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Transforming diabetes care with the i3-diabetes programme

Changing Diabetes: An overview of a new collaboration designed to improve the care of people with diabetes in London.

A new programme “i3-diabetes” was launched in January this year with the aim of developing a new model of specialist diabetes care. This unique collaboration was set up with King’s Health Partners Academic Health Sciences Centre and comprises King’s College London, Guy’s and St Thomas’, King’s College Hospital, and South London and Maudsley NHS Foundation Trust, alongside Novo Nordisk.

This programme was designed to integrate specialist and community care, and improve services for people with diabetes treated at King’s Health Partners in this evolving NHS and economic environment.

The vision
The collaboration is planned to run for five years. During this time, stakeholders in the partnership are gathering and analysing patient data in South London to gain a deeper understanding of the breadth of care needs in the area and generate an improved model of care.

The model will fit around the changing role of specialist and tertiary diabetes services in the UK, including the shift to more community-based and primary care services. While i3-diabetes currently has a local focus, the partners believe the model of care they research and develop could similarly improve health systems in other parts of the world.

Professor Stephanie Amiel, Professor of Diabetic Medicine at King’s College London and Leader of the Diabetes Clinical Academic Group, King’s Health Partners, said:

“Services for people with diabetes are changing, as are the needs of people with diabetes and the tools we have to support them. We need to evolve our specialist diabetes services to improve how people with diabetes access them and benefit from them.”

Two-phase approach
i3-diabetes is thought to be the first collaboration of its kind between an Academic Health Science Centre and a pharmaceutical company. In the research phase, which has been running since 2012, the collaboration has developed comprehensive data resources that enable close analysis of current processes and their associated costs and outcomes. Drawing on these data and the diabetes expertise of the institutions, a project that focuses on coordination of care and another project on risk stratification are being implemented across King’s College Hospital and Guy’s and St Thomas’.

Coordination of care
More than 85% of people with diabetes who are managed by King’s Health Partners have a comorbidity. The care coordination project will investigate ways that specialists can work more effectively together, to better support people with diabetes with complex needs. Clinical processes will be modified to provide more joined-up care, and thus reduce the need for secondary referrals. In addition, new multidisciplinary and multi-specialty clinics will be designed to improve efficiency of care, streamline patient management, and integrate with evolving services for diabetes in the community and primary care.

Risk stratification
A new diabetes support and treatment tool will be developed and will be used to tailor care based on the individual’s psychosocial, physiological, medical and pharmacological needs. The new risk strategy approach will be integrated across relevant specialties and healthcare settings to provide connected support, management and treatment from the most appropriate healthcare professionals and from the most appropriate location.

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