Diabetes
Over the last decade, there have been significant improvements in the delivery of diabetes care across NHS Orkney. We would like build on this over the coming years.
Prevalence
The number of people with diagnosed diabetes in Orkney continues to rise steadily (increased by 4.7% since 2020) and in December 2021 there were 1278 people with Diabetes. 11% (140) had Type 1 Diabetes and Type 2 89% (1138).
Self Management
NHS Orkney would like to improve access to structured education for people with diabetes, as this would enable them to make informed decisions about their care. The Diabetes Specialist team would like to continue a blended approach for the delivery of education by offering a combination of both online and face to face opportunities. Online and face-to-face educational opportunities for Type 1 and Type 2 diabetes includes: for newly diagnosed Type 2 diabetes (Control-IT), intensive insulin therapy for Type 1 diabetes (include DIANE and STEP programme), insulin pump initiation for Type 1 diabetes, flash monitoring education for insulin treated diabetes using a basal bolus regimen.
We encourage people to access the online patient portal; "My Diabetes My Way" - which gives them access to their personal diabetes related health records. This includes details about their overall blood glucose control and relevant information about risk factors for future diabetes related diabetes complications. Currently, 58.2% of adult patients with Type 1 diabetes and 16.2% of adult Type 2 patients have access to the portal. We will promote the uptake of this over the next 5 years. My Diabetes My Way also gives these people access to a number of educational modules.
We will continue to work with Diabetes UK (Scotland) and JDRF to ensure that people with diabetes have access to the excellent self management resources and peer support that they offer.
Technology
The Diabetes Team continues to embrace the rapid advances in Diabetes technology for supporting the delivery of diabetes care including provision of blood glucose monitoring, insulin pump technology, tele-consultations, home device downloads, remote and rural support. We have been leading on the delivery of specialist telemedicine support for diabetes care since 2008. Over the coming years we plan to support the use of advanced insulin automated insulin delivery systems where clinically appropriate and based on national guidance.
Workforce and Staff Education
NHS Orkney has recognised the increasing need for supporting diabetes services in Orkney and has funded an additional Diabetes Specialist Nurse. This will allow the Team to increase the support of non specialist primary and secondary care teams across Orkney. We will continue to enhance the educational opportunities that are available to both GP practice, hospital and third sector staff for managing people with diabetes. We will continue to use a blended approach for these sessions.
Treatment
There has been a paradigm shift in the management approach to both Type 2 and Type 1 diabetes with the increasing availability of novel treatment regimens. These treatments not only help improve blood glucose control but also decrease the risk of developing long term diabetes complications. This will decrease the detrimental impact on both people with diabetes and NHS Orkney by reducing the prevalence of expensive therapies in the future.
Improve
We would like to implement the Scottish Diabetes improvement plan commitments – 2021 to 2026 to improve the prevention, treatment and care for those affected by diabetes in Orkney. We will actively support the national programme for the prevention and early treatment of Type 2 diabetes by aligning with NHS Orkney’s Weight Management.
It has been challenging to obtain timely access to Mental Health Services for people with diabetes in NHS Orkney. We will work with both the adult and CAHMs services in NHS Orkney to implement national guidance for mental health provision for people with diabetes.
We would like to integrate the hospital information system with the national diabetes record (SCI-diabetes) to help streamline the support for people with diabetes when admitted to hospital. We will upgrade our hospital blood glucose monitoring technology to enable the specialist team to provide remote advice in a timely manner.
Diagnosis
We will implement new technologies that will allow for better identification of the type of diabetes and deliver personalised treatment strategies for people with diabetes. This will include the roll out of the national programme of C-peptide testing in people with a clinician-diagnosis of Type 1 diabetes which is being introduced in NHS Scotland.
Future
We currently have an experienced specialist team in Orkney and we hope to increase the resilience of the specialist services by developing a robust succession plan. We will continue to look for staff development opportunities to attract clinicians to specialist diabetes care. Working in a multidisciplinary manner with colleagues in primary and secondary care and people with diabetes we will strive to deliver a high quality, innovative and personalised diabetes service.