{"id":5700,"date":"2024-11-14T10:07:14","date_gmt":"2024-11-14T10:07:14","guid":{"rendered":"https:\/\/integratedcarejournal.com\/?p=5700"},"modified":"2024-11-14T12:56:02","modified_gmt":"2024-11-14T12:56:02","slug":"value-partnerships-enabling-holistic-diabetes-care","status":"publish","type":"post","link":"https:\/\/integratedcarejournal.com\/the-value-of-partnerships-in-enabling-holistic-diabetes-care\/","title":{"rendered":"The value of partnerships in enabling holistic diabetes care"},"content":{"rendered":"

The Diabetes Care programme has been sponsored by Boehringer Ingelheim. Boehringer Ingelheim has had no influence over the agenda, programme development, content or selection of faculty.\u00a0 This Editorial was written by PPP but features content from an interview with Boehringer Ingelheim. Boehringer Ingelheim has therefore reviewed the content for factual accuracy only.<\/em><\/p>\n

\n

Since their establishment in 1885, Boehringer Ingelheim has evolved into a leading manufacturer of pharmaceutical drugs for both human and animal healthcare. As a research-driven company operating in the UK among many other countries, Boehringer Ingelheim aims to support the NHS in improving clinical outcomes, access to evidence-based care and the quality of life.[1]<\/sup> To make this happen in diabetes care, Boehringer Ingelheim researches and develops innovative\u00a0\u00a0medications to\u00a0support patients throughout their care journey.[2]<\/sup><\/p>\n

Naj Rotheram is Medical Lead for Partnerships at Boehringer Ingelheim. Having worked in the NHS for fifteen years before joining industry thirteen years ago, her experience makes her well-placed to understand how the NHS can deliver successful holistic care to people with diabetes. In her current capacity, Naj collaborates closely with the NHS across all disease areas, including diabetes, to address challenges and improve patient outcomes.<\/p>\n

Developing preventative, holistic care<\/h3>\n

Naj describes a now familiar picture of the NHS: a system burdened by resource constraints, backlogs, workforce pressure, low morale \u2013 issues that have been further exacerbated following the COVID-19 pandemic. These challenges have dominated health discourse in recent years, and were recently highlighted in Lord Darzi\u2019s\u00a0independent investigation, with political figures warning that the system will collapse without reform. In view of this fact, Naj has long advocated for a structural transformation within integrated care systems (ICSs) to enable entire care pathways to deliver care collaboratively and holistically, treating patients as a whole rather than focusing on a single diagnosis.<\/p>\n

\u201cThe long-term goal of structural transformation is to support better integrated care and therefore a better patient experience, hopefully across the entire pathway and better working together. But it does take time for that integrated way of working to embed itself.\u201d<\/p>\n

ICSs were set up with the aim of improving health and care services, prioritising a focus on prevention, better outcomes and reducing health inequalities. The power of prevention in diabetes care has already been demonstrated by the NHS-funded Diabetes Prevention Programme, which has been shown to reduce the risk of type 2 developing by 40 per cent. \u00a0Yet, a study by The King\u2019s Fund has found that local systems are at risk of going \u2018off-track\u2019 due to pressures on services, intense political scrutiny, and extremely difficult economic circumstances \u2013 and the impact these conditions are having on the ability of local, regional and national leaders to act.[3]<\/sup><\/p>\n

The challenge for ICSs is reflected in diabetes prevalence and linked co-morbidity figures, which are continuing to rise. Since 1996, the number of people with diabetes in the UK has risen from 1.4 million to more than 4.8 million and is estimated to reach 5.3 million by 2025.[4]<\/sup> The challenge of a growing at-risk cohort is compounded by an ageing population, and the complexities linked with long-term diabetes management, including complications and multimorbidity cases. Recent data from the 2023 National Diabetes Audit shows that more than 3.5 million people registered with a GP were identified with non-diabetic hyperglycaemia, also known as pre-diabetes. [5][6]<\/sup><\/p>\n

Diabetes often \u201cstarts with one diagnosis,\u201d\u00a0explains Naj,\u00a0\u201cand then accumulates a host of other health risks and problems\u201d.\u00a0In fact, diabetes is the leading cause of blindness in working-age adults, and around 10 per cent of diabetes patients will develop leg ulcers at some point in their lives.[7][8]<\/sup> Naj\u2019s ideal vision is a model of localised care, centred on early diagnosis, better prevention and early intervention, thereby reducing the risk of these complications developing.\u00a0Central to this approach is including patient perspectives to better understand their experiences. Naj also emphasises the importance of involving primary care professionals, ICS leaders, commissioners, and national policymakers in the development of multidisciplinary, holistic care pathways.<\/p>\n

\u201cPatients want to be treated by someone who considers the impact that disease might have on their heart, on the kidneys, on their brain, on their eyes. They say, \u2018please look after me as a whole person,\u2019 but the NHS isn\u2019t necessarily well set up for that.\u201d
\n-Naj Rotheram<\/p><\/blockquote>\n

Diabetes outcomes are significantly impacted by health inequality, with rates of undiagnosed diabetes being twice as high in areas in the lowest Index of Multiple Deprivation quintile compared to the top.[9]<\/sup> Naj stressed the importance of harnessing and embedding data-driven insights from population health management (PHM) into diabetes care pathways to allow systems to identify, and target interventions towards, underserved communities. An example of this is the Joint Working Project between Boehringer Ingelheim Limited and Salford Care Organisation.[10]<\/sup> The project aims to implement an integrated, neighbourhood-based, holistic diabetes service to address the complex needs of patients with cardio-renal-metabolic (CRM) diseases in Salford. By employing a workforce with diverse skillsets, and\u00a0using data to identify individuals with the greatest needs, the project has successfully engaged communities within Salford\u2019s population that have traditionally been reluctant to participate in healthcare.<\/p>\n

\u201cUtilising the insights at a very local level can help us understand the challenges affecting specific areas and allow us to develop programmes and care pathways.\u201d
\n-Naj Rotheram<\/p><\/blockquote>\n

ICSs have a range of assets available to build more holistic, preventative diabetes care. Utilising all of general practice, community pharmacy, dental services, and optometry, primary care is in a strong position to deliver comprehensive, holistic diabetes care. However, Naj points out that current support for primary care is inadequate due to limited resources and high patient volumes \u2013 leading to a more reactive rather than a preventative approach. This means that primary care is often an underutilised preventative asset.<\/p>\n

To remedy this, Naj advocates for greater support in terms of resources, training and action on workforce sustainability. \u201cPrimary care should feel valued; they are working on issues that matter to patients,\u201d\u00a0says Naj.\u00a0\u201cThese primary care healthcare professionals are making a difference at a community level, and this long-term holistic focus is the reason why they entered the profession in the first place.\u201d\u00a0Naj also discusses the importance of supporting and valuing the workforce\u2019s skills, by addressing discrepancies in workforce development, job reimbursement, and fair pay. An international survey has found that primary care doctors in 10 high income nations\u00a0say that they are overworked, demoralised, and undervalued. [11]<\/sup><\/p>\n

The value of partnership<\/h3>\n

Another often underutilised asset in improving diabetes care is industry partnership. The NHS and pharmaceutical industry have an opportunity through partnership to redesign local and national pathways, enabling\u00a0better collaboration for the patient\u2019s benefit.\u00a0Alongside clinical and care pathway knowledge, industry partners offer a range of practical resources and expertise relevant to NHS system ambitions, including project management, stakeholder involvement and multidisciplinary team mobilisation.[12]<\/sup> Naj has been intimately involved in this work, and posits partnerships as one way of promoting ethical practices and to provide highly regulated and standardised settings in which the NHS and industry can operate. Naj believes that partnerships can help to improve trust between the NHS and industry through greater transparency regarding all parties\u2019 actions, long-term motivations and impacts. For this reason, the NHS could rely more on the “tremendous” skills and resources that industry brings, which extend beyond just the financial resources it provides.<\/p>\n

We need to embrace working together and pooling those skills and those resources to overcome some of the NHS challenges that we are collectively facing.
\n-Naj Rotheram<\/p><\/blockquote>\n

PPP\u2019s\u00a0Diabetes Care Programme\u00a02024\u00a0has uncovered fascinating insights and developed vitally important recommendations to improve the delivery of diabetes care. Stakeholders and experts present across the roundtables have consistently highlighted the need to move away from treating diabetes as a single diagnosis and condition to treating the whole patient in holistic terms.<\/p>\n

The theme of holistic care has shaped the basis of 2025\u00a0Diabetes Care\u00a0Programme,\u00a0Holistic approaches to diabetes care: treating the whole patient, to discuss the challenges and opportunities for a holistic approach to care that treats the \u2018whole\u2019 patient and not just their diabetes. The series will feature a set of roundtables to create insights and strategies for holistic approaches to diabetes management and long-term conditions. We will\u00a0address key questions including:
\n\u2022 How can systems balance personalisation and population health management to ensure we get population health rights, while meeting the individual needs of people?
\n\u2022 What role can technology, data and digital play in reducing inequalities for those with the highest needs?
\n\u2022 What innovations are game changers and are they sustainable?
\n\u2022 How do we develop our prevention and risk strategy, to break down siloed disease working so that cardio, renal, and metabolic condition are joined-up effectively within the health and care system?
\n\u2022 Where are the overlaps within the multi-morbid patient population and how can we create a one-stop shop in the community?
\n\u2022 How significant is genetic predisposition in causing diabetes compared to dietary and environmental factors?<\/p>\n

If your organisation would like to learn more about getting involved in this innovative programme, then please contact\u00a0Ameneh.saatchi@publicpolicyprojects.com\u00a0to find out more.<\/p>\n

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References<\/h3>\n

[1]\u00a0https:\/\/medical.boehringer-ingelheim.com\/uk\/nhs-partnering<\/a>
\n[2]\u00a0https:\/\/www.boehringer-ingelheim.com\/uk\/human-health<\/a>
\n[3]\u00a0https:\/\/www.kingsfund.org.uk\/insight-and-analysis\/reports\/integrated-care-systems-workforce<\/a>
\n[4]\u00a0\u00a0https:\/\/www.diabetes.org.uk\/about-us\/about-the-charity\/our-strategy\/statistics<\/a>
\n[5]\u00a0https:\/\/www.england.nhs.uk\/2024\/06\/nhs-identifies-over-half-a-million-more-people-at-risk-of-type-2-diabetes-in-a-year\/<\/a>
\n[6]\u00a0https:\/\/www.endocrine.org\/patient-engagement\/endocrine-library\/diabetes-and-older-adults<\/a>
\n[7]\u00a0https:\/\/www.cdc.gov\/diabetes\/diabetes-complications\/diabetes-and-vision-loss.html<\/a>
\n[8]\u00a0https:\/\/www.england.nhs.uk\/north\/wp-content\/uploads\/sites\/5\/2018\/05\/NWCSN_Diabetes_Footcare_Final_Report_2017-1.pdf<\/a>
\n[9]\u00a0https:\/\/assets.publishing.service.gov.uk\/media\/66e1b49e3b0c9e88544a0049\/Lord-Darzi-Independent-Investigation-of-the-National-Health-Service-in-England.pdf<\/a>
\n[10]\u00a0https:\/\/www.boehringer-ingelheim.com\/uk\/salford-crm-joint-working-summary<\/a>
\n[11]\u00a0https:\/\/www.bmj.com\/content\/382\/bmj.p1925<\/a>
\n[12]\u00a0https:\/\/www.nhsconfed.org\/publications\/partnering-purpose-ICS-industry<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

PPP\u2019s Director of Market Access and Policy, Ameneh Saatchi, spoke with Naj Rotheram, Medical Lead for Partnerships at Boehringer Ingelheim, to discuss their view on primary care, partnerships and how they can best support the NHS in delivering a new holistic approach to diabetes care.<\/p>\n","protected":false},"author":167,"featured_media":5711,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[64,44,33],"tags":[],"class_list":["post-5700","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-boehringer-ingelheim","category-featured","category-primary-care"],"acf":[],"_links":{"self":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/5700"}],"collection":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/users\/167"}],"replies":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/comments?post=5700"}],"version-history":[{"count":10,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/5700\/revisions"}],"predecessor-version":[{"id":5713,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/5700\/revisions\/5713"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media\/5711"}],"wp:attachment":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media?parent=5700"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/categories?post=5700"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/tags?post=5700"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}