In 2017, the Merton Health and Wellbeing (HWB) agreed to adopt a whole system approach to tackling diabetes across the life course. Rather than a focusing on diabetes as a specific disease, the aim of the project is to use it as an exemplar for a whole system preventative approach because it lends itself to clinical, non-clinical and prevention approaches.
As part of this whole system approach, between January and March 2018 Health and Wellbeing Board members buddied up with residents who were at risk of diabetes, living with diabetes or caring for someone with diabetes. The purpose was to deepen their understanding, hear people's stories and to identify root causes, barriers and influencers of change.
This was continued in October 2018 through two mini-conversations, where we delved a little deeper into the issues and challenges that were identified in phase one of the programme. These mini-conversations, attended by 37 people, were designed and delivered by Merton CCG and Merton Public Health.
|What were people asked?||What did people tell us?|
|How we can support people to be healthy and raise awareness of their risk of diabetes?|
How we approach making healthy lifestyle choices is important. There needs to be more communication, education and awareness raising about how to eat healthily and options for physical activity.
Taking a proactive outreach approach would support people to manage their diabetes and break down cultural barriers and stigma. This would also support those who are at risk.
Existing resources and voluntary and community groups were cited as important assets.
|How we can encourage people to attend (structured education) classes to help manage or prevent their diabetes|
Flexible timings and lengths of courses as well as locations were all cited as important in encouraging attendance.
People also felt these needed to be culturally appropriate and be shaped by those with lived experience.
|Where they go to find information and support for their diabetes ||It was recognised that a mix of face-to-face and digital methods work best. |
|What other services should be available||It was recognised that a holistic and joined up approach needs to be considered, as diabetes impacts physical and mental health. |
|The best places for the delivery of diabetes service ||Most people felt that community based services worked best, recognising differing needs for those who are housebound. |
|Their experiences of different diabetes services||Experiences were mixed and, in general, depended on which healthcare professional people saw. |
|If there is a role for diabetes champions/support groups for Merton||Diabetes champions would be welcomed, if they linked in with voluntary and community groups. |
This feedback has been used to shape commissioning activity around diabetes services and will also be used to inform the development of the local health and care plan.
Further engagement work is planned to test the plan with local people to make sure it's content is right. Our Patient Engagement Group provided further feedback on the plan in January 2019 – read the minutes here.