Diabetes Roadshow

Ever heard of a Diabetes Roadshow? Not sure you will have, because we've just invented it in our PCN.

For the last 18 months, on the back of Type 2 diabetes (T2D) recovery funding, we've been doing something a little different in our PCN. We got local patients and voluntary groups together and asked what they most want out of our diabetes services. They told us they wanted a 'life enhancing service for all people living with T2D'. We then set about co-producing it. They wanted a hopeful service that focused on the whole person, and made the most of peer support......"after all, we often know best what it feels like to live with T2D".

Together we co-produced a range of services. We developed a 'Kickstarter Group', patient led, designed to make people feel included. it involved very basic baseline education, with a cup of tea and invitation to share experiences.....good and bad.

Alongside this group we deigned a more in-depth 'Diet for Remission' program. It was based on the Public Health Collaboration resources www.phcuk.org

Our approach is very much about understanding insulin metabolism, and how understanding real food, low-carbohydrate-healthy-fat diet can return control to the patient.

We included a medical clinic led by a GP and nurse to interpret blood results and offer medication reviews, alongside 1:1 health coaching and social prescribing for people with predominating social issues.

It's been a great success. People have often come to the kickstart group and gone onto the remission group. From 44 graduates who we have follow up data so far, 25% now have an hba1c of less than 48. 60% of people have lost weight , 2 people more than 15kg.

But we struggled to get patients to come. They didn't want to go to another practice, and to be honest practice diabetes teams were a little reticent to send 'their patients' elsewhere, maybe a little wary of our new approach ("will you hit all the QoF targets"?)

So we came up with the idea of a Diabetes Roadshow. It started as a way to engage practices and take something to each practice, but it has developed into something I'm really excited about.

Across August we ran a genuine co-production set of meetings (we getting good at this now). 6 of the patient leaders from the clinic and similar number PCN staff, on an even footing listening to each other . Our challenge was to create an engaging 1.5 hour 'show' to put on in practice waiting rooms at lunchtime. We agreed it needed to feel inclusive, interesting and fun, it needed to empower and give hope, and maybe trigger a few light bulb moments ('I never realised you could come off insulin').

We have landed on a mix of patient story telling with question and answers and some 'polling' of experiences. The design is patient led, and so is the delivery. We'll be starting off with questions like "how many of you struggle to resist cake?".......leading on to "how many of you have felt shamed while buying clothes?". Of course we'll be serving everyone a cuppa too.

It felt important for this to full endorsed and supported by the practices. We have visited practice teams to check our plans. They will help us invite anyone with T2D on their practice list (texts, emails, letters), we also have care co-ordinators phoning too if needed. Their staff will introduce the peer volunteer team, will be on hand to answer questions, but just like me as the PCN Diabetes lead, we will sit in the background. We may not be needed at all.

The Roadshow is going around each of our 7 practices this autumn. Our aim is to raise the profile of the education sessions, but mostly to demonstrate the power of peer support, and the hope and enthusiasm that can be sparked by people who know what it's like to live with T2D in our community.