CQC carried out fieldwork for the review between January and March 2016 including East Lancashire, Liverpool and North East Lincolnshire in the North. The review looked at 4 key aspects of care for people with diabetes, including:
• Identification and diagnosis
• Structured education and support for self-management
• Care pathway
• Person-centred care coordination
The review included interviews with GPs, clinicians and commissioners; multi-professional / multi agency focus groups with staff; focus groups, 1 to 1 interviews, and case tracking of people with diabetes. The review looked at existing evidence from CQC’s comprehensive inspections, information provided by Healthwatch, CCGs and other data sources. The review also used an online web form, limited to the areas covered by the fieldwork, to gather the experiences, opinions and insights of people about their diabetes care.
The review discovered that people at high risk of developing Type 2 diabetes were not always identified and supported to become healthier. Some people felt they were not receiving enough emotional support – providing this support at diagnosis and beyond can contribute to more effective self-management and increase engagement with services and attendance at structured education programmes.
CQC saw many examples that others can learn from, including local commissioners and providers proactively engaging with individuals and communities, and innovative methods to increase people’s ability to self-manage. The review also highlighted that people who had attended structured education courses felt it improved their ability and confidence to manage their diabetes. Where these courses were less likely to be accessed, for example by people from black and minority ethnic (BME) groups, some local services were able to show how they were providing culturally relevant information, support and training to people in their local community.