Diabetes care - progress against national priorities: commitments - 2021 to 2026

Priority 8 – Innovation

To accelerate the development the development and diffusion of innovative solutions to improve treatment, care and quality of life of people living with diabetes.

The Diabetes Improvement Plan 2014 highlighted the increasing pressures being placed on diabetes services due to the increasing prevalence and the resultant need to ensure it strengthens capacity through innovation. This includes innovation through medicines management, emerging technologies, and collaborations.

Action 8.1 Promote networking and mechanisms to support innovation

Scottish Diabetes Technologies & Innovations Group

To progress this priority the Scottish Diabetes Group in conjunction with the Chief Scientist Office have established a Scottish Diabetes Technologies & Innovations Group (SDTIG). The aim of the group is to establish an infrastructure to ensure Scotland can maximise the opportunities around data, technologies and innovation to improve diabetes care and outcomes in Scotland.

The group are also keen to support Scotland becoming an internationally renowned 'test bed/research' arena for the development and assessment of technologies and innovations used in diabetes care.​ The SDTIG is a facilitative /advisory group and its functions include sharing information to facilitate collaboration and act as a source of expertise and signposting. The group shares information about innovation projects and funding opportunities and encourage registration of initiatives. Its role also includes proactively communicating with wider audiences in order to promote and protect diabetes interests. The SDTIG is currently running an open innovation SBRI competition (Small Business Research Initiative) in diabetes, funded by Innovate UK and NHS Scotland. There are 3 separate challenges, being run from NHS Highland, NHS Lothian and NHS Greater Glasgow and Clyde. The challenges are as follows:

• Using artificial intelligence and machine learning to help develop prediction algorithms and risk stratification for diabetes foot ulceration, amputations and mortality.
• Improving the clinical care of patients with a pre-existing diagnosis of diabetes when admitted to hospital by developing a real-time decision support tool and alert mechanism. The tool must improve triage, prevent medication errors, identify emergencies and streamline the diabetes care pathway.
• Improving the identification (case-finding) of people at risk of osteoporosis and fracture, including those with diabetes.

Another key function of the group also includes helping initiatives to navigate a health technology assessment (HTA) and acts as a contact point for Scottish Government, health boards (E-health) and procurement for providing strategic advice on the purchase and implementation of diabetes technologies.

The SDTIG aims to add value by working with others to iteratively consider how the priorities within the Diabetes Improvement Plan might be solved/supported by technology and innovation. The SDTIG links into existing groups and offers a supportive infrastructure to make it faster and easier to bring together those with needs and challenges in diabetes, with the people, organisations and businesses capable of developing a solution.

Action 8.2 Increase the pace of adoption of proven innovations

Innovative Technology

The SDG and wider diabetes community have worked in conjunction with NHS Scotland procurement to revise the framework for technologies involved in diabetes care. This collaborative approach has helped ensure wide stakeholder engagement in this process and improved communication across all areas of NHS Scotland involved in this process.

The Type 1 subgroup of the SDG have also worked closely with the Scottish Health Technologies Group to assess the clinical and cost effectiveness of Flash Glucose monitoring (Freestyle Libre). Scotland was one of the first countries in the world to provide a HTA of the device. This helped support a standardised approach to access to this innovative product and this ongoing collaboration will help assess the effectiveness of this device in a 'real world' setting and help inform ongoing roll out across Scotland.

These types of collaboration and 'whole system' working help increase the pace of adoption and also help assess devices within NHS Scotland to ensure ongoing clinical and cost effectiveness. They also help develop an infrastructure for the ongoing assessments of new technologies that are likely to come in the near future.

The SDTIG also links into NHS Scotland wider innovation work streams and is leading on several diabetes specific initiatives. These include evaluation and potential adoption of technologies such as the bionic pancreas as well as projects aimed at improving in-patient diabetes care and foot ulcer prevention. In addition several Scottish based groups are looking to develop health informatics and artificial intelligence solutions to improve risk stratification, communication and improve person centred care models.

The SDTIG is currently developing a framework to support horizon scanning for forthcoming innovations. This will consider how to support innovation from concept, to development, through regulation, assessment, procurement and ultimately adoption. Supporting the entire innovation pathway will help improve timely adoption of innovative solutions to improve the care and outcomes for those with diabetes.