Commissioning diabetes care should be a strategic process involving a wide range of different people, including patients, carers and clinicians and taking into account the local vision for health and social care in the community.
Having a dedicated needs assessment of the local population is a fundamental starting point. (see http://www.yhpho.org.uk/default.aspx)
This can help bring together key data to assist commissioners in relating good practice to their local population.
The Diabetes NSF Standard 3 highlights self-management as the cornerstone of diabetes care and the importance of structured patient education to facilitate this. In 2003, NICE recommended that all people with diabetes should be offered structured education (Guidance on the use of patient-education models for Diabetes) and the Department of Health and Diabetes UK Patient Education Working Group set out clear guidance for patient education programmes:
DESMOND is the only programme that currently meets the standards identified by NICE and its implementation would fulfill PCT / Health organisations obligations for structured education.
DESMOND is a structured, nationally recognised education programme for patients with Type 2 diabetes. Each 6 hour DESMOND course, presented by two health professionals, is mapped to an accredited curriculum and is delivered to 10 patients (patients may be accompanied by a friend, relative or carer).
A randomised controlled trial provided evidence that patients participating in DESMOND demonstrated greater understanding of diabetes and decreased depression scores compared with patients in the control group exposed to a spectrum of routine care. Furthermore, DESMOND appeared to elicit greater improvement in lifestyle measures (propensity to smoke and weight loss), as well as significantly greater improvement in risk scores for Coronary Heart Disease (Davies et al, 2008).
Each module is delivered by 2 trained DESMOND Educators who are registered health care professionals. The modules can be delivered in 1 day or 2 half day formats. Further training of 1 day is required to deliver the BME modules.
Walking Away is a new intervention for those at risk of developing Type 2 diabetes and is 3 hours of structured education. This is particularly relevant for those patients identified through the National Vascular checks programme.
Desmond is a cost effective treatment in the management of diabetes. The Wanless report (2002) asserts that every £1 spent on education saves £1.50 in the long-term.
For an accurate costing for the DESMOND newly diagnosed and Foundation programmes to be delivered in your health organisation please contact the National Office using the form below for a bespoke cost per patient based on your needs.