Diabetes Community Support Project
| Description | Engage people with diabetes to provide feedback on local diabetes services |
|---|---|
| Setting | Community centres, day centres, shops, healthy living centres and sheltered housing. Some consultation work and information sessions held at local working men’s clubs. |
| Populationting | People with diabetes living in Wansbeck, Northumberland |
| Intervention summary | Offers education, support and signposting services |
| Outcome Summary | People with diabetes given access to information and education about diabetes at a level they could understand |
| Startup Cost | £10 000 |
| Running Cost | £15 000Salary plus on-site costs: £12 500 Professional support, administration, events, marketing and travel: £2 500 |
| Funding | The first year of the project was funded by Northumbria Diabetes Service and, subsequently, by the Primary Based Commissioning Group Enhanced Services budget. However, funding ends in March 2007 and will not be renewed due to budget constraints. |
| Started | March 2003 |
| Ended | March 2007 |
| Location | Northumberland, England |
| Contact |
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Background
The aim of this project is to shape healthcare services to the needs of people with diabetes, rather than to the needs of the system.
This is achieved by engaging the local community who are affected by diabetes and giving them a ‘voice’ to help shape diabetes services of the future by feeding this information back to healthcare professionals through training.
What is the problem you are trying to solve?
Results from the 2001 census indicated that, for the Wansbeck Neighbourhood Renewal Fund Wards, perceived health is poor compared with other wards in Northumberland. The project was set up primarily to develop user involvement, and because there was no Diabetes UK group between Newcastle and Berwick
What local organisations are involved?
There is a great deal of effort put into linking with other agencies, such as primary care, the Northumbria Diabetes Service, Wansbeck Healthy Living Centre, Wansbeck Council for Voluntary Service and other local voluntary services. We also received support on a specific aspect of the work from the North of Tyne Mental Health Trust.
How many people are running this project and who are they?
One Diabetes Community Support Worker runs the project, working 18.5 hours per week. The post is supported by a small multi-agency steering committee. This post is managed by Northumberland Care Trust Health Improvement Service, Northumbria Health Care Diabetes Service and Primary Care.
What local population are you targeting?
The target populations are people affected by any type of diabetes, their families and carers, who live in Wansbeck, Northumberland. This includes East Ashington, Bedlington, Choppington, and Newbiggin by the Sea. These areas are characterised by social deprivation, with an old coalmining community and limited transport facilities.
How many people are you targeting?
Approximately 4000 people with diabetes
Interventions
What interventions are you using to address the problem?
The project is seeking to engage people affected by diabetes in the local area through the community development approach to health. This has involved developing small groups, one to one contact, and large open day events. Feedback gathered from the users is then used to raise awareness of issues that affect local people. This is to help effect change in service provision for people affected by diabetes.
Is the project design based on evidence? If so, please state reference.
No.
Outcome
What outcomes or planned outcomes are you measuring?
Feedback around understanding diabetes was taken from one to one contact, discussion groups, semistructured interview techniques, questionnaires, taped conversations, activity days/open events in the community and the making of a video/CD.
Do you have any outcomes or results yet? If so, what are they?
Achievements have included successful partnership working, signposting, and the involvement in developing a new sharps disposal policy. The open day events were very popular and the results of the evaluations showed that we had met the needs of the community regarding involvement in services and education/information sharing.
There has been a concentrated effort to engage the black and minority ethnic (BME) population who account for 1% of the local population but whose risk of developing diabetes is six times greater compared to the British white population. There have been presentations to a research conference and primary care practices on the theme of user involvement.
Is your project relevant to a government target or guideline?
Our project is relevant to the National Service Framework (NSF) for Diabetes 1 and the Neighbourhood Renewal Floor Targets 2 . Some of the goals are to substantially reduce mortality rates by 2010 from heart disease, stroke and related diseases by at least 40% in people under 75, with a 40% reduction in the inequalities gap between the fifth of areas with the worst health and deprivation indicators and the population as a whole.
Feedback
What obstacles did you have to overcome to set up this project?
It is difficult to engage people about their health when there are so many other outstanding issues for them to deal with. In this area of Northumberland, some people are affected by poverty, poor access to local services, family problems, limited access to education and information, unemployment, mental health difficulties, social isolation and have a philosophical approach to life. For example, ‘Why bother trying to lose weight or take a bit more exercise? I could get run over by a bus next week, I will be dead before I have the time to have my toes amputated.'
What have you learned about the project so far?
The impact of type 2 diabetes is not immediate and some people feel no different when they are diagnosed. Therefore, the understanding that diabetes is a serious disease process has little effect on daily living. This makes it hard for people affected by type 2 diabetes to take the health message on board.
Some healthcare professionals do not see the value of user involvement as a way of shaping services and there is a possibility that embedding the views of patients into service delivery could take years. As a way of shaping services, the concept of user involvement can be difficult for healthcare professionals because of other demands on their role. The idea can also be challenging and perceived as a threat by some.
What would you do differently?
We would have looked at more supportive ways of engaging with primary care. From the original broad approach, we could have targeted more focused action based on user issues. For instance, one of the main themes that emerged was 'We need education and information at a level we can understand.' We could have taken this theme and spent more resources on developing an appropriate guide to diabetes, or accessed resources from outside agencies that would have met the educational needs. We could have recommended a specific publication to be accessed by primary care so there would be equity in the service.