Minutes of the Cross Party Group on Diabetes
Tuesday 4 June 2014
Attendees
Jenny Rathbone AM (Chair)
Armon Daniels (GP Cardiff)
Kamila Hawthorne (GP Cardiff)
Lynne Hughes (RCN Wales)
Sarah Davies (GP Cardiff)
Vaughan Gething AM
Julie Morgan AM
Helen Nicholls (British Dietetic Association)
Scott Cawley (All Wales Podiatry)
Robert Wright (Lay Member)
Paul Coker (Input Patient Advocacy)
David Chapman (Representing Medtronic)
Ros Meek (Medtronic)
Robert Koya Rawlinson (Novo Nordisk)
Chris Williams (Novo Nordisk)
Wendy Gane (Diabetes Peer Support)
Sara Moran (Diabetes UK Cymru)
Jason Harding (Diabetes UK Cymru)
Helen Cunningham (Office of Jenny Rathbone AM)
Mirriam Dupree (Office of Jenny Rathbone AM)
Apologies
David Melding AM
Bethan Jenkins AM
Dai Williams (Diabetes UK Cymru)
Penny Griffiths (Abbott Diabetes Care)
Dr Lindsay George
Lesley Jordan (Input Patient Advocacy)
Yvonne Johns (Diabetes North Wales Reference Groups)
Rhian Shaw (Sanofi)
Steve Bain (Swansea University)
The
cross party group would like to thank the following organisations
for their support:
Introductions
Jenny Rathbone AM welcomed attendees to the ninth meeting of the group in the fourth Assembly. Jenny thanked members for re-electing her as chair of the cross party group. Members introduced themselves and their organisations.
1. Minutes of last meeting and matters arising
The group agreed the accuracy of the minutes of the previous meeting.
The chair advised members that she had written to Powys LHB to ask how patients can engage with the health board. A response has still not been received from the director.
Robert Wright advised members that the last meeting was on 4 March. Since that meeting there have been two meetings set for the Diabetes Planning and Delivery Group on 18 March and 9 June that have both been cancelled. Four meetings have been cancelled since June 2013. Robert indicated his dismay that DPDGÕs were referred to as central in Diabetes care in both the delivery plan and the enquiry, but Powys LHB donÕt appear to acknowledge this. Robert advised members that having raised concerns with the LHB via his Assembly Member Russell George; he received a response from his LHB stating that he can feed in through the Community Health Council. Robert attends the CHC but in his experience doesnÕt feel this is the right forum. The CHC have advised him that the CHC is not the right forum for the technical diabetes questions he is raising.
Vaughan Gething commented that when the Health Committee did the enquiry they had concerns about the DPDGs, in particular the matter in Powys was raised. Vaughan suggested that as well as requesting a response to the letter; the current Chair of the health committee should be made aware that it is a follow up action from the report.
Jason Harding corroborated the issues raised by Robert Wright. Diabetes UK had requested clarification of what is going on in the Health Board and no response has yet been received. Jason suggested the CPG raise the concerns regarding Powys with Adam Cairns, Chair of the All Wales Diabetes Implementation Group. Adam has stated he is committed to visiting all LHBÕs and Jason believed that Adam would welcome the issue being brought to his attention.
Wendy Gane said that she had been a Chair of CHC in the Valleys for nine years and that the CHC has a role of monitoring diabetes (and other) services, so Robert had been incorrectly informed that the CHC was not the correct place for him to raise concerns regarding. Wendy suggested that all CHC across Wales should be contacted to see what they are doing to monitor this new delivery plan and its implementation. Wendy added that she sits on the implementation group and is going to raise patient involvement when the group meets next week.
The
Chair suggested that the correspondence to the LHB is escalated by
writing to the Chief Executive with a copy to Adam Cairns.
The Chair added that if the issue was not resolved with a response
from the Health Board in a timely manner then she will raise it
with the Minister for Health and Social Services.
Action: Chair to write to Powys LHB Chief Executive re DPDG
and lack of response
The Chair confirmed that a letter had been written to the minister about the number of Diabetes Specialist Nurses (DSN). His response (included with the minutes) stated that the Chief Nursing Officer is doing an audit of what DSN across wales do and he will ensure that the CPG receives a copy of the final report in summer which the CPG can review at the autumn meeting. The letter states that in the consultation for Together for Health for diabetes, no evidence was found suggesting lack of training effecting support for patients using insulin pump therapy or Smart blood glucose meters. Paul Coker said there are patients who are told that they can have a pump but then are put on a waiting list for training.
A response (included with the minutes) had been received from David Rees, chair of the Health and Social Care Committee. The letter indicates that it was a very broad approach taken to measure technologies, which wasnÕt looking specifically at insulin pump therapy but it was a key recommendation in their NSF report on diabetes.
The Chair advised members she wrote to Adam Cairns to ask for the timetable for the clinical lead to be appointed. Jason Harding confirmed that the advert was released approximately three to four weeks ago, and the closing date was one week ago. Applications had been received and interviews will take place at the end of June.
2.
Improving
Primary Care: GPs Armon Daniels & Kamila Hawthorne on the
Rumney & Butetown experiences
Dr Kamila Hawthorne made a presentation to the group on a project that run for five years from 2002-2007 called the Heartlink project. The project was set in the South West locality of Cardiff across Riverside, Butetown and Grangetown, covering 13 GP practices and was funded through the Welsh Government health inequalities fund. Kamila become involved in the project through her interest and research into culturally appropriate health education for minority groups with type 2 diabetes.
Dr
Armon Daniels spoke about his experiences in his Rumney practice.
He advised members that the prevalence of diabetes had grown from
3% to almost 6%, which is an underestimate and the size of the
problem is growing each year. He spoke about how the QOF NICE
Clinical Guidelines had helped him to think not only about the
patient in front of him, but all of his patients. Armon also spoke
about how virtual clinics are used at the practice.
3. European Diabetes Leadership Forum: Report back by Jenny Rathbone
Jenny provided
the group with a written report of her attendance at the European
Diabetes Leadership Forum in March. Some of the themes included the
importance of re-shaping serviced to meet the needs of patients.
The shift of focus from secondary to primary care will be a long
term effort. Jenny also informed the group the Horizon 2020 might
be an opportunity to research and share best practice about
Diabetes as a Europe-wide problem.
4. Sub group updates
The group were provided with terms of reference documents drafted by Diabetes UK. David Chapman reminded the group that a lot of effort went into the Diabetes Implementation Framework last year and this is an opportunity to transform the picture on pumps. He would like to be involved in the pumps group and sees it working as a positive, pro-active campaign that includes case studies of the transformative power of pumps.
The Chair re-iterated that the role of the groups are to scope problems and share good practice. The work should be done within 12 months. She posed the question of how to influence health boards to do some of this work as it canÕt all be done by the sub groups
Scott Cawley suggested that a consultant is needed on the inpatient sub group. Chris Williams added that a specialist nurse would be a good addition too.
Wendy Gane confirmed she would like to be involved with both sub groups. She said that the lack of patient choice between pumps and issues with sensors is a problem. She also provided the group with an update on the Retinopathy sub group and informed the group that there is still some work to do in the sub group.
5. Any Other Business and date of next meeting
The Chair reminded the group that the annual diabetes stakeholder event takes place on 11 June and is open to all
The date of the next meeting is Tuesday 14 October