This document discusses a Diabetes Local Improvement Scheme (LIS) in Sandwell. It notes that the area has high rates of diabetes, complications, admissions, and mortality compared to national averages. The LIS aims to redesign diabetes care through specialist community teams and increasing primary care expertise to manage 95% of type 2 and stable type 1 diabetes cases in the community. The goals are to reduce emergency admissions, A&E visits, and complications like amputations through better integrated care between primary and secondary services. Initial outcomes include reduced inpatient and outpatient activity as well as improved HbA1c levels and care integration.