabetes locally.
A simple example of what works well and
what doesn’t is getting to speak to the people you need to. On appointment day
it’s not unusual for me to see the consultant and also squeeze in a meeting
with the diabetes support nurse (DSN) and dietician at the same time. However
contacting someone when away from the hospital means leaving an answer-phone
message with the DSNs that will be listened to the same day (if Monday to
Friday 9am to 5pm) and you normally get a call back the same day or the next.
But when leaving the message you’ve no idea if or when you will get responded
too. Likewise email responses are, what’s the word, ah yes, intermittent. And out of
hours; you’re flying solo matey.
Obviously as this is the local NHS,
resource is always a constant issue and we were reminded during the night that
people are being stretched as far as they can. I fed back that I understood
this but this has to seen from the other direction. Whilst the HCP is running
around saying “I’m busy, I’m busy” I’m sat there waiting for an hour, looking
at my watch thinking of the work building up back at my office and watching the
emails come in that I need to deal with urgently but can’t because I’m sat on
an uncomfortable chair and don’t have a decent phone signal. Being a person
with diabetes takes time as I’ve touched on before and if I had a choice of
hobby, this wouldn’t be it!
Through the night some fantastic yet simple
ideas were coming out. For example, move the consultants desk to break down
that ‘headtecher’ style barrier to communication, put up a noticeboard with
posters of local support groups to enable peer to peer support, text alerts for
appointments, same day HbA1c tests where currently it takes a few, remote
appointments such as via Skype for those who find it hard to travel, a coffee
machine in the waiting area with diabetes literature (Balance etc) to generate
conversation etc.
I kept bringing up again and again the
subject of social media and peer support. It’s hard to judge but I got the
feeling the heads were being nodded but the historical fear of ‘nutters on the
net’ still exists. The presentations given at the recent Diabetes Professionals
Conference show that online support is a significant aid and encouragement to
better self-management and to ignore or dismiss it at the stage would be
foolish. I really do hope I’m wrong on how I think this will go. There were
enough people with diabetes in the room that were there because of meeting
others that showed if you can encourage it you will get a much higher
involvement and therefore far less ‘did not attends’ on the appointment list.
Paired with this I’m sure people in the room (including me) would be also
willing to help provide some simple pointers (such as Kev’s great leaflet) for
people to connect with other local, national and international people who
understand what they are feeling too. On a local level we NEED to engage with
those better. Some people don’t want to tweet, Facebook or blog. That’s fine.
But they must at least know that these avenues exist.
Throughout the meeting we were asked to
write our thoughts down and these would be taken away and fed into the decision
making process. This must be applauded as connecting at any level can only help
to make the proposed centre more successful going forward. Indeed some of the
ideas already on the slides pre-prepared for a summary at the end matched the
feedback we gave last night. This shows that the thinking is going in the right
direction. Great!
The key question now is what is going to
happen next? I have a very real fear that last night was an exercise in ticking
boxes and if the decision makers were asked in the future if they had consulted
they can say yes.
Some of things discussed don’t need a new
centre building; they just need the process tweaking. And by tweaking this
process it may help to ease the burden on the wonderful DSNs rather than adding
to it.
I hope with a passion that this is just the
start of the consultative process and as well as looking locally at what’s
desired they can look nationally at other diabetes centres to find best
practice and excellence in each strand of the diabetes journey.
This is the chance to redefine local
diabetes care for a generation. Let’s do it! Let’s do it together!
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