PCDS Newsletter: Update on the Primary Care Diabetes Society’s role and developments 2011–12

The mission statement of the Primary Care Diabetes Society (PCDS) is for:

“The promotion and protection of health for the benefit of the public, in particular by advancing the education of healthcare professionals in diabetes care and the promotion of research into the cause, cure and treatment of diabetes, and publishing results.”

The role of the PCDS
The committee of the PCDS comprises the trustees of the charity. The committee meets formally throughout the year to discuss current issues affecting people living with diabetes and their families, and to support those delivering care to people with diabetes, including carers and healthcare professionals; the aim of the PCDS is to improve diabetes care and knowledge. Some of the activities that the committee have been involved in over the past year are outlined below. All trustees work full-time or part-time for the NHS, and current roles within the committee include GPs, diabetes specialist nurses, practice nurses, GPs who work in hospital or community clinics, a pharmacist and a podiatrist. The PCDS currently has a membership of 7400 healthcare professionals.

Advancement in education
The PCDS trustees believe that one of the ways to make a real difference to the health and wellbeing of people with diabetes, their families and carers, is by advancing the knowledge of the healthcare professions delivering diabetes care.

An exciting development this year has been to extend the work of the PCDS into the Republic of Ireland. At the All-Ireland National Conference held in Athlone in April 2012, the Minister of State for primary care, Roisin Shortall, presented reforms for developing diabetes care in primary and secondary care.

Early this year saw the launch of the PCDS new website – www.pcdsociety.org (see also www.diabetesonthenet.com) – with links to the continuing professional development (CPD) modules, conferences, journals and news.

Over the past year the PCDS has:

• Expanded its membership to 7400 healthcare professionals.
• Continued to provide up-to-date and evidence-based diabetes education through its journal Diabetes & Primary Care, with its circulation of over 16 000 healthcare professionals.
• Completed the first 18 CPD modules, which were written by experts on key topics with questions at the end to test the readers’ knowledge. The modules are used as teaching aids for groups of healthcare professionals and have been published in the journal and online. They were revised at the end of 2011 and the PCDS has embarked on another 3-year programme of modules with similar topics and updates complete with a new set of questions.
• Worked with other journals, including Practice Nurse, the Journal of Diabetes Nursing, The Diabetic Foot Journal, Diabetes Digest, the Pharmaceutical Journal, Pulse and GP.
• Participated in updates and webcasts to reach a wider audience.
• Worked with nursing organisations, such as Training, Research and Education for Nurses in Diabetes (TREND-UK), to address nurse competencies as the PCDS believes that people with diabetes should receive care from people who are trained and remain up-to-date with the skills to deliver excellent diabetes care.
• Delivered conferences in Birmingham, Glasgow, Cardiff and Northern Ireland in 2011 and in the Republic of Ireland in 2012, which were attended by over 1000 delegates; the conferences focused on ensuring a new decade of high-quality diabetes care. Areas covered updated healthcare professionals in many topics, including: ethnicity and inequalities; diabetes emergencies; the vulnerable adult; running a diabetes clinic; and obesity.

Advancement of health and saving lives
To make a positive impact in the delivery of diabetes care nationally that will benefit the lives of people with diabetes, the trustees work with national bodies to promote health and understanding in diabetes. The trustees’ work this year has included:

• The Forum for Injection Techniques, which reviews guidance on correct injection technique, injection sites and sharps safety to come into line with European law in 2013. Work is ongoing to develop guidance to support people with diabetes using injectable therapies.
• Work has continued on the safety issues surrounding the safe prescribing, dispensing and administering of insulin. An area for concern has been problems encountered by people who use insulin, including: people with impaired vision; those who rely on others to administer their insulin, such as family members or community nurses; and those who have healthcare professionals managing their insulin when in hospital.
• Collaboration between several organisations and the National Patient Safety Agency (NPSA) has seen the development of the “insulin passport” and an NPSA leaflet. Insulin safety cards have been produced by three of the major insulin companies. Further information is highlighted by NHS Diabetes (2012).
• The All-Party Parliamentary Group for diabetes, with representation from the Department of Health, House of Lords, healthcare professionals, academic institutes, diabetes charities and patient user groups, met in January to discuss variations in diabetes care and strategies for improving diabetes care and services. Key areas included: children and young people and early diagnosis of type 1 diabetes; education and self-management; diabetes complications; access to specialist care; and prevention and detection of type 2 diabetes.
• Public consultations have been taking place to consider independent prescribing for podiatrists and physiotherapists in order to provide rapid assessment and treatment of foot infections and neuropathy in the community and appropriate referral to secondary care when needed.
• The National Diabetes Audit (Adults) Partnership Board has launched the next phase of the National Diabetes Audit for Adults. The consortium of Diabetes UK, the NHS Information Centre, Diabetes Health Intelligence for the Yorkshire and Humber Public Health Observatory and PCDS is committed to ensuring that the next phase of the National Diabetes Audit will continue to progress as it engages with clinicians and people with diabetes to work towards meeting the needs of the diabetes community.
• Following a consultation period, the Driver and Vehicle Licensing Agency updated their requirements for people with diabetes to ensure safety to drivers and the public with special advice for those on medication that carry a risk of hypoglycaemia.
• The PCDS is currently involved in work with Sanofi, looking at ways of reducing unnecessary admissions for people with diabetes. A parliamentary policy document has been published and launched at the House of Lords following two parliamentary round-table discussions. This work is ongoing with involvement from MPs looking at how this document is implemented within primary care trusts.

Community development
The trustees believe that working in collaboration with other organisations is an effective way to draw together knowledge and expertise that benefits people with diabetes. This year the trustees have worked with charities, including the Association of British Clinical Diabetologists and Diabetes UK, and with the Royal College of General Practitioners, the Royal College of Physicians and the Royal College of Nursing.

The work of the PCDS also realises the importance of developing diabetes care in ethnic minority and hard-to-reach groups and draws from the experience of one of our trustees who runs a minority ethnic long-term medicines service in Glasgow. Clinics are held in elderly care centres, shops, homes and GP practices, and a Ramadan study day and resource pack has proved useful.

Following on from the third Welsh PCDS conference, our trustees are involved in: the Welsh Endocrine and Diabetic Society’s executive committee, which is involved in the management of diabetes care and education; and the Welsh assembly on the All-Wales Cross-Party Diabetes Working Group and the Welsh Advisory Group for Diabetes Care in Wales to advise and liaise with ministers on the management of diabetes care and needs for people with diabetes in Wales.

Work has continued in Scotland in the past year with medication reviews of south Asian people with diabetes and the minority ethnic medicines service. This work has included educating healthcare professionals on managing patients during Ramadan and ethnic inequalities.

Advancement of science
The PCDS is involved in the advancement of science to improve diabetes care in the following ways.

• To ensure people with diabetes receive the best care, it is important that the care being delivered has been tried and tested. The trustees believe that research is the key to this and have formed a research and education subcommittee. The hypoglycaemia study is an exciting large prospective study that is in its early stages and is looking at how this problem affects people with diabetes. The PCDS is working with five companies to fund this £200 000 study, which hopes to recruit 400 people with diabetes from 20 practices over the next year.
• It is not always clear whether a person has type 1 or type 2 diabetes. Some of the trustees have been involved in developing guidelines on the classification of diabetes so that people with diabetes receive the most appropriate care and treatment. The PCDS will be a conduit to PCDS members taking part in the NHS Diabetes-Royal College of General Practitioners’ classification work. Getting the diagnosis and classification of diabetes correct was the focus of a key lecture at the annual PCDS conference.
• The PCDS offers support to healthcare professionals undertaking educational activities and research by providing guidance and bursary awards. The trustees believe people with diabetes will benefit by supporting such initiatives.

Advancement of those in need
The advancement of those in need is a core value of the PCDS, and NICE has asked the PCDS and other bodies to provide information on UK-based projects or interventions that prevent the progression of pre-diabetes to type 2 diabetes in vulnerable or disadvantaged groups, including the elderly, homeless, those in prison, those with mental health problems, refugees, those with disabilities and those living in poverty.

Work is also underway looking at the management of diabetes in people requiring some anti-psychotic medications.

Plans for the future
The trustees are excited by the positive response to the PCDS conferences in England, Wales, Scotland, Northern Ireland and the Republic of Ireland, and are committed to meeting the needs of people with diabetes in a diverse healthcare system. This coming year will see the PCDS develop subcommittees to meet the specific needs of each nation. The PCDS is currently applying for charity status in Scotland. With an additional trustee sitting on the Scottish Diabetes Group, the issues that are important to the people of Scotland can be taken to Holyrood.

The trustees are committed to fulfilling the PCDS mission statement. The PCDS will continue to provide up-to-date, evidence-based education for healthcare professionals through journals, its conferences, CPD modules and website.

The PCDS is committed to developing diabetes care through supporting and taking part in research projects. The hypoglycaemia study will soon be up and running, and it is hoped that it will provide information that will help healthcare professionals treat people with diabetes safely and effectively. In order to benefit those living with diabetes, the trustees will continue to listen to those who live with diabetes and their families, and to collaborate with healthcare professionals involved in delivering diabetes care.

The PCDS will continue to collaborate with other professional organisations, charities, governmental bodies and pharmaceutical companies to support healthcare professionals working in the field of diabetes and improve diabetes care for people with diabetes and their families and carers.