Diabetes Managers – We Need You

I get this type of phone call from a manager every week:

“Hello, my colleague suggested I call you.  I’m on a short term contract and have been asked to cover diabetes.  I haven’t been given much of a hand over”.

I’m thinking:  “Crikey.  The last manager didn’t last long”.

“I’ve never done diabetes before.  I need to know how many Type 1 diabetes cases will be avoided by the diabetes prevention programme for the business plan I am writing”.

I’m thinking: “Oh dear!!”

“I cover Long Term Conditions and Cancer.”

I’m thinking: “Well no wonder you don’t know the difference between Type 1 and Type 2 diabetes when you covering so many conditions”.

Diabetes affects people from head (retinopathy) to toe (neuropathy).  People with diabetes account for at least 17% of all hospital beds.  Diabetes cuts across and impacts every patient pathway and care is commissioned from social care; to public health; to primary care; to community care to hospital care.  It is a complicated condition.  It is complicated to commission.

In England there are 209 CCGs (too many in some areas, if you ask me, but I’m hoping STPs will sort this out).  Each CCG has a manager who supports a CCG GP Lead for diabetes.  The turnover of CCG GP and Manager Diabetes Leads seems excessive and sometimes a change of person leads to planning, rather than getting on with implementation, starting all over again.

CCGs hold a third of the £76bn of the NHS budget and we know that at least 10% is spent on diabetes.

Yet many managers are being asked to squeeze diabetes in on top of a myriad of other conditions that they have to provide management support for.

Managers like everyone in the NHS are extremely busy.  They go from a meeting about cancer straight into a meeting about diabetes.  It doesn’t matter how much support, simplification, tools that are provided - there are only so many hours in a day. 

We now have a “Diabetes Aide Memoire” to support the Sustainability and Transformation Planning process.  For a document that is only 2 pages long there is a lot to achieve.  We need management capacity to support the team/network/STP approach to getting it right.

Given the lack of management capacity to support diabetes care.  I am constantly in awe of how much managers, as part of a team, achieve.  But more management support, particularly to support “the doing” rather than just the planning, are needed to make the seismic shift in preventing diabetes and preventing the complications of diabetes.

The Right Honourable Stephen Dorrell, in his opening address last week at the NHS Confederation Conference said:

 “It is important to begin this conference by restating yet again the vital role played in by the management community.  Managers are not a cost born by the healthcare team, they are part of the team an indispensable part of the team and part of its success “.

Managers are needed.  More management support for team/network approaches to diabetes improvement is needed.  Managers working in diabetes are amazing.