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.

1. Diabetes LIS
(Local Improvement Scheme)
Gursharan Kaur
Commissioning Manager

2. Background
• High diabetes prevalence and complications
• High admission rates
• Overspend on diabetes management drugs
• High Mortality rates in people with Type 2
Diabetes (Sandwell) in 2011
• High number of major amputations for
diabetic people in Sandwell compared to
national average
• RCRH

3. Diabetes Redesign
Specialist Community
Diabetes service
• Redesigned Specialist
Community Diabetes
service specification
• DiCE teams
• Reduction in emergency
acute admissions
• Reduction in A&E
attendances
• Reduction in amputations,
renal dialysis and blindness
Diabetes LIS
• Diabetes LIS (Local
Improvement Scheme)
• Increase Primary care
expertise & management
• 95% type 2 and Stable Type
1 diabetes care in
community
• Aim to meet Diabetes UK 15
Care essentials

4. LIS Sign-up
 Level 1: 75 practices
 Level 2:
 GLP1s- 54 practices
 Insulin – 43 practices

5. Outcomes
• Reduction in activity
 Inpatient: 14/15- 5%, 15/16- 10%
 Outpatient: 14/15- 5%, 15/16- 10%
• More integrated working between primary
and secondary care clinicians
• Improved outcomes such as HbA1c levels in
the diabetic population
• Reduction in A&E and emergency activity
related to Diabetes

6. Future Vision
• Review Diabetes Care Pathways
• Improved diagnosis and management of
diabetes and associated long term conditions
i.e. stroke
• Deliver more care closer to home
• Reduce unnecessary hospital appointments
and visits
• Empower and up-skill primary care to manage
patients in the community
• Empower patients to become partners in
managing their health

7. Integrated Care Model
Up-skilling
Primary care
& deliver care
closer to
home
Redesigned &
Integrated
Diabetes
service
Education &
Training
Programme
Mentorship

8. Questions?