The Horse’s Mouth

We are all eagerly awaiting the NHS England bidding process for the diabetes transformation fund announced in the 2017-19 NHS Operational and Planning Guidance (page 22)

There is a huge amount of speculation and diabetes managers have been bombarded, since the announcement on the 22nd of September, with questions from providers, commissioners and businesses, about how to get their hands on some of the funding.

There are questions about who can bid; how much; how many bids can be submitted; what’s the evaluation process, etc, etc.

It is also believed that the bidding process will be one bite of the cherry.  That the funding bids will be for a portion of £80m across 2 years (£40m in 2017/18 and £40m in 2018/19).  That the bids will be the one and only opportunity.  However, this is probably incautious speculation. 

Much better to get information from the horse’s mouth.  So this week my action for Diabetes Managers is to sign up for the “Diabetes Programme E-Bulletin”.  It was formally called the “Diabetes Prevention Programme E-Bulletin” but now there is a national “Diabetes Treatment and Care Programme” it has expanded to include information on this as well.

Please follow this LINK to sign up.

This month’s bulletin has the following information regarding the bids which you may find helpful:

National Diabetes Treatment and Care Programme Update

• As announced in the 2017-19 Planning Guidance, NHS England will be launching a wider programme of investment to support the treatment and care of people who already have diabetes.
• CCGs and CCG-led partnerships will have the opportunity to bid for additional national funding of approximately £40m in 2017/18 to promote access to evidence based interventions which will improve:
• uptake of structured education;
• access to specialist inpatient support
• access to a multi-disciplinary foot team for people with diabetic foot disease; and
• the achievement of the NICE recommended treatment targets whilst driving down variation between CCGs.
• Using a Best Possible Value approach, the national team have reviewed the evidence base and identified key initiatives which will result in the highest return on investment in these four areas.

The bidding process

• The bidding process for the diabetes transformation fund will form part of a wider process alongside several other clinical priority areas, such as maternity, cancer and mental health.
• CCGs and CCG-led partnerships will be invited to submit bids including details of their current services for patients with diabetes and outline delivery plans for proposed new or expanded services/initiatives. The nature of who participates in the partnership, and the roles of each partner, will be for local determination.
• It is expected that the bidding documentation will be published during early November. This timeline should enable successful areas to be informed of their allocation ahead of the start of the 2017/18 financial year.

Ahead of the publication of bidding documentation, and throughout the bidding period, we will be holding webinars with the Clinical Network, Diabetes UK and CCG colleagues (dates to follow) to inform of progress, encourage feedback and respond to queries.

No doubt the official notification regarding the bid process will ensure that Diabetes Managers will be kept very busy in the weeks before Christmas but hopefully the effort put in will reap a nice post festive bonus for diabetes care.

WW2

Don’t worry I’m not about to start a history lesson.  In fact history is not my strongest subject, partly because I was too busy sending love notes to the cute boy in my history classes at school.  But I digress.

“Welcome Wave 2”

The Expressions of Interest for the National Diabetes Prevention Programme Wave Two sites have been submitted. 

The anecdotal evidence suggests  interest is very high and that there will be a healthy cohort of wave 2 sites ready to start work by the end of the year.

So here are some initial top tips from a Wave one site to Wave two sites.

1.       Get the LMC involved:

Primary care is stretched to breaking.  However, I haven’t met anyone in primary care who doesn’t feel frustrated that they will see patients on a daily basis that are at risk of diabetes and there is very little they can offer.  The Diabetes Prevention Programme is directly funded by NHS England. But the identification and referral of patients is not. CCGs need to identify ways to reduce workload for primary care and look for solutions for incentivisation and support.  Some of the Demonstrator sites and Wave one sites are coming up  with creative ideas, i.e. auto populated referrals; hiring of someone to identify and discuss risk and referral with patients; text messages, review of local enhanced diabetes services/agreements etc, etc

2.       CCGs don’t need do any “Contract Management” with the provider:

NHS England is funding the service provision and has hired the South, Central and West CSU to do the contract management. You might want to get someone from the South Central and West CSU at one of your first Steering Group meetings to share how this will work and what reports you will get locally

3.       Stakeholder Communication:   

Make sure you have regular steering group meetings that include, GPs, Diabetes specialists, Commissioners, Public Health – PHE and Local Authority, Diabetes UK, Biochemists, Communications, Service users and the Provider (once confirmed).  Remember that one size does not fit all.  Holding clinical Webinars might be useful.

4.       Lead Organisation:

There is not getting around it the project takes a minimum of 3 days a week project management time, probably irrespective of site size.  There is a lot to do.  It is also helpful to have a lead clinician.  The Lead Organisation needs to develop good relationships with all the partner organisations and the provider and be prepared to share learning.

5.       Sign up:

The Memorandum of Understanding (MOU) will need to be signed by the lead organisation and NHS England.  Although not a requirement, it is really helpful to get all partner organisations (CCG and LA) to have high level physical sign off on the MOU as well.

6.       Alignment with other programmes: 

It is important to identify any existing diabetes prevention programmes and consider alignment with NHS Healthcheck and weight management programmes.  NHS England can provide 2 very helpful documents one of which is published here:

7.       Champions:

Start working with CCGs about how to identify “Champion Practices” who would be willing to be early referrers.

8.       And Finally:

Don’t forget to subscribe to the NHS England Diabetes Prevention Programme newsletter:  ndpp.england@nhs.net

We know that the NHS Diabetes Prevention Programme is not the panacea.  We all eagerly await more information about the CCG Improvement & Assessment Framework, “Improvement Offer” which we know will include £40m for treatment and care for people with existing diabetes. 

Sticking with the theme I started with - we know we have a battle on our hands but we will know that we will have several things in our armoury to support the fight for improvement in diabetes.