Year of Care

Improving the care of people with diabetes and providing a framework for personalised care in long-term conditions

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This programme is closed for applications.

Key Points

  • Aimed to improve the care of people with diabetes and provide a framework for personalised care in long-term conditions, put those with diabetes in the driving seat, and give them the tools and confidence to manage their conditions.
  • Run in partnership with Diabetes UK and NHS Diabetes.
  • Programme ran between 2007 and 2012 at three pilot sites: Tower Hamlets Primary Care Trust, Calderdale and Kirklees Primary Care Trusts, and NHS North of Tyne.

Aims

The Year of Care programme aimed to take a new look at the relationship between people with long-term conditions and the NHS, using diabetes as an exemplar. The longer term goal was to enable patients to manage their own conditions and reduce the burden on the NHS in terms of avoidable admissions, ambulance call-outs and A&E costs.

Training was given to develop care planning consultation skills (using the appropriate implementation tools), allowing clinicians and patients to work together to create packages of care that were personal to the patient. Once developed, care plans were regularly reviewed.

Outcomes

  • Care planning was adopted in a majority of practices across the pilot communities.
  • 76% of people with Type 2 diabetes on practice registers had at least one care planning consultation.
  • 1,000 health care professionals were trained.

Benefits

  • People with diabetes reported improved experience of care and real changes in self care behaviour.
  • Professionals reported improved knowledge and skills, and greater job satisfaction.
  • Practices reported better organisation and team work.

Learning

The Year of Care programme found that care planning was a huge cultural change for organisations and those involved, with success depending on:

  • commitment to care planning right from the top, right from the start
  • support for reorganisation of routine diabetes care from clinics and administration teams
  • robust training linked to practical approaches
  • support for those adopting this approach.

Year of Care: NHS North of Tyne consortium

Improvement project

This project set out to engage primary care in care planning for people with diabetes. Project information was shared with commissioning groups, and training days were provided for GP practice staff.

Year of Care: Tower Hamlets Primary Care Trust

Improvement project

Run by Tower Hamlets Primary Care Trust (PCT), this project set out to break the 'tick box' mindset of annual diabetic reviews, to improve care, and support self-management. The work engaged with peop...

Year of Care: Calderdale and Kirklees Primary Care Trusts

Improvement project

This project set out to improve quality of life for people with diabetes and to reduce the burden diabetes presents to public service finances and staff. 

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