Original researchEvaluation of a community diabetes initiative: Integrating diabetes care

- We evaluate a community diabetes initiative integrating primary and secondary care.
- We demonstrate our community diabetes initiative is effective.
- The initiative reduced the number of referrals (p < 0.01).
- The initiative improved the quality of referrals (p < 0.01).
- Our model is a feasible approach to optimising diabetes management in the community.

AimsTo evaluate the impact of a community diabetes initiative, aiming to improve the efficiency of type 2 diabetes (T2DM) care within the Cardiff and Vale Health Board.MethodsIn 2012, a community diabetes initiative was introduced in Cardiff and Vale. Ten National Health Service (NHS) consultant diabetologists and three nurse specialists supported 69 general practices in this region. Here we evaluate the impact of this initiative by assessing the number and quality of secondary care diabetes clinic referrals before (2011-2012) and after implementation (2013-2014). Referrals pre and post initiative were audited against Cardiff and Vale T2DM referral guidelines in two 6-month periods.ResultsIn the 6-months prior to the initiative, 108 referrals were received, 78 of which were in line with local guidance. Approximately one year after embarking on the diabetes initiative (2013-2014) there was a 31% reduction (p < 0.01) in the total number of T2DM clinic referrals and a 57% reduction (p < 0.01) in referrals outside the guidelines. A decrease in referrals was not seen in the practice noted not to engage with the initiative.ConclusionsThe community diabetes initiative intervention has significantly improved the appropriateness of T2DM referrals from GP practices engaged with the initiative. As a result we advocate a move towards integrated diabetes care within the community.