Scottish Diabetes Framework

Scottish Diabetes Framework

Implementation

Implementation and Monitoring

124. Although the publication of a Framework is an important step forward, without effective implementation, the recommendations of the Diabetes Framework will have no impact. It is therefore essential that the Framework contains within it mechanisms to support implementation and systems to monitor progress. The challenge is to build upon best practice to ensure improvements in diabetes care are achieved consistently across Scotland, taking into account local needs and circumstances. This will require concerted effort both nationally and locally.

125. The Framework sets out a range of initiatives and ideas to support NHS boards and healthcare professionals to implement the recommendations. The main mechanism for supporting this work will be the Scottish Diabetes Group. This professionally-led expert group will provide leadership at national level, ensuring that diabetes services remain focused on the key objective - to improve care for people with diabetes. Delivering and sustaining improved standards in diabetes services will take a number of years and the Diabetes Framework itself will need to be revised and updated over the years if it is to remain a useful tool and if all aspects of diabetes care are to be addressed. The Scottish Diabetes Group will wish to monitor progress towards meeting the objectives of the Framework and to publish their findings.

126. In addition to the Scottish Diabetes Group, there will be four other mechanisms providing information about progress:

An action-focused reporting mechanism is an integral part of the Diabetes Collaborative Improvement Programme. Detailed information on progress will be available for the period that the Collaborative runs.

The Clinical Standards Board for Scotland has defined standards for the delivery of diabetes care and will be reviewing local services against those standards. The first CSBS report on diabetes services (in 2003) will provide a detailed and objective assessment of the quality of diabetes care in Scotland.

MILESTONE

The CSBS will publish an assessment of the standards of care provided by diabetes services in 2003.

The Scottish Diabetes Survey will provide an annual snapshot of some of the most important indicators of diabetes care. The Survey will provide an increasingly comprehensive and accurate picture of diabetes in Scotland. The next survey is due to be reported at the end of 2002 (see paragraph 117).

The Performance Assessment Framework (PAF) is the mandatory core framework for assessing the performance of the NHS in Scotland and forms the basis of the annual NHS Accountability Review. The PAF includes a number of indicators which are relevant to diabetes, in particular it stresses compliance with CSBS standards.

127. At a local level, the main drivers for securing implementation of the Framework objectives will be NHS boards (and their constituent parts) in conjunction with LDSAGs and managed clinical networks. Although the Framework sets out the broad objectives and the necessary scope of local developments (in particular in the 'Strategy, Leadership and Teamworking' section above), it is for local teams to work through the challenges and opportunities of their own circumstances to determine how best to proceed.

128. Other agencies, such as local authorities, schools and the pharmaceutical industry, need to consider their role and what contribution they might make to improving care and support available to people with diabetes.

Community Issues

Community Issues - Issues involving other agencies

129. In order to improve the lives of people with diabetes there is a need to focus not only on the role of the NHS and equal access to standards of health care, but on a range of 'community issues', which relate to living with diabetes. As a condition, diabetes can affect not just patients but those closest to patients - partners, parents, siblings, and friends. Diabetes also impacts on access to, for example, employment, leisure, transport, education, welfare benefits and social care services. Addressing 'community issues' is about taking a holistic view of diabetes and recognising that living with the condition is about much more than health care. These should not be seen as marginal issues. The Diabetes Framework has the potential to act as a catalyst in recognising and responding to these aspects of living with diabetes and as a means to inform different Executive agencies about community issues as they effect people with diabetes.

130. One of the examples of community issues raised by people with diabetes when asked by Partners in Change was food. Finding ways for people to be sure of access to reasonably priced fresh food was raised as a major issue by people in rural areas and by people in some larger housing estates. People thought there were ways in which the health services could work with other people to help people with diabetes - and everyone else in that community - live in a more healthy way, such as through food co-ops and vans in rural areas.

131. NHS organisations need to work more creatively with other agencies in order to address these issues, for example to ensure that health and social care provision for people with diabetes is as seamless as possible. The Community Planning process provides an important route for taking on many of the wider issues raised by people with diabetes and their families.