The UK’s leading free-to-attend conference & exhibition for diabetes healthcare professionals

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CPD-certified conference

Diabetes Professional Care returns on 15 & 16 November 2017 with its biggest and best edition to date. This year’s event will feature CPD-certified content from more than 100 of the world’s leading international practitioners.

Over two days, the DPC2017 conference will share real-world learning and expertise from top practitioners and thought leaders from across the diabetes arena.

This year, we've increased our programme to 8 streams, to reflect the diverse interests and educational needs of our visitors. Please click the session titles for further information on the presentations and speakers.

 

Agenda
Wednesday 15th November 2017

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Diabetes in Primary & Secondary Care
Theatre 1

Commissioning for Better Diabetes Care
Theatre 2

Obesity in Practice and Diabetes Prevention
Theatre 3

Paediatric to Adolescent & Crossover Care
Theatre 4

Diabetes Technologies & Diagnostics Theatre


09:00 - 10:00
Registration
10:00 - 10:10
Welcome
10:10 - 10:45
Keynote Session:
Align. Focus. Deliver.
Prof Jonathan Valabhji, National Clinical Director for Obesity and Diabetes, NHS England
Dr Partha Kar, Associate National Clinical Director for Diabetes, NHS England
Theatre 1
10:50 - 11:20
The Future of In-patient diabetes care
Dr Mayank Patel, Consultant in Diabetes, University Hospital, Southampton
Diabetes and the new landscape for the NHS - accountable care organisations and systems
Bob Ricketts, Director of Support Strategy & Market Development, NHS England
Diabetes Prevention Programme South East – Lessons Learnt
Dr David Lipscomb, Diabetes Clinical Lead, South East Clinical Networks
Identifying the barriers to effective diabetes transitional care. A qualitative study of patient satisfaction and experiences of transition
Kate Wilson, Network Manager, East of England Children and Young People’s (CYP) Diabetes Network
11:20 - 12:10
NETWORKING & EXHIBITION
12:15 - 12:45
Type 2 Diabetes in General Practice
Prof Sir Denis Pereira-Gray, Emeritus Professor, University of Exeter, and Eleanor White, Medical Student, University of Exeter
Preventing diabetes through focused treatment of obesity
Prof Paul Gately, Prof of Exercise and Obesity, Leeds Beckett University
Paediatric weight management programme for children with diabetes: a pilot study
Raphaella Rookes, Specialist Paediatric Dietician, Gloucester NHS Foundation Trust; & Niamh Gilligan, Specialist Paediatric Dietician, Royal Manchester Children’s Hospital
VOCAL – virtual online consultations: advantages and limitations
Dr Joseph Wherton, Nuffield Department of Primary Care Health Sciences, University of Oxford
12:50 - 13:20
Understanding clinical inertia
Dr David Strain, Senior Clinical Lecturer, Diabetes & Vascular Research Department, University of Exeter Medical School
The role and impact of specialist diabetes pharmacists
Victoria Ruszala, Specialist diabetes pharmacist, North Bristol NHS Trust
Tackling Childhood Obesity
Richard Sangster, Deputy Branch Head, Childhood Obesity, Department of Health
‘Young Diabetes Connections’: a network for children, young people and their families in south London
Dr.Tony Hulse, Consultant Paediatric Endocrinologist, Evelina London Children's Hospital, Guy's and St.Thomas’ NHS Foundation Trust
Virtual vs reality in the diabetes world-this is how we do it
Kelly Carden, Nurse, Southampton Universit Hospital and co-founder Sugar Buddies & June Murphy, Diabetes nurse – Insulin pump specialist, University Hospital Southampton NHS Foundation Trust
13:20 - 14:35
14:00 - 14:30
Diabetes Burnout: Fact or Fiction?

Debbie Hicks, Nurse Consultant - Diabetes, Enfield Health, Barnet, Enfield & Haringey Mental Health Trust
NETWORKING & EXHIBITION
14:40 - 15:10
15:15 - 15:50
Keynote Session:
Awaiting session information
Special Guest Speaker
Theatre 1
15:50 - 16:40
NETWORKING & EXHIBITION
16:40 - 17:10
The challenges of managing patients with diabetes living in care homes
Prof Roger Gadsby, Honorary Associate Clinical Professor, Warwick Medical School and GP Clinical Lead for National Diabetes Audit
Reducing costs and amputations by commissioning joined up diabetes foot services: the Somerset experience
Dr Julia Thomas, Consultant Physician and Lead for Diabetes Footcare, Taunton & Somerset NHS Foundation Trust
Bariatric surgery and type 2 diabetes
Richard Welbourn, Consultant Upper G.I. Surgeon, Musgrove Hospital, Taunton
Type 2 diabetes in adolescents – a weighty problem
Dr Martha Ford-Adams, Consultant Paediatrician, King’s College Hospital
20 years experience with a diabetes database
Dr Nicholas Morrish, Consultant Diabetologist /Deputy Responsible Officer / CCIO, Bedford Hospital NHS Trust, Diabetes Clinical Lead, East of England Clinical Networks
17:15 - 17:45
Understanding and managing gestational diabetes in primary and secondary care
Dr Michela Rossi, Consultant in Diabetes & Endocrinology, Whittington
Working with commissioners to achieve a funding solution for CGM – A case example from the SHIP8 Commissioning Cluster
Dr Iain Cranston, Consultant Diabetes Physician & Endocrinologist, Portsmouth Hospital NHS Trust
Children and Young People’s South East Coast and London Network
Professor Peter Hindmarsh, Professor of Paediatric Endocrinology, Developmental Endocrinology Research Group, University College London

Keynote Session: Align. Focus. Deliver.

An update from NHS England diabetes team, their priorities, update on transformation funds - as well as an opportunity for questions and answers with the professionals.


Prof Jonathan Valabhji
National Clinical Director for Obesity and Diabetes, NHS England

Professor Jonathan Valabhji is National Clinical Director for Obesity and Diabetes at NHS England. He is a Consultant Diabetologist at St Mary’s Hospital, Imperial College Healthcare NHS Trust in West London and so remains highly active at the clinical coalface. The published clinical outcomes from his Multidisciplinary Diabetic Foot Service at the Trust are comparable to the best centres internationally. He is Adjunct Professor at Imperial College London, with a current research focus on diabetic foot disease as well as on diabetes population level health, and past publications on cardiovascular disease in diabetes. He is a committee member of the Association of British Clinical Diabetologists. As National Clinical Director, he is currently providing clinical leadership around a number of national initiatives, including the NHS Diabetes Prevention Programme, a collaboration between NHS England, Public Health England and Diabetes UK that aims to cause England to be the first country to implement at scale a national evidence-based Type 2 diabetes prevention programme.


Dr Partha Kar
Associate National Clinical Director for Diabetes, NHS England

Dr Partha Kar has been a Consultant in Diabetes & Endocrinology at Portsmouth Hospitals NHS Trust since 2008. He has been the Clinical Director of Diabetes from 2009-2015, being part of a multiple national award-winning department (HSJ Awards / BMJ Awards) for services and care provided.

One of his main areas or passion is in helping to redesign diabetes care in an attempt to integrate chronic disease management across primary and secondary care. He is the pioneer of the Super Six Diabetes Model which aims to deliver diabetes care differently. He is an avid user of social media such as twitter (@parthaskar) to engage with patients - and been recognised as a "Social media Pioneer" by HSJ in 2014. Recent innovations have involved the Hypoglycaemia Hotline, which was recognised in the Guardian Healthcare Awards 2013.

He is also the co-creator of TAD talks (Talking About Diabetes) and the Type 1 Diabetes comic (“Origins”)- while also involved in setting up a Type 1 Diabetes information portal (T1resources.uk).

Partha is Associate National Clinical Director, Diabetes with NHS England leading on the Right Care pathway.

How real-time data could transform the Diabetes consultation

How utilisation of the latest real world digital health solutions could improve your consultations with real time data, accessible at any time or anywhere.


Awaiting Speaker Information

Diabetes Prevention Programme South East – Lessons Learnt

Kent, Surrey & Sussex started referrals as a Wave One Diabetes Prevention site on the 19th of September 2016. This presentation will focus on our experiences of implementing this programme across 20 CCGs and 6 local authorities and provide some practical advice and shared learning for Wave two and three sites.

Learning outcomes

  • Key issues to consider when setting up your local programme
  • Identifying the right patients for referral to the DPP
  • Practical tips for promoting and embedding DPP
  • Linking with NHS Health Checks

Dr David Lipscomb
Diabetes Clinical Lead, South East Clinical Networks

David is a Consultant in Community Diabetoloigst at East Sussex Community NHS Trust.  He has a strong clinical interest in diabetes in pregnancy having previously been part of a National pre pregnancy NHS diabetes group leading to development of the "SAFER" leaflet. David was also part of the Diabetes Section of the Map of medicine and has been Clinical Lead for Diabetes for the South Coast Clinical Network for the past 2 years. He is a regular member of the Westminster diabetes think tank and has contributed to the National Audit Office value in diabetes project as well as a CQC thematic review. Within endocrinology David has been a National Pituitary tumour service peer reviewer, deputy lead of the Sussex Pituitary MDT and cofounder of the East Sussex adrenal MDT. David has a passion for promoting high quality care within diabetes and endocrinology.

The Future of In-patient diabetes care

Year on year, the number of patients with diabetes in UK hospitals continues to rise. This is a group that may require additional support and attention by clinical staff. An admission to hospital for any reason has the potential to destabilise usual diabetes control. It may also provide a bedside opportunity to offer a diabetes review.

This talk will provide an overview of the impact of a hospital admission on diabetes. The speaker will also share some local experiences and learnings that have helped to shape and inform the way in which inpatient diabetes care is delivered in Southampton. This large NHS trust hosts up to 200 patients a day with diabetes (approximately 16% of all adult inpatients).

Learning outcomes

  • Insight into how an admission to hospital can affect diabetes control
  • Areas of risk in diabetes care that clinical staff must be aware of
  • Examples of ways in which patient care is supported
  • Examples of ways in which staff training in diabetes is delivered

Dr Mayank Patel
Consultant in Diabetes, University Hospital, Southampton

Dr Mayank Patel has worked as a Consultant Physician in Diabetes and Acute Medicine at University Hospital Southampton since 2008. He completed his specialist clinical training in Wessex. Since starting as a Consultant, he has overhauled and developed the trusts adult inpatient diabetes service.  He also contributes to medical undergraduate and postgraduate diabetes training, as well as regularly delivering diabetes teaching sessions to patients, public and other healthcare professionals in primary and secondary care. He co-developed ‘Microguide DiAppbetes’, a smartphone application to help HCPs managing people with diabetes. He is also the Work Based Learning module lead for the Diabetes best practice MSc at the University of Southampton. He also co-created the ‘T1:Origins’ Diabetes comic book.

Diabetes and the new landscape for the NHS - accountable care organisations and systems

Overview

  • Overview of the concepts of Accountable Care Organisations (‘ACOs’) & Accountable Care Systems (‘ACSs’)
  • Challenges in developing ACOs/ACSs
  • Implications for the NHS, clinicians & patients
  • Examples (U.S. & U.K.)
  • What’s likely to be the impact on diabetes patients and services?

Bob Ricketts
Director of Support Strategy & Market Development, NHS England

Bob is a senior civil servant and policy maker with over 35 years’ experience in health services. Bob led the introduction of patient choice and commissioning. Seconded to NHS England to develop commissioning support for CCGs and, more recently, transformational support for emerging Accountable Care Systems.

Identifying the barriers to effective diabetes transitional care. A qualitative study of patient satisfaction and experiences of transition

Disparities in the quality of care for young people with type 1 diabetes (T1D) undergoing transition from children’s to adult clinical services are well recognised. Poor planning and lack of defined care pathways promote patient disengagement with many becoming ‘lost’ to specialist follow-up for many years. This study sought to obtain the views of young people’s experiences of transition to identify their perceived barriers to delivering an effective and rewarding transition experience.

This study sought to obtain a baseline analysis of young people’s levels of satisfaction and their experiences of transitional care across 17 units in the East of England Children and Young People’s Diabetes Network. It aimed to discover the barriers that they perceived existed to delivering an effective and rewarding transition experience in their local clinic and how these might be overcome.


Kate Wilson
Network Manager, East of England Children and Young People’s (CYP) Diabetes Network

I graduated from Cambridge University with a degree in Social and Political Sciences in 2001. Since then I have worked mainly in the voluntary sector with stints at the Big Lottery Fund, managing their network of community funded projects, the Charity Commission and Cambridge Council for Voluntary Service.

I have been working for the East of England Children and Young People’s Diabetes Network as their Network Manager since 2010. During that time I have co-ordinated and overseen a number of quality improvement initiatives to improve the standard and quality of care that children and young people with type 1 diabetes receive across the East of England. Projects have included the design, development and launch of the first e-learning module for those responsible for supporting CYP with diabetes in schools, the establishment of the East of England Diabetes Adventure camps which are now in their 6th year and have enabled over 250 children with type 1 to become more independent in the management of their diabetes whilst making friends and trying new activities. I have played a key role in the establishment of our region wide diabetes, sports and exercise specialist advice clinics, and set up the first ever annual regional symposium on transitional care.

VOCAL – virtual online consultations: advantages and limitations

The VOCAL study (funded by the National Institute for Health Research, 2015-2017) is an ethnographic and action research project that seeks to illuminate the complexity of remote video consultations and the system in which they are nested (including organisational, legal, regulatory and policy contexts). The research is based in two contrasting clinical settings (diabetes and cancer). It consists of in-depth studies of real consultations (micro-level) embedded in an organisational case study (meso-level), and review of the national context (macro-level).

This presentation will highlight:

  • Role of ethnographic and action research for the study of remote consultations in a clinical context
  • Key challenges to the implementation and sustained use of Skype for remote consulting in a large NHS trust.
  • Benefits and challenges to conducting remote consultations
  • Organisational barriers and the practical steps taken to help integrate such service within routine care practice.
  • Key findings and resources developed through the VOCAL study

Dr Joseph Wherton
Nuffield Department of Primary Care Health Sciences, University of Oxford

Joe is a Senior Researcher at the Nuffield Department of Primary Care Health Sciences, University of Oxford. He has a background in psychology and human-computer interaction and his research focuses on the participatory design of assisted living technologies and services. His research is strongly interdisciplinary, involving ethnographic and participatory design methods to inform the development and implementation of technology-supported services for health and social care. In particular, his research seeks to support the co-production of personalised care solution that can address the complex and diverse needs of service users. Joe obtained his Psychology BSc at University of Bath (2004) and his Psychology PhD at University of York (2008).

Preventing diabetes through focused treatment of obesity

Type 2 diabetes remains a national challenge. Despite this weight management programmes for severe obesity remain minimal and fragmented. Despite strong evidence for what works, disconnected national and local policy and systems as well as austerity are major influences on action, which adds to the burden of obesity and the challenge of Type 2 diabetes. This presentation will explore these issues.

Learning outcomes

  • Wide ranging impacts of severe obesity
  • Understanding of the evidence of what works in treating severe obesity
  • National and local action and policy issues
  • Impact on type 2 diabetes prevalence
  • A way forward

Prof Paul Gately
Professor of Exercise and Obesity, Leeds Beckett University

Paul is director of MoreLife and a Professor of exercise and obesity at Leeds Beckett University. He is also a visiting professor in the department of surgery and cancer at Imperial College London. Paul is the principle investigator on Public Health England’s Whole Systems Approach to Obesity and he is the co-director of the Centre for Applied Obesity Research. His primary research interest is adult and childhood obesity treatment strategies but he has a focus on the use of systems approaches to tackle the wider determinants of obesity.

Type 2 Diabetes in General Practice

This presentation will look at the background to policy making for diabetes care in the UK emphasising the serious problem of conflicts of interest in standard setters and the inadequate representation of general practitioners, with suggestions for reform. (DJPG)

It will present information about the characteristics of over 400 patients with T2DM in the St Leonard’s Practice analysing whether they were diagnosed before or after presenting symptoms of diabetes, and by their medical and social characteristics.

Learning outcomes

  • Conflicts of interest are corrosive and need to be stopped
  • Most patients with T2FDM are cared for in general practice which needs to be fairly represented in standard setting groups
  • Most patients with T2DM can now be diagnosed in general practice before they report a symptom of diabetes
  • Medical complications are common and important
  • The social circumstances of patients with T2DM are undervalued can now be measured in new detail and are important

Professor Sir Denis Pereira-Gray OBE
Emeritus Professor, University of Exeter; former President Royal College of General Practitioners; former chairman, Academy of Medial Royal Colleges; former chairman the Nuffield Trust

Sir Gray qualified in medicine from Oxford University and St. Thomas' Hospital and trained in diabetes centres at Leicester, Poole, St Thomas', Exeter and Bristol. Since 1980 he has been consultant physician with a special interest in diabetes at Northampton General Hospital.

His special interests in diabetes are education, communication and patient empowerment, with particular emphasis on diabetes in people at each end of the spectrum, that is young adults and older people with diabetes. Since 1986 he has organised an annual counselling and empowerment course for health care professionals working in diabetes.

Sir Gray have worked with the R&D unit at Northampton General Hospital since it was founded in 1982 and have been Principal Investigator in a large number of studies, including UKPDS, DESMOND and 4T. He has published papers on patient risk awareness.

He has recently become interested in the problem of diabetes and dementia and the training of professionals who work in this area.


Eleanor White
Medical Student, University of Exeter

Eleanor White is a medical student at the University of Exeter. Eleanor has just completed a BSc degree during which she was seconded for a 10 month research placement at St Leonard’s Practice, Exeter, where she was supervised by Professor Sir Denis Pereira Gray. This was the first placement of a BSc student in general practice in Devon and Cornwall and provided essential research experience and training. This opportunity led to co-authorship on the article “Is the ‘scandal’ of diabetes care in general practice fact or fiction?” published in the BJGP.

NHS RightCare and the power of variation: delivering population healthcare improvement and value across the system


Michelle Mello
Deputy Director, NHS RightCare

Paediatric weight management programme for children with diabetes: a pilot study

The presentation will provide an overview of teaching sessions completed by Niamh and Raphaella through the Stepping Stones programme which took place in the Heart of England NHS Trust in 2016. There will then be a summary of paediatric weight management and current strategies to support this within the UK.

Learning outcomes

  • An overview of a paediatric weight management programme for children with diabetes
  • Awareness of challenges faced when delivering structured education programmes
  • Insight in to rewards and challenges of managing
  • Exercise for children with diabetes
  • Discussion around National and International management of exercise in paediatric diabetes
  • Practical tips for setting up exercise clinics (individually and group) within your own organisation

Raphaella Rookes
Specialist Paediatric Dietician, Gloucester NHS Foundation Trust

Raphaella has background experience as a dietitian in diabetes, bariatric surgery and respiratory care. Since then, she has specialised in paediatric dietetics and in particular paediatric diabetes. Raphaella has worked previously in the Heart of England NHS Trust for three years as a paediatric diabetes dietitian before taking a promotion as Paediatric Team Leader in Gloucester. Her current role as a paediatric diabetes dietitian is on the committee of the DSG-Paeds Specialist Group, the Dietetic Group of the South West Network and she is currently focusing in particular on the prescription of insulin by AHP’s, annual review clinics (for which Gloucestershire NHS Foundation Trust) won a QiC award and paediatric diabetes sports clinics. Outside of the NHS, she is also the Module leader for Diabetes in the Young Module, which forms part of the MSc Diabetes at Southampton University.


Niamh Gilligan
Specialist Paediatric Dietician, Royal Manchester Children’s Hospital

Niamh graduated with an honours degree in BSc (Hons) dietetics in 2014 from University of Ulster Coleraine. From there she began her dietetic career covering respiratory medicine and upper head and neck cancer. She then specialised in paediatric dietetics, initially paediatric diabetes, within the Heart of England NHS Foundation Trust for a year, before taking a promotion and relocating to Royal Manchester Children’s Hospital. Within her current role she covers PHDU, LTV and CF. Outside of the NHS Niamh is currenty working towards her master’s degree in Paediatric dietetics in association with Plymouth university.

Virtual vs reality in the diabetes world-this is how we do it

The increasing prevalence of diabetes continues to put pressure on the NHS, not least on our appointment system and seeing our patients. More importantly giving our patients the time they need, especially in the early stages of diagnosis can have a profound effect. As healthcare professionals we need to strike a balance to enable us to continue and provide a world class service, as well as improve our efficiency and quality.  One approach we have taken is to provide virtual clinics. This enables enhanced communication with our patients, increases engagement and empowers self-management. It can also minimises potential barriers to consultations.

This presentation will discuss our positive experiences and the advantages that virtual clinics provide both the clinician the patient.

Learning outcomes:

  • Gain an understanding of how downloading data enhances consultations
  • Explore the benefits and areas of development within diabetes consultations through using face to face consultations vs digital technology
  • Improve efficiency for patient and healthcare professional

Kelly Carden
Nurse, Southampton Universit Hospital and co-founder Sugar Buddies

Kelly is a nurse with type 1 diabetes. She is passionate about sharing her journey and experiences of life with type 1 through her blog, articles published in national diabetes magazines including DUK & DRWF and speaking at national and local conferences. Kelly delivers presentations to health care professionals and local universities to give an insight of living with type 1 diabetes.

Following her diagnosis in 2013, Kelly helped to set up a local peer support, Sugar buddies, in Hampshire. Sugar buddies support patients and health care professionals to help improve experience and services offered to people with diabetes. Sugar buddies was awarded 'highly commended' at the Quality in Care awards in 2015.

In 2016 Kelly, along with 16 others, Kelly cycled from London to Paris. Between them they raised approx. 6.5k for the local hospitals diabetes charities, JDRF & DUK. Since achieving this Kelly is keen to help raise awareness of exercise and diabetes.

Kelly is very passionate about improving patient experiences and is currently working alongside local diabetes teams to set up a service to support university students with diabetes and a Type 1 event for people with diabetes.


June Murphy
Diabetes nurse – Insulin pump specialist, University Hospital Southampton NHS Foundation Trust

June has been in nursing since 1980 and has worked in diabetes since 1993 her team call her Jurassic June as she been around so long!

June started out as diabetes research nurse for David Kerr in BDEC Bournemouth. She started in pump therapy in 1994 as the only nurse in department who could take blood!! That’s when her love for pumps and CGM  started.

June was asked to try all the pumps and CGMs that were around so that she could fully understand what patients have to go through – she even had an induced hypo ( dropped to 2.3 mmols). June left BDEC in 2005 and became a Nurse Advisor for the Industry. Having been made redundant in 2008 she returned to the NHS as a DSN and helped set up what is now West Hampshire diabetes service. In 2014 they needed pump service set up and June was seconded from West Hampshire.

She retired in December 2014 and returned back for 3 days a week to run the pump service (her dream job).

Tackling Childhood Obesity

Richard Sangster presents an overview of the scale of challenge on childhood obesity; the reasons for this and how Government is delivering its childhood obesity plan to combat it.

Learning outcomes:

  • Understand the key drivers of childhood obesity
  • How the Government is tackling this issue through the delivery of the childhood obesity plan
  • What role everyone plays in achieving this

Richard Sangster
Deputy Branch Head, Childhood Obesity, Department of Health

Richard Sangster is currently head of the Obesity Policy team at the Department of Health and led on the development of the recently published childhood obesity plan. Previously, Richard headed the Children and Young People’s Public Health Policy team covering a broad portfolio of areas.

Richard joined the Department of Health in 2009 having previously worked for the Department of Education for eight years in a number of roles and policy areas.

Understanding clinical inertia

Clinical inertia, the tendency to maintain current treatment strategies despite results demanding escalation, is thought to substantially contribute to the disconnect between clinical aspirations towards optimal control of the disease and reduction in complications for patients with diabetes and targets achieved. The Time2DoMore project is a collaboration between the International Diabetes Federation and experts from around the world.

This presentation will present the principal findings of the survey. It suggests that impairments in communication are at the heart of clinical inertia. It will present some key strategies in order to try to combat clinical inertia in daily practice.

The complete manuscript for physicians can be downloaded at http://www.diabetesresearchclinicalpractice.com/article/S0168-8227(14)00219-8.pdfadditionally a secondary manuscript aimed at people with diabetes can be found at http://www.idf.org/sites/default/files/attachments/2014_3_Strain_EN.pdf

Learning outcomes:

  • The health outcomes for people with diabetes are a function of the communication between the healthcare professionals and people with diabetes acting as a team.
  • It is the duty of that team to establish realistic shared goals and a contract in order to achieve these objectives.
  • Individualizing care needs to be personalized to all aspects of the needs of the person with diabetes, not simply chasing glycaemic, blood pressure or lipid targets.
  • We would suggest that more time being made available to tackle the impairments in communication that are at the heart of clinical inertia, will help combat clinical inertia in daily practice.

Dr David Strain
Senior Clinical Lecturer, Diabetes & Vascular Research Department, University of Exeter Medical School

David is currently a Senior Clinical Lecturer at the University of Exeter Medical School, where he was successful in achieving a National Institute of Healthcare Research Clinical Senior Lecturer Award Fellowship. His primary interest is individualizing care for people with diabetes, particularly the older adults. In meeting this aim, he has run programs comparing patient’s interpretations of their quality of life and that of their relatives, in decisions about their health.. He was the global lead on a study determining the effectiveness of individualised treatment targets in elderly patients with diabetes, and is currently chairing the steering committee of a global project in association with the International Diabetes Federation (IDF) called ‘Time 2 Do More in Diabetes™’ targeting clinical inertia.

The role and impact of specialist diabetes pharmacists

This presentation will outline the current situation of pharmacists involved in the care of patients with diabetes. It will discuss the opportunities that are available and outline the skills that pharmacists can offer and competency frameworks to aid development. It will also look at what has been achieved by those already working in diabetes.

Learning outcomes:

By the end of this session you will be able to:

  • Outline the current situation and future opportunities for pharmacist involvement in diabetes care
  • List the skills that pharmacists can offer to MDTs
  • Understand how to use competency frameworks to develop your skills in diabetes

Victoria Ruszala
Specialist Pharmacist, Diabetes and Endocrinology, North Bristol NHS Trust

Vicky Ruszala is a clinical pharmacist based on the Acute Medical Unit at North Bristol NHS Trust. She works in a specialist capacity with the inpatient diabetes and endocrinology team, as well as completing projects and providing advice to Bristol CCG, trying to improve the patient experience for those with diabetes and reducing errors in diabetes care.

She has practised in the field of diabetes and endocrinology for the past 9 years and is recognised as an expert nationally. She was the expert pharmacist for NICE on the Type 1 diabetes guideline and is currently one of the pharmacist leads in the endocrinology Clinical Reference Group for specialised commissioning in NHS England. As one of the clinical leads in Bristol Diabetes Transformation Project she was responsible for working across the interface between primary and secondary care; prioritising areas of care, medicines optimisation projects and areas of governance such as audits and policy writing.

Currently the co-chair of the UKCPA Diabetes and Endocrinology group, she has been a member of the committee for 7 years allowing her to provide and influence the education of fellow pharmacists, as well as taking part in opportunities to influence national policy on diabetes, education and training and the development of the RPS professional curriculum.

She has been published in a range of journals on different aspects of diabetes care. As a speaker she has had the privilege of attending and speaking at a range of conferences, including the 1st International Conference of Clinical Pharmacy in Saudia Arabia. In addition she works locally providing diabetes education for primary and secondary care health professionals.

‘Young Diabetes Connections’: a network for children, young people and their families in south London

Young Diabetes Connections [YDC] is a collaborative network formed in 2013 between the children and young person diabetes teams of the Evelina Childrens Hospital, Kings College Hospital and Lewisham Hospitals as equal partners. The aim - to combine the advantages of a larger service serving over 400 families with the local delivery of service which we know is highly valued. YDC achievements include shared protocols, an ‘Out of Hours’ [OOHs] service for families, a very active parents support group and educational and social events that are shared across the network. We believe that this model of care provision has the potential for improving diabetes care for children in the UK.

Learning Outcomes

  • Bigger teams does not = centralised care
  • An OOHs service can provide what families want – a rapid response by an expert in diabetes
  • The OOHs service has substantially reduced A & E attendances for children with diabetes
  • Diverse teams can share strengths and novel ideas
  • YDC – supporting families to live well

Dr.Tony Hulse
Consultant Paediatric Endocrinologist, Evelina London Children's Hospital, Guy's and St.Thomas’ NHS Foundation Trust

Tony has been a Paediatrician and Paediatric Endocrinologist at the Evelina London Childrens Hospital at St.Thomas’ Hospital since 2007. He previously worked as a Consultant Paediatrician at Maidstone Hospital in Kent where he ran the childrens diabetes service. As a trainee he worked at both Great Ormond Street Hospital and in the University of California, San Francisco in research positions.

He has wide ranging interests in growth and endocrine disorders of childhood including neonatal screening for congenital hypothyroidism. At the Evelina he has developed the diabetes services extensively including the insulin pump service and helped establish the Young Diabetes Connections network. He is also a Governor of Guys and St.Thomas’ NHS Trust.

Update on new treatments and technology in 2017. What’s on the horizon and what has made the most waves?



The formula for diabetes prevention: effective weight loss and maintenance with total diet replacement

This presentation will explore the nature of formula-food total diet replacement (TDR) nutritionally-complete weight loss programmes and their use to deliver 10% body weight loss in pre-diabetes, early and late diabetes and other obesity-related co-morbidities such as obstructive sleep apnoea (OSA) and cardiovascular disease. The published evidence and clinical trials under way will be highlighted, with a brief review of metabolic benefits and symptom improvement in OSA and osteoarthritis. Strategies for delivery within health-care settings and community settings on referral from primary care, for diabetes prevention, remission, medication dose reduction or improved control, will be discussed.

Learning outcomes:

  • Will learn that formula diet weight loss using total diet replacement (TDR) can deliver an average 10% weight loss in about 8 weeks with metabolic improvement and symptom benefit;
  • Will acknowledge that recent authoritative US clinical guidelines recommend a 10% body weight loss for diabetes prevention, remission, medication dose reduction or improved control;
  • Will appreciate that formula TDR 800kcal/d diets can be delivered in primary care, secondary care settings and in community settings after self-referral or referral by GPs;
  • Will understand that TDR have a manageable risk profile with fully published adverse events profiles, relatively low lean-mass losses and evidence for weight maintenance for up to four years;
  • Will be aware that major global and UK-based clinical trials in pre-diabetes, early diabetes reversal and weight loss in insulin-treated diabetes are underway.

Declaration of Interest: Anthony R Leeds is employed full-time as Medical Director of Cambridge Weight Plan (a company owned by an employee ownership trust) but has no direct shareholding in the company.


Prof Anthony R Leeds
Department of Diabetes and Endocrinology, Central Middlesex Hospital, London; Faculty of Science, University of Copenhagen, Denmark; Parker Institute, Frederiksberg Hospital, Denmark; School of Health Sciences, International Medical University, Malaysia; Medical Director, Cambridge Weight Plan

Meal time management

Managing blood glucose levels effectively around mealtimes is fundamental for patients on bolus therapy to reduce not only the risk of hypoglycaemia but also hyperglycaemia. Understand the importance of managing levels in Post Prandial Glucose (PPG), Fasting Plasma Glucose (FPG) and HbA1c as well as the importance of injection techniques, the impact of carbohydrates on blood glucose levels and selecting the most appropriate therapy for the patient to help shape the quality of life and level of control of blood glucose for patients with diabetes.

Learning Outcomes:

  • Importance of managing blood glucose at mealtimes
  • Understanding the impact carbohydrates have on blood glucose levels, and how to monitor carb intake
  • The importance of injection techniques
  • The available therapies to help manage blood glucose during and after mealtimes

(this session has been organised and speakers remunerated by Novo Nordisk and is non promotional)

Dr Kevin Fernando
GP & Partner, North Berwick Health Centre

Kevin Fernando is a GP Partner at North Berwick Health Centre. He is a committee member of the Primary Care Diabetes Society and a Diabetes UK Clinical Champion.

Kevin graduated from Edinburgh University during 2000 and holds both MRCGP and MRCP. He has completed a Masters degree in Diabetes, passed with distinction. Kevin was elected to Fellowship of the Royal College of Physicians of Edinburgh for his work in diabetes professional education.

Kevin is also a GP Presenter for NB Medical Education on their popular Hot Topics GP Update courses, run throughout the UK and abroad.

Away from work, Kevin is married with four children. The GMC have imposed restrictions on his family planning consultations. Kevin enjoys cooking and entertaining and his claim to fame was winning Come Dine With Me Edinburgh during 2013!

Everything you need to know about STPs and the potential impact for diabetes care

The presentation will give a policy background to the development of STPs, and trace the evolution of STPs from the initial conception as planning arrangements to the role they are now taking on system coordination and drivers of new models of care.

The challenges and paradoxes of this new way of working will be explored, together with some thoughts on likely direction of travel post the 2017 election.

The need to shift resources into prevention and treatment in community and primary care settings will be explored, with diabetes highlighted as an example of the kind of condition that needs to be re-designed for the 21st century NHS.

Learning outcomes:

  • An appreciation of the role of STPs and their position in the governance and regulatory framework of the NHS
  • An understanding of the scale of the challenge STPs and the NHS faces, moving to new models of care delivery
  • An understanding of the tensions in the system we are trying to work in, and how those tensions might be resolved
  • How changing the delivery of diabetes care fits into the wider NHS change process
  • The implications for patients and clinicians of the evolving NHS landscape

Mark Easton
Programme Director, South East London STP

Mark has a long career in NHS management. He has led, as chief executive, acute and community services, as well as commissioning organisations and a strategic health authority.

Entering the NHS as a management trainee, he began his career working in acute hospital trusts in London, including at the Royal Free Teaching Hospital, where he worked as Deputy Chief Executive.  He then led the North Central London Strategic Health Authority as Interim Chief Executive, prior to the creation of NHS London.  Mark then went into commissioning as Chief Executive at NHS Brent Primary Care Trust.

He then returned to the acute sector as Chief Executive at Barnet and Chase Farm Hospitals NHS Trust, before moving to Barts Health NHS Trust – advising on the development of Barts Cardiac Centre.

Following that he worked with councils and clinical commissioning groups in London to advise on the successful delivery of integrated care, and spent six months as interim chief executive of Norfolk Community services.

He took up his role as Programme Director with South East London in July 2015.  The SEL STP has been recognised as one of the most developed in the country. 

I’m a teenager – hurry up and cure Diabetes!

It’s hard enough being a teenager today – but a teenage with Type 1 Diabetes is even more challenging! This session will provide a real insight into what it’s really like to be a teenager with Type 1 Diabetes.


Sophie Beale, PWD, aged 14

Sophie is 14 years old.  She is a talented dancer and participates in dance competitions at a national level.   She is a keen animal lover and enjoys country walks with her Tibetan Terrier puppy Evie.

Sophie was diagnosed Type 1 at age 5 and has tackled it head on and does not let it get in the way of being a teenager and doing all the things she loves to do.  Sophie would love to see Diabetes be a thing of the past for herself and for fellow sufferers and is very keen to hear professionals views on how that might be achieved!

Keynote Session:

Awaiting session information


Special Guest Speaker

20 years experience with a diabetes database

A review of the use and development of a ‘whole department’ diabetes database over two decades. The presentation will look at the pros and cons of using the Diamond diabetes database and the way in which it is used by the multidisciplinary team. It will look at the ways in which access to information can support and drive improvement in diabetes care and will report on the effect of ‘traffic light’ prompts on the completeness of recording the 9 care processes over a year.

Learning outcomes

  • Use of dedicated diabetes database over time
  • Tool for multidisciplinary communication
  • Use in audit and QI
  • Use in the community
  • Potential in future for patient involvement via ‘patient portal’

Dr Nicholas Morrish
Consultant Diabetologist /Deputy Responsible Officer / CCIO, Bedford Hospital NHS Trust, Diabetes Clinical Lead, East of England Clinical Networks

Nick Morrish trained at Cambridge and Guy’s and qualified in 1975. He has been a diabetologist at Bedford Hospital since 1991. He has a particular interest in the management of diabetes in pregnancy and in the organisation of diabetes care. He was the national manpower coordinator for diabetes for 10 years and has sat on the Royal College of Physicians Joint Speciality Committee and the SAC for Diabetes and Endocrinology. He has had an active involvement in working with primary care since his appointment in Bedford and has been involved in the introduction of the Integrated Community Diabetes Service in Bedfordshire. He is the clinical lead for diabetes for the East of England Diabetes Clinical Network and CCIO for Bedford Hospital.

Bariatric surgery and type 2 diabetes

Type 2 diabetes is increasing in epidemic proportions and no country has yet succeeded in prevention. Bariatric surgery offers the potential for remission of diabetes – normalising HbA1c and getting patients off medication – and is recommended as a treatment option by the American Diabetes Association. The presentation will go through the evidence for bariatric surgery as a treatment for diabetes, review the NICE Guidance and some of the barriers to uptake.

Learning outcomes:

  • Understand the indications for bariatric surgery
  • Understand about the different operations available
  • Understand about holistic effects of surgery on other disease
  • Understand cost-effectiveness of surgery
  • Understand need for follow up and joined up pathways

Richard Welbourn
Consultant Upper G.I. Surgeon, Musgrove Hospital, Taunton

Richard is part of a 3 consultant unit undertaking bariatric surgery at Musgrove Park Hospital in Taunton UK. He is Past-President of the British Obesity and Metabolic Surgery Society 2013-15. In 2014 he led multi collegiate commissioning guidance for the Royal College of Surgeons for bariatric multidisciplinary clinics and was a member of the 2014-16 NICE Guidance and Quality Standards Advisory Committees for obesity and bariatric surgery for the National Health Service. He is former Chair of the UK National Bariatric Surgery Registry committee and is a member of the International Federation for Surgery for Obesity (IFSO) Global Registry Committee. He is the World Congress President for IFSO 2017, to be held in London 29th August - 2nd September

The challenges of managing patients with diabetes living in care homes

This presentation we review the management of older people with diabetes looking at recommendations from national and international guidelines.

It will look at the “Good clinical practice guidelines for care home residents” and how these are being enacted as shown in the National Care homes diabetes survey. The presentation will also look specifically at Nursing home residents with diabetes and consider issues of over prescribing in them.

Learning outcomes

  • An understanding of national/international guideline recommendations for older people with diabetes
  • An appreciation of the good clinical practice guidelines for Care home residents with diabetes
  • An understanding of whether these are being enacted
  • Goals of management for Nursing home residents
  • Reducing inappropriate prescribing in Nursing home residents

Prof Roger Gadsby
Honorary Associate Clinical Professor, Warwick Medical School, University of Warwick and GP Lead for National Diabetes Audit

Roger was a GP for 31 years and has written 4 diabetes textbooks, 12 textbook chapters and over 300 articles and papers. At Warwick he has developed a number of assessed accredited courses in diabetes care. He has been on the guideline development groups for 5 NICE diabetes guidelines, and the IDF guideline on Type 2 Diabetes in Older People.  He has had a long standing interest in diabetes in older people, and was Visiting Professor at IDOP, University of Bedfordshire working with Prof Alan Sinclair. . He was awarded an MBE in the Queen’s Birthday Honours list in 2009 for “services to medicine and diabetes care”.

Reducing costs and amputations by commissioning joined up diabetes foot services: the Somerset experience

This presentation will address some of the challenges in reducing amputations in patients with diabetes. It will look at NICE and Diabetes UK guidelines for diabetes foot services. Using Somerset as an example, it will look at building cross-organisational MDT services and review the outcomes, both financial and in terms of reduction in amputations, that such services can offer.

  • Overview of guidelines
  • Somerset as an example
  • Setting up and establishing a cross-organisational diabetes foot service
  • Improving inpatient diabetes foot care

Learning outcomes – changes in amputation rates and costs of the service


Dr Julia Thomas
Consultant Physician and Lead for Diabetes Footcare, Taunton & Somerset NHS Foundation Trust

Juila is a general physician and endocrinologist with a specialist interest in Diabetes Footcare. She was appointed to lead Diabetes Footcare at Taunton and Somerset NHS Foundation Trust in 2012, with the mandate to “reduce Somerset amputation rates”. Based in secondary care, Julia has been working with healthcare providers across community and hospital Trusts, and with the CCG, to create cross-organisational patient pathways, improve education and training and seek to reduce amputation rates in Somerset. The work particularly focuses on meeting the needs of the rural, elderly population.

Julia also run specialist clinics in Pituitary Disease and Medical Weight Management, as well as serving as a trustee for Somerset’s hospice service, St Margaret’s Hospice.

Type 2 diabetes in adolescents – a weighty problem

This presentation will summarise Type 2 diabetes in adolescence -incidence, diagnosis, UK wide trial (JUMP), complications, together with treatments now and in the future. It will also touch on adolescent obesity as well as the risks of diabetes in this group.

Learning outcomes

  • Type 2 needs to be considered in at risk groups with its increasing prevalence in the UK
  • Diagnosis often takes longer than Type 1 - important to enter patients in JUMP
  • It can have significant complications
  • Treatment can be challenging
  • New treatment modalities are available

Dr Martha Ford-Adams
Consultant Paediatrician, King’s College Hospital

Martha Ford-Adams is the Lead Clinician for Paediatric Diabetes and Obesity at Kings College Hospital, London. Kings works as part of the collaborative service -Young Diabetes Connections - comprising the Evelina Childrens’ Hospital and Lewisham University Hospital serving over 400 patients in South East London.

Martha was the founding co-chair of the London and South East Coast Paediatrics Diabetes Network which was established in 2009 in parallel to the national network. Her research interests are in obesity and Type 2 diabetes and new treatment for both these chronic conditions.

What diabetes tech is for my patient? – NICE Guidelines criteria for type 1 and 2 technology


National Institute for Health and Care Excellence

The role of keto diet in treating medical conditions


Awaiting speaker information

Understanding and managing gestational diabetes in primary and secondary care

The presentation will discuss:

  • Latest guidelines re definition of Gestational Diabetes (GDM)
  • Latest guidelines re best management of GDM
  • Controversies within this area
  • Long term consequences for the mother and the baby

Learning outcome

A better understanding of the challenges faced in the management of gestational diabetes in primary & secondary care


Dr Michela Rossi
Consultant in Diabetes & Endocrinology, Whittington Hospital

Michela was appointed as Consultant in Diabetes & Endocrinology at the Whittington Hospital in 2002. She is currently lead in Diabetes Pregnancy Service, Diabetes Foot Disease and Endocrinology. For the Diabetes Pregnancy Services Michela has written local guidelines and undertakes regular audits, which have shown on going improved standards of care. She co-ordinates regular meetings with the team for service development issues and co-ordinates and presents on pre-pregnancy information giving sessions for women with diabetes. She liaises with local GPs to invite women with type 2 diabetes. The networks established for good working relationships have been key to producing excellent outcomes.

Working with commissioners to achieve a funding solution for CGM – A case example from the SHIP8 Commissioning Cluster

Using a mixture of clinical vignettes and evidence-based arguments I’ll describe the process which allowed us in 2016 to achieve funding for CGM within a “technology-assisted type 1 diabetes management pathway” rather than simply an “insulin pump pathway” across the 8 commissioning groups which make up the SHIP8 cluster.

Case histories used to make the case and results for individuals on the pathway will be discussed.

  • The principles applied by NICE to pump therapy introduction can be extended to other technological assistance for self-management
  • Working collaboratively with commissioning teams can produce positive results
  • Recognising that local commissioning groups do not have “unlimited funds” and making clinical requests appropriate to their ability to respond is an important lesson for clinicians
  • Insulin Pump therapy, although often transformational, is not the only solution for problematic BG control in type 1 diabetes. Continuous monitoring with Flash Monitoring devices can achieve similar results in some individuals at a fraction of the cost

Dr Iain Cranston
Consultant Diabetes Physician & Endocrinologist, Portsmouth Hospital NHS Trust

After a period in clinical research looking at the issues of impaired awareness of hypoglycaemia in type 1 diabetes and how to reverse the problem, based at Guys/Kings & St Thomas’ in the early 1990’s Iain has spent the last 25 years as a consultant in clinical practice (first in SE London and since 2001 in Portsmouth). His clinical interests have been focussed on applying the lessons learnt during the research period into routine clinical care. This has involved him in being a pioneer utilising both SMBG and CGM data as a part of the routine consultation process, a practice he tries to spread amongst other clinical teams whenever he meets them! He is the clinical lead in Portsmouth for Intensive Insulin services & pumps and also the lead for diabetes services to support the regional renal unit in Portsmouth.

In addition to his NHS work, he is a Director of the AGP Clinical Academy and Southern Diabetes Medical Services, both of which entities concern themselves with the improvement of medical care for diabetes locally and internationally.

Children and Young People’s South East Coast and London Network

As medical science and technology have advanced at a rapid pace the health care delivery system has struggled to provide consistent high-quality care. There is a short-fall between knowledge acquisition and translation into practice safely and appropriately. Better use of resources will become an increasingly important issue in an environment where investment will only be undertaken on the proviso of increased value for the money expended. Diabetes is a chronic condition and requires continuous monitoring/input and a high level of patient/parent involvement.

Health care at present has safety and quality problems because the system that is utilised is outmoded. Poor design sets the workforce up to fail regardless of how hard they try leading to a browbeaten, disillusioned and cynical group. If we want safe, high quality care then system redesign is essential.

The delivery of care varies across the South East Coast and London area as exemplified in the National Paediatric Diabetes Audit (2016). Glycosylated haemoglobin (HbA1c) is an internationally recognised measure of diabetes control. Very few services approach the benchmark measures of Germany, internationally recognised as providing the best quality of care. Access to intensive insulin regimens such as pump therapy, which provides the best control, is variable across the sector with 76% of patients at one hospital on insulin pump therapy versus 8% at some other sites. The Network was created to introduce the principles of chronic care and to achieve a value based service using the 6 components of Quality Care defined by the Institute of Medicine. The initial phase has been to create a network that exchanges information and to build on this into a coordinated managed system.

LEARNING OUTCOMES:

  • Components of Quality Care as defined by the Institute of Medicine
  • Principles of chronic care management using the Wagner model
  • Organisation of Health Care – what needs to be in place
  • Establishing a network – getting buy in
  • Introducing value into the care system

Professor Peter Hindmarsh
Professor of Paediatric Endocrinology, Developmental Endocrinology Research Group, University College London

Peter Hindmarsh is Professor of Paediatric Endocrinology at University College London and Consultant in Paediatric Endocrinology and Diabetes at University College London Hospitals and Great Ormond Street Hospital for Children. Currently he is applying Chronic Care Models to Diabetes Care Delivery. His research interests are in long term complication in diabetes and the mathematical modelling of data sets. He is currently Divisional Clinical Director for Paediatrics at University College London Hospitals.

Diabetes Burnout: Fact or Fiction?

This presentation will aim to explore the concept of ‘burnout’ within diabetes care from a dual perspective, those of the person with diabetes and those healthcare professionals who work in diabetes care.

At the end of this session you will be able to:

  • Know and understand what Diabetes Burnout is?
  • Know how Diabetes Burnout can be recognised within your patient caseload?
  • Learn what you can do to help the patient with Diabetes Burnout?
  • Demonstrate simple practical suggestions to help
  • Recognise if you are at risk from Diabetes burnout?

Debbie Hicks
Nurse Consultant - Diabetes, Enfield Health, Barnet, Enfield & Haringey Mental Health Trust

I lead a team of specialist nurses in providing an intermediate diabetes specialist service based in the community for people with diabetes living in Enfield.

I am a founder and Co-Chair of TREND-UK (Training, Research and Education for Nurses in Diabetes) which provides education, resources and support to all nurses working in diabetes care.

I am the founder and Chair of FIT UK (Forum for Injection Technique) which provides best practice information in Injection Technique.

I am the Editor-in-Chief of the Journal of Diabetes Nursing.


 

Agenda
Thursday 16th November 2017

CPD Logo
 

Obesity in Practice and Diabetes Prevention
Theatre 1

Type 1

Theatre 2

Diabetes in Primary & Secondary Care
Theatre 3

Diabetes Co-morbidities

Theatre 4

Diabetes Technologies & Research Theatre


08:45 - 09:30
Registration
09:30 - 10:00
Keynote Session:
NICE, evidence and guidelines:  pitfalls and practicalities
Prof Gillian Leng, Deputy Chief Executive and Director of Health & Social Care, NICE
Theatre 1
10:05 - 10:35
The sugar reduction and wider reformulation programme- its contribution to the obesity agenda
Dr Alison Tedstone, Deputy Director, Diet and Obesity/Chief Nutritionist, Public Health England
Insights into maintaining quality in structured education from a national programme over 15 years
Sally Woolgar, National Educator, Dose Adjustment For Normal Eating Programme, Northumbria Healthcare NHS Foundation Trust
Origins of DKD and CKD epidemic and current treatment strategies
Prof Magdi Yaqoob, Professor of Nephrology, Barts Health NHS Trust & William Harvey Research Institute
Identifying Monogenic diabetes in practice
Prof Maggie Shepherd, Honorary Clinical Professor, University of Exeter/Royal Devon & Exeter Foundation Trust
10:40 - 11:10
Carb awareness – what diet should I recommend for my diabetes patient?
Dr Sean Wheatley, Researcher and Trainer in Public Health, X-PERT Health
The Power of The Pump: A child and adult patient view!
Amy Winchcombe, PWD, aged 16; and Dr Sufyan Hussain, Consultant Physician in Diabetes and Endocrinology, Royal Free Hospital
Improving diabetes care at scale: A clinical transformation tale
Dr Tony Willis, Clinical Diabetes Lead, CWHEE
A time for change: a new evidence-based approach to managing CV risk in Type 2 Diabetes
Dr Kevin Fernando, GP & Partner, North Berwick Health Centre; and Dr Richard Brice, GPSI in Diabetes, Whistable
Derbyshire NHS and EMAHSN – technology enabled integrated MDT diabetic foot care
Chris Hart, Commercial Director, East Midlands AHSN; & Prof Fran Game, Consultant Diabetologist and Director of R&D, Derby Teaching Hospitals NHS Foundation Trust
11:10 - 12:00
NETWORKING & EXHIBITION
12:40 - 13:10
The role of primary care in referring type 1 patients & supporting secondary care
Dr Rustam Rea, Consultant in Diabetes & Acute General Medicine, Oxford University Hospitals NHS Trust
New treatment strategies in the diabetic foot – what is up and coming?
Graham Bowen, Clinical Services Manager, Solent NHS Trust
The psychological impact of diabetes
Professor Cathy Lloyd, Prof of Health Studies, The Open University
13:10 - 14:25
NETWORKING & EXHIBITION
13:50 - 14:20
Testosterone deficiency and sexual dysfunction – time for proper personalised patient care

Prof Geoff Hackett, Prof of Men’s Health, Department of Diabetes, University of Bedfordshire
NETWORKING & EXHIBITION
14:30 - 15:05
Keynote Session:
Population accountability for people with type 1 and 2 diabetes
Professor Sir Muir Gray, Director, Better Value Healthcare and Oxford University Hospitals NHS Trust
Theatre 1
15:10 - 15:40
Pregnancy is the most important life-stage for providing weight management guidance – an evidence based approach to support this statement
Dr Amanda Avery, Associate Prof in Nutrition and Dietetics, Senior Fellow of the Higher Education Academy, Division of Nutritional Sciences, University of Nottingham
Helping your patients benefit from diabetes technology
Melissa Holloway, Chief Advisor, and Lesley Jordan, Chief Executive, INPUT Patient Advocacy
Getting it Right First Time - a programme designed to improve clinical quality and efficiency within the NHS by reducing unwarranted variations.
Dr Partha Kar, Associate National Clinical Director for Diabetes, NHS England and Gerry Rayman
Management of diabetic ketoacidosis and the invisible collateral damage
Dr Ayush Sinha, Consultant Anaesthetist & Intensivist, West Suffolk Hospital, Bury St Edmunds
Automating inpatient glucose control – addressing the unmet need in the general wards
Dr Hood Thabit, Consultant Diabetologist, Manchester Diabetes Centre, Manchester Royal Infirmary, Central Manchester University Hospital Trust/University of Manchester
15:40 - 16:25
NETWORKING & EXHIBITION
16:30 - 17:00
Type 2 diabetes or walking deficiency syndrome
Professor Sir Muir Gray, Director, Better Value Healthcare and Oxford University Hospitals NHS Trust
Young-onset diabetes subtypes in UK ethnic groups – how do we differentiate them?
Dr Shivani Misra, Consultant in Metabolic Medicine, Imperial NHS Trust Healthcare College
What part can primary care play in increasing numbers that take up retinopathy screening invitations? What are the barriers to attendance?
Nikita Padda, NHS NWL Engagement Manager, North West London Diabetic Eye Screening Programme

Keynote Session: NICE, evidence and guidelines:  pitfalls and practicalities

The presentation will provide an overview of NICE’s role and why it is relevant to diabetes care. It will describe how research evidence is used to inform guidance and standards, and discuss the pitfalls and practicalities of assessing evidence and changing practice. The presentation will conclude with benefits of evidence-based practice for diabetes care, and how this can be measured.

Learning outcomes:

  • The role of NICE in the health and care system
  • Evidence assessment and guideline development
  • The challenges of changing practice and driving implementation
  • Quality standards for diabetes care
  • The role of measurement to drive improvement

Prof Gillian Leng
Deputy Chief Executive and Director of Health & Social Care, NICE

Gillian trained in medicine at Leeds, then obtained a doctorate on research into peripheral vascular disease at Edinburgh University. She was involved in the Cochrane Collaboration as it became established, and specialised in public health. At NICE, Gillian was responsible for the initial set up of the clinical guidelines programme, for NHS Evidence and for implementation support, before becoming the deputy Chief Executive. Gillian is a member of the English National Quality Board and is actively involved in research into quality improvement at King’s College, London. She is a trustee and honorary librarian at the Royal Society of Medicine, and a trustee of the Guidelines International Network.

Origins of DKD and CKD epidemic and current treatment strategies

10% of global population has chronic kidney disease (CKD) which is associated with increased morbidity and mortality. Diabetes is the leading cause of CKD in the western world. Survival in patients with Diabetic kidney disease is worse than many types of cancers.

This presentation will focus on the origins of DKD and CKD and also discuss how current treatment strategies have been derived.

  • In chronic non-communicable diseases prevention is a misnomer. It should be more appropriately labelled as postponement with current strategies
  • Prevention of chronic diseases should start at birth.
  • We have become the victims of our own success because life expectancy has reached beyond 80 years
  • In 21st century focus should be on healthy aging

Prof Magdi Yaqoob
Professor of Nephrology, Barts Health NHS Trust & William Harvey Research Institute

Muhammad Magdi Yaqoob is Professor of Nephrology at the Centre for Translational Medicine & Therapeutics at the William Harvey Research Institute (WHRI), academic director of the department of renal Medicine and transplantation and Diabetic Kidney Center at the Barts Health NHS Trust, UK.  Magdi Yaqoob is an internationally recognized expert in nephrology and transplant medicine in areas of cardiovascular diseases of uraemia, diabetic kidney disease, pharmacogenomics in transplantation, renal anaemia, and renal bone disease, progression of chronic kidney disease and mediators of acute kidney injury. He has published over 300 peer reviewed publications in addition to seven book chapters in medical text books including Clinical Medicine by Kumar & Clark, Oxford Clinical Medicine and Oxford Clinical Nephrology.

The sugar reduction and wider reformulation programme- its contribution to the obesity agenda

Tackling obesity, particularly in children, is a national priority. In August 2016 the government published Childhood Obesity: a plan for action which outlined its plans to significantly reduce childhood obesity. Public Health England’s (PHE) sugar reduction and wider reformulation programme is a key commitment in this plan. PHE is working with all sectors of the food industry to reduce the amount of sugar in their products by 20% by 2020, with a 5% reduction in the first year. The programme is also being extended to other nutrients of public health interest (calories, salt and saturated fat).

Learning outcomes:

  • The evidence base underpinning PHE’s programme
  • Establishing a sugar reduction and wider reformulation programme, including stakeholder engagement, setting baselines and data used etc
  • Sugar reduction and portion size/calorie guidelines
  • Monitoring progress
  • Future work in this field


Dr Alison Tedstone
Deputy Director, Diet and Obesity/Chief Nutritionist, Public Health England

Alison is Deputy Director with responsibility for diet, nutrition and obesity in the Health and Wellbeing Directorate of Public Health England. Her teams work areas include the National Diet and Nutrition Survey, nutrient composition of foods, scientific advice on nutrition (including the Scientific Advisory Committee on Nutrition), messaging on nutrition, dietary improvement and a programme of work to tackle the nation’s obesity problem. Alison transferred with other nutrition colleagues from the Department of Health in 2013 and before that from the Food Standards Agency (FSA) in 2010. Before joining the FSA, in 2001, Alison was an academic at the London School of Hygiene and Tropical Medicine. Alison completed post doctorate research in Oxford and is a registered public health nutritionist.

A holistic view and approach to type 1 diabetes care


Awaiting speaker information

Insights into maintaining quality in structured education from a national programme over 15 years

The national Dose Adjustment For Normal Eating (DAFNE) programme began roll out in the UK in 2002. The programme meets DoH criteria for structured education, including quality assurance and has evolved over the intervening 15 years. The presentation will describe how the national quality assurance programme has evolved while maintaining the focus on improved outcomes through key performance indicators. It will cover current redesign to meet the needs of HCPs in a changing working environment while maintaining the core elements that define quality.

Learning outcomes:

  • Recognise the measures of quality used in the DAFNE programme
  • Understand the benefits of national quality assurance
  • Appreciate how the national quality assurance programme has evolved to meet the needs of the NHS today
  • Consider how quality in diabetes self management training can benefit service users
  • Reflect on the benefits to HCPs and service providers of national quality measures in diabetes education

Sally Woolgar
National DAFNE Educator, Dose Adjustment For Normal Eating Programme, Northumbria Healthcare NHS Foundation Trust

Sally has been a diabetes specialist dietitian since 2001 with experience in primary and secondary care and in higher education. Her main interest is diabetes education and training for both health care professionals (HCPs) and people with type 1 diabetes. She is an enthusiastic exponent of effective self-care and structured therapeutic adult education.

Sally has been involved in the national Dose Adjustment For Normal Eating (DAFNE) programme since 2002. She has been National DAFNE Educator since 2014 and is currently leading on the redesign of the DAFNE training portfolio, quality assurance and audit programmes, to ensure that the DAFNE programme continues to meet the needs of people with type 1 diabetes and HCPs in todays NHS. She believes that through a unifying philosophy and consistency in information we can achieve improved outcomes for service users and greater work related satisfaction for providers.

Identifying Monogenic diabetes in practice

The presentation will discuss monogenic diabetes, highlighting how to identify possible cases and the impact of a genetic diagnosis. Genes causing both maturity onset diabetes of the young (MODY) and neonatal diabetes will be discussed. Case studies will highlight the specific characteristics associated with different types of monogenic diabetes which can easily be recognised, ensuring appropriate tests are recommended, enabling accurate diagnosis and most appropriate treatment. Use of non-genetic tests / biomarkers (c-peptide and islet autoantibodies), the MODY probability calculator and the Diabetes Diagnostics App will also be discussed. Ensuing treatment changes, implications for other family members and the emotional impact of a ‘new genetic diagnosis’ and the consequence of stopping insulin injections will also be discussed.

Learning outcomes:

  • Awareness of the key characteristics of MODY
  • Awareness of the key feature of neonatal diabetes
  • Knowledge of how to access genetic testing
  • Knowledge of where to find more information on monogenic diabetes
  • Knowledge of non genetic tests that may aid differential diagnosis in diabetes

Professor Maggie Shepherd
Honorary Clinical Professor, University of Exeter / Royal Devon and Exeter NHS Foundation Trust

Maggie trained as an RGN at King’s College Hospital and worked as a Diabetes Specialist Nurse in Greenwich prior to joining the monogenic diabetes team in Exeter in 1995. She have a PhD in Medical Science and qualifications in medical education and genetic counselling. Maggie is an Honorary Clinical Professor at the University of Exeter Medical School, lead nurse for research at the Royal Devon and Exeter NHS Foundation Trust and lead co-ordinator of the national Genetic Diabetes Nurse project.

Particular interests include increasing awareness of monogenic diabetes and ensuring correct diagnosis and treatment. Maggie has over 100 publications (30 first author) and she is an editorial board member of the European Diabetes Nursing Journal.

Maggie delivered the Janet Kinson award lecture at DUK in 2003, and is a member of the team that received the Queens Anniversary Prize for higher and further education in 2006, Hospital Doctor Academic Medicine team of the year 2005, BMJ diabetes team of the year 2016 and Quality in Care award for the Genetic Diabetes Nurse project.

A time for change: a new evidence-based approach to managing CV risk in Type 2 Diabetes

Learning Outcomes:

  • Gain an understanding that diabetes is a multifactorial condition
  • Understand how each drug class impacts each of these multifactorial elements
  • How to apply this knowledge in clinical practice

* (This session is sponsored by Novo Nordisk and is not CPD accredited)


Dr Kevin Fernando
GP & Partner, North Berwick Health Centre

Kevin Fernando is a GP Partner at North Berwick Health Centre. He is a committee member of the Primary Care Diabetes Society and a Diabetes UK Clinical Champion.

Kevin graduated from Edinburgh University during 2000 and holds both MRCGP and MRCP. He has completed a Masters degree in Diabetes, passed with distinction. Kevin was elected to Fellowship of the Royal College of Physicians of Edinburgh for his work in diabetes professional education.

Kevin is also a GP Presenter for NB Medical Education on their popular Hot Topics GP Update courses, run throughout the UK and abroad.

Away from work, Kevin is married with four children. The GMC have imposed restrictions on his family planning consultations. Kevin enjoys cooking and entertaining and his claim to fame was winning Come Dine With Me Edinburgh during 2013!


Dr Richard Brice
GPSI in diabetes, Whistable

Richard graduated from Cambridge university in 1999 and completed his postgraduate training at St Mary's hospital in London. Having passed the MRCGP examination with distinction he went on to become a partner at Whitstable Medical Practice in 2004 and has been chairman of the practice, one of the largest in the UK, since 2007.

He has had an interest in diabetes since medical school days and has been a GPSI in diabetes and locality lead for over a decade now.

Whitstable medical practice achieved vanguard status in 2015 for the new models of care program and under Richard's leadership was awarded an outstanding rating from CQC last year.

Carb awareness – what diet should I recommend for my diabetes patient?

People with diabetes are carbohydrate intolerant and struggle to metabolise carbs. In Type 2 diabetes this is due to insulin resistance and in Type 1 diabetes, insulin insufficiency. Everyone has a different carb tolerance level. Diabetes UK 2011 dietary guidelines recognise this by stating “Nutrition management has shifted from a prescriptive one-size fits all approach to a person-centred approach”. Eating carbs beyond ones’ personal threshold can lead to hyperinsulinaemia, insulin resistance, weight gain and fatty liver. Empowering education enables people to assess their carb tolerance and reduce the carb load by adopting a Mediterranean, low carb high fat and/or intermittent fasting dietary approach.

By the end of the presentation delegates will be able to:

  • Identify how the amount and type of carbs impact on blood glucose and insulin levels
  • Describe how hyperinsulinaemia can lead to insulin resistance
  • Explain how both hyperinsulinaemia and insulin resistance can develop future health problems such as diabetes progression, weight gain, fatty liver, CVD and dementia
  • Guide patients in assessing their personal carb threshold
  • Support patients in adopting a Mediterranean, low carb high fat or intermittent fasting dietary approach

Dr Sean Wheatley
Researcher and Trainer in Public Health, X-PERT Health

Sean has worked for X-PERT Health as a Researcher and Trainer in Public Health since September 2016. As part of this role he has contributed to the development of structured diabetes education programmes and has trained health care professionals across the country to deliver the X-PERT materials. Before starting this role Sean was a part-time lecturer in physiology and biomechanics at Leeds Beckett University, where he also completed his PhD looking at cardiometabolic health in young people.

X-PERT Health is a registered charity that provides structured education to people with, or at risk of, diabetes. They have approximately 90 centres across the UK and Ireland. The X-PERT programmes have been shown to improve patient empowerment, weight management, blood glucose control and other markers of health.

The Power of The Pump: A child and adult patient view!

This presentation will look at the merits of being a pump user, discussing both the challenges and benefits. Uniquely, it will look at both sides of the coin – from the perspective of Amy, who three years after diagnosis started using an Insulin pump to Dr Hussain, an expert in his knowledge of diabetes, and his experiences.

Learning outcomes:

  • Strength and challenges of the pump
  • Does one size fit all?
  • Psychological benefits of pump use

Amy Winchcombe
PWD, aged 16

Amy is currently studying for A-levels and hoping to go on to medical school.

Amy loves theme parks, music and gigs, especially when she is playing keyboard with her band. She also loves travelling abroad, having backpacked around India twice since being diagnosed.

Diagnosed with T1 soon after her 10th birthday in 2010, Amy started using an insulin pump in June 2013 and would never go back to MDI. She uses both CGM and Nightscout to help her manage her diabetes.


Dr Sufyan Hussain
Consultant Physician in Diabetes and Endocrinology, Royal Free Hospital

Dr Sufyan Hussain is a consultant physician in diabetes and endocrinology at Royal Free Hospital in London. He has over 25 years personal experience of living with type 1 diabetes and is passionate about improving care for diabetes. He graduated in medicine from the University of Cambridge and undertook his post-graduate clinical training in London teaching hospitals.  He was a visiting scholar at Joslin Diabetes Centre, Harvard Medical School and completed his PhD in diabetes and obesity at Imperial College London. His research work with Sir Professor Stephen Bloom (2009-13) discovered a key brain mechanism regulating glucose appetite. He has received several training awards and prizes. He was appointed as a Darzi fellow in Clinical Leadership in 2014-15 where he undertook several large-scale projects aimed at implementing new models of care in diabetes and telemedicine. He is a course organiser and lecturer on a range of diabetes courses at Imperial College.

His current interests include type 1 diabetes, technology in diabetes, transitional diabetes, complex type 2 diabetes, population health and general endocrinology. He has authored a number of publications and books in the field of endocrinology, including "Insulin pumps and continuous glucose monitoring made easy" book for health professionals. He has helped develop several technology platforms for self-management in diabetes. Outside work, he loves spending time with his three young children and playing tennis.

Improving diabetes care at scale: A clinical transformation tale

Kicked off by a group of clinicians in North West London and enacted by groups of local clinicians, the diabetes transformation programme is now demonstrating the benefits of investment in grassroots diabetes care, supported by good clinically focussed informatics and contracting. This presentation will share the ongoing learning and approach from North West London and what the team we are looking to achieve through their diabetes transformation funding.

Learning outcomes:

  • Improving key care processes and treatment targets in diabetes
  • Improving care at large population scale
  • Developing new models of commissioning
  • Winning over senior management teams
  • The importance of clinical leadership
  • Quality improvement principles

Dr Tony Willis
Clinical Diabetes Lead, CWHEE

Dr Tony Willis is a GP in Shepherd’s Bush and clinical lead for diabetes for the CWHHE CCG Collaborative in North West London. Having qualified in 1992, he initially trained in general medicine before undertaking a PhD in molecular biology at the Institute of Cancer Research and then transitioning to general practice. He is currently leading the diabetes strategy for the 5 CCG Collaborative, key elements of which involve reducing variability in care, promoting self-management and prioritising prevention. His other keen interest is in Information Technology and maximising the use of IT platforms to promote change and improve care.

Derbyshire NHS and EMAHSN – technology enabled integrated MDT Diabetic foot care

The presentation will provide an overview of changes to the DFU treatment pathway in Derbyshire, supported by an innovative digital imaging and assessment system, which has supported both MDT DFU treatment and increased care in community clinics. Initially deployed as an EMAHSN supported demonstration in Southern Derbyshire, the solution is now also being deployed in Northern Derbyshire and the East of England.

Learning Outcomes:

  • How to optimise on-going treatment of DFU when supported by a digital solution to enable the capture of condition of ulcers and remote consultation with acute based consultants
  • How to achieve costs savings using this approach compared to an acute based MDT treatment pathway
  • Benefits of the use of digital DFU image and clinical record system

Chris Hart
Commercial Director, East Midlands AHSN

Chris Hart joined East Midlands Academic Health Science Network as Commercial Director in 2014.

Prior to joining this, Chris worked for over 25 years in healthcare and technology industries across Europe and the United States, most recently as founder and CEO of SRC Ltd and Business Development Director with UK healthcare systems supplier Allocate Software PLC.

His role within EMAHSN focuses on building closer links between the NHS, public health and healthcare businesses; identifying new services and products that will benefit patients and the healthcare system throughout the East Midlands and addressing barriers to the rapid spread and adoption of proven innovations. Also delivering programmes to support local companies achieve accelerated access to healthcare markets in the UK and abroad.


Prof Fran Game
Consultant Diabetologist and Director of R&D, Derby Teaching Hospitals NHS Foundation Trust

Professor Fran Game is a Consultant Diabetologist and Director of R,D&I at Derby Teaching Hospitals NHS FT. She is an Honorary Professor at the University of Nottingham and has an International reputation in the field of the Diabetic Foot. She has been Chief Investigator on several National and International trials, including several trials on wound healing. She regularly lectures at national and international diabetes conferences on the subject of the diabetic foot and has published over 70 papers and book chapters. She has twice Chaired the Wound Healing subgroup of the International Working Group of the Diabetic Foot and is an Associate Editor of Diabetologia. Closer to home, she co-chairs the East Midlands Diabetic Foot network and works with Diabetes UK on their “Putting Feet First” campaign.

Evidence into action - putting some bite into holistic diabetic care pathways for patients


Sara Hurley
Chief Dental Officer England

Sara Hurley CDO England joined the Chief Professionals’ Office in July 2015 where she supports NHS England. Previously Sara served as a clinical dentist with the Royal Centre for Defence Medicine before expanding her career portfolio across the domains of public health, wider healthcare policy and commissioning.

LIVE DEBATE



Making hypos history: research approaches to tackle hypoglycaemia

Hypoglycaemia, and fear of hypoglycaemia, are a major barriers which stop people living with type 1 diabetes from achieving the glucose control they want. JDRF is supporting multiple strands of research which aim to tackle hypoglycaemia and make day to day living with type 1 diabetes easier. From laboratory investigations to clinical trials we will discuss projects that have the potential to transform our approach to this complex aspect of glucose control.

Learning Outcomes

  • Understand the impact of hypoglycaemia on people with type 1 diabetes
  • Discover how approaches to improve glucose control may lessen hypoglycaemia
  • Find out how laboratory investigations are developing new approaches to address hypoglycaemia
  • Learn about current clinical trials to address hypoglycaemia
  • Understand the goals of the JDRF PEAK programme

Rachel Connor
Director of Research Partnerships, JDRF UK

In April 2016, Rachel was appointed Director of Research Partnerships at JDRF UK. In this role she focuses on identifying and developing strategic opportunities for collaboration in type 1 diabetes research, and facilitating the smooth and effective running of JDRF’s research in the UK.

Rachel is the spokesperson for JDRF UK on research issues. She represents JDRF and people with type 1 diabetes on a number of project groups, and she also acts as a point of liaison for the UK type 1 diabetes research community.

Rachel joined JDRF in 2008 as Research Communication Manager. In this role and following her subsequent promotion to Head of Research Communication, she focused on communicating effectively about JDRF’s research with people affected by type 1 diabetes, policy makers and the general public. She continues to lead this work in her current role.

Awaiting session information





The psychological impact of diabetes

Understanding the importance of good mental health is vital in order to promote overall wellbeing in people with diabetes. This presentation will discuss the relationship between diabetes and depression, highlighting the impact on the self-management of diabetes. The role of diabetes-related distress and how it may overlap with symptoms of depression will be considered, including the challenges of disentangling these to help inform practice. How to identify the presence of depression and/or distress in individuals from minority ethnic groups will be addressed, and the clinical implications of supporting people with co-morbid diabetes and depression/distress examined.

Learning outcomes:

  • Acknowledge the importance of the relationship between diabetes and psychological well-being
  • Consider how depression and diabetes-related distress may overlap and the implications of this for diabetes self-management
  • Understand the challenges of supporting individuals from minority ethnic groups who may be suffering from depression
  • Understand some of the ways in which depression and diabetes-related distress can be identified
  • Consider the implications of identifying symptoms of depression and distress for practice

Professor Cathy Lloyd
Professor of Health Studies, The Open University

Cathy Lloyd is a Professor of Health Studies in the School of Health, Wellbeing and Social Care at The Open University. She has an international reputation for research in the psychosocial field of diabetes. Her research interests center on diabetes and mental health within which there are two overlapping strands.

The first of these focuses on the relationship between diabetes and mental health, and how this might impact on self-management and on health service provision. The second strand is her commitment to taking an inclusive approach to her research, developing alternative ways of involving minority ethnic groups in research, where Cathy Lloyd is a Professor of Health Studies in the School of Health, Wellbeing and Social Care at The Open University. She has an international reputation for research in the psychosocial field of diabetes. Her research interests center on diabetes and mental health within which there are two overlapping strands.

The second strand is her commitment to taking an inclusive approach to her research, developing alternative ways of involving minority ethnic groups in research where they are often excluded due to language and literacy difficulties. Professor Lloyd is currently leading an international research study, spanning 20 countries, which is examining pathways to care for depression and other mental health problems in people with type 2 diabetes.

LIVE DEBATE



The role of primary care in referring type 1 patients & supporting secondary care

New treatments and technologies abound for people with Type 1 Diabetes. How do we ensure that all patients have access to these new developments? What about patients who seem to drop out of the traditional medical system? How can we best work together to enable all patients achieve their goals?

Learning outcomes:

  • To recognise the dangers of the current models of care
  • To understand the newer models of care for patients with Type 1 Diabetes across primary and secondary care
  • To be aware of the use of technology in supporting the care of people with Type 1 Diabetes
  • To be aware of the use of information in evaluating the quality of care locally for people with Type 1 Diabetes
  • To decide on one new service improvement that you will implement for people with Type 1 Diabetes

Dr Rustam Rea
Consultant in Diabetes & Acute General Medicine, Oxford University Hospitals NHS Trust

Rustam is a consultant in Diabetes at Oxford University Hospitals NHS Trust. Together with colleagues in primary and secondary care he developed a new model of integrated diabetes care in Derby. He was the co-chair of First Diabetes, an award winning partnership organisation responsible for diabetes care in Derby. He is currently working with colleagues to develop an integrated diabetes services across Oxfordshire.

His other interests include transitional diabetes care and inpatient diabetes care. He is the Editor in Chief of Practical Diabetes (www.practicaldiabetes.com) a multidisciplinary diabetes journal with a readership of 16,000 diabetes healthcare professionals in the UK.

New treatment strategies in the diabetic foot – what is up and coming?

The diabetic foot is a challenging area to manage. This presentation will look at the outcome data from the published amputation data and the National Diabetes Footcare Audit and also disucss various treatment strategies that can improve patient outcomes

Learning outcomes:

  • Be able to find and use local data to support developments in diabetic foot pathways
  • Share treatment strategies that are evidence based that could be used to improve outcomes
  • Look at what needs to be in place to optimise care

Graham Bowen
Clinical Services Manager, Solent NHS Trust

Graham is clinical lead for Podiatry at Solent NHS Trust and works in and across community and secondary care MDT clinics. His clinical focus is managing and preventing acute diabetic foot disease. Graham has a key interest in ensuring that appropriate offloading is provided to all suitable foot ulceration and Charcot patients.



Keynote Session: Population Accountability for People with Type 1 and 2 Diabetes

Here are some questions that we still cannot answer

  • Is the service for teenagers with type 1 diabetes in Manchester of higher value than the service in Liverpool?
  • Which service for people with type 2 diabetes in London provides the best value?
  • Is the service for people with type 2 diabetes in Somerset better than the service Devon?
  • How many services are there for people with Type 1diabetes in the North East, and which gives best value?

There should be answers to these questions, not for NHS England but for people with type 1 or type 2 diabetes. This is called population accountability. To be able to answer such questions it is necessary for the whole population to be covered by a set of population based systems , working to the same set of objectives and using the same set of criteria to measure progress, both relating to outcome and resource use.

By the end of the session participants will:

  • What is meant by population accountability
  • Appreciate the need to focus on populations rather than on services or institutions
  • The difference between population healthcare and bureaucratic care
  • What NHS Rightcare is doing to develop valued based care for people with diabetes
  • The need to be flexible in defining the optimal size of population for different types of diabetes

Professor Sir Muir Gray
Director, Better Value Healthcare and Oxford University Hospitals NHS Trust

Muir Gray entered the Public Health Service in Oxford in 1972 after qualifying in medicine in Glasgow. He now works one day a week as a consultant in public health in Oxford University Hospitals NHS Trust.

He has been working with both NHS England and Public Health England with the aim of increasing value for both populations and individuals and published How To Get Better Value Healthcare in 2007. The means of doing this through Systems and Personalisation is now called Population Healthcare and the aim of population healthcare is to maximise value and equity by focusing not on institutions, specialties or technologies, but on populations defined by a common symptom such as breathlessness, condition such as type 1 or Type 2 Diabetes or by a common characteristic, such as multiple morbidity.

Recently he has returned to his first public health mission - preventing the changes we assume are due to ageing and disease by getting the right attitude and fighting back against an environment that makes us inactive. His key books include Sod70! And, with Diana Moran, Sod Sitting, Get Moving!

Management of diabetic ketoacidosis and the invisible collateral damage

Hospital admissions with diabetes and its complications are on the rise. A recent UK survey revealed that despite following the JBDS guidelines for the management of DKA, the incidence of biochemical abnormalities like hypoglycemia and hypokalemia remain high. We, from our own experience of reduced rate of hypoglycemia as compared to the national average, suggest some alterations to the existing JBDS guidelines to improve patient outcome.

Learning outcomes

  • Recognition that diabetes and its associated complications are on rise and constitute about 17% hospital admission
  • New guidelines to reduce the incidence of hypoglycemia and hypokalemia during the management of DKA
  • Long term consequences of episodes of hypoglycemia

Dr Ayush Sinha
Consultant Anaesthetist & Intensivist, West Suffolk Hospital, Bury St Edmunds

After initial training in anaesthesia in India, Ayush moved over to U.K in 2003 where he passed his FRCA. Ayush trained at Addenbrookes Hospital Cambridge, Guys and St Thomas hospital and Kings College Hospital London. He has a fellowship in paediatric anaesthesia and anaesthesia for liver transplant. Special interest- diabetes, paediatric anaesthesia and intensive care. Ayush is working as a consultant in anaesthesia and intensive care at West Suffolk Hospital, Bury St Edmunds. He has contributed to various publications in anaesthesia and intensive care journals.

Pregnancy is the most important life-stage for providing weight management guidance – an evidence based approach to support this statement

Tackling maternal obesity is where we can make a real difference. What happens to children in their earliest moments – even before birth is critical to health in later life and may influence the risk of chronic diseases such as obesity and type 2 diabetes. There is a window of opportunity – perhaps the first 1000 days from conception, which can have a massive influence on future health status. But currently there is lack of emphasis on the importance of early nutritional interventions. Whilst it is suggested that public health interventions are required which promote a healthy pre-pregnancy BMI, we need to ask when parents are the most receptive to receiving advice?

Higher total gestational weight gain (GWG) significantly increases the risk of overweight or obesity by 1-23% in children aged between 2 and 19 years at follow-up (Lau et al., 2014).  In a random sample of 5,125 Greek children, those born to mothers who exceeded the Institute of Medicine (IOM) GWG recommendations had an increased risk of obesity at the age of 8 years (OR: 1.45; 95%CI 1.26, 1.67) compared to those born to mothers with a GWG within the recommended range (Mourtakos et al., 2015).

Pregnancy is a significant factor in the development of obesity in women, many women retain cumulative weight gained over several pregnancies and women with high weight gain during pregnancy retain more weight in later years increasing the risk of developing associated conditions such as type 2 diabetes.

This presentation argues the case for developing interventions, which help prevent excessive gestational weight gain and presents the current evidence base as to what works.

Learning outcomes:

Participants will be able to;

  • Recognise that cumulative weight gain over several pregnancies is often retained and can lead to the development of obesity in the woman
  • Appreciate the importance of preventing excess gestational weight gain to prevent subsequent obesity and type 2 diabetes in the off-spring
  • Cite the IOM recommendations for weight gain during pregnancy for the different pre-pregnancy BMI classifications
  • Consider some of the antenatal interventions which have been evaluated to-date with an overview of some of the published results
  • Appreciate the need to invest further in antenatal care and to view this as a period where small changes can make a real difference to the future health of both the mother and child

Dr Amanda Avery
Associate Prof in Nutrition and Dietetics, Senior Fellow of the Higher Education Academy, Division of Nutritional Sciences, University of Nottingham

Amanda is a registered dietitian with over 20 years of experience working as a community dietitian in the NHS before moving into academia.

Whilst on a secondment in Public Health in 2000 Amanda was tasked with exploring the feasibility of referring patients from primary care to the commercial slimming sector. This was part of a larger agenda focussing on the development of a local obesity strategy and reducing health inequalities.

She is currently chair of the British Dietetic Association’s Obesity group and has helped to develop research questions including answering the question ‘what interventions can reduce the consumption of SSBs by children and lead to changes in body composition?’ She is a member of the European Dietetic Association’s Public Health group.

She was also involved in the Public Health England task group investigating fiscal and other measures to reduce the consumption of sugar sweetened foods and beverages.

She is also involved in active research which is on-going, looking at weight management across the first five life stages including both pregnancy and the post-natal period. Some of this research involves the commercial sector. Further research activity includes the evaluation of interventions designed to optimise glycaemic control in people with diabetes in a community setting.

For the past 8 years Amanda has worked at the University of Nottingham as part of the core team delivering the Masters of Nutrition and Dietetic programme and a portfolio of postgraduate modules including Obesity management, Paediatric Nutrition, Diabetes and Public Health Nutrition.

Helping your patients benefit from diabetes technology

This presentation will present hypothetical/illustrative case studies based on INPUT enquiries. These case studies will cover:

  • Appropriate blood glucose testing – how many test strips, what choice of meter and why?
  • Referral pathways for structured education and insulin pump therapy – when and why to refer to secondary care?
  • Data management – how can primary care help patients engage with their own diabetes data?

Learning outcomes:

  • Actionable steps to support patients in achieving diabetes management goals with technology and education available in primary care
  • Awareness of technologies appraised as cost-effective by NICE and provided by the NHS that patients can access in secondary care
  • Empowerment to make appropriate referrals to secondary care
  • Awareness of diabetes data management principles
  • Clarity regarding NICE guidelines relating to diabetes technology and structured education

Melissa Holloway
Chief AdvisorLesley Jordan, Chief Executive, Patient Advocacy

Melissa advises and supports people who contact INPUT and works on policy issues. Diagnosed with type 1 diabetes aged 12, she has used an insulin pump for over 21 years and CGM for 11 years. She came to the UK in 2001 to pursue postgraduate studies in history at Oxford University. In 2003 she joined Close Concerns and began her career in the diabetes care industry. Melissa moved to London in October 2007 to work in healthcare business consulting. In 2009, she became a medical copywriter for healthcare advertising agencies. She lives in central London with her husband and son.


Lesley Jordan
Chief Executive, Patient Advocacy

Lesley volunteered for INPUT from 2005 and took over its leadership when the founder, John Davis MBE, retired in 2011. Now a registered charity, INPUT has a mission to help people access diabetes technology and support from the NHS, including insulin pumps, smart glucose meters and continuous glucose monitoring. INPUT can be contacted via its website, freephone, Twitter and Facebook, and numerous events. Each year, their website is visited by over 60,000 visitors and they deal with over 400 one-to-one enquiries.

Lesley was diagnosed with type 1 diabetes aged 2 in 1968 and has used an insulin pump for 15 years.

Getting it Right First Time - a programme designed to improve clinical quality and efficiency within the NHS by reducing unwarranted variations.

GIRFT is a national programme, led by frontline clinicians, created to help improve the quality of medical and clinical care within the NHS by identifying and reducing unwarranted variations in service and practice.


Dr Partha Kar
Associate National Clinical Director for Diabetes, NHS England

Dr Partha Kar has been a Consultant in Diabetes & Endocrinology at Portsmouth Hospitals NHS Trust since 2008. He has been the Clinical Director of Diabetes from 2009-2015, being part of a multiple national award-winning department (HSJ Awards / BMJ Awards) for services and care provided.

One of his main areas or passion is in helping to redesign diabetes care in an attempt to integrate chronic disease management across primary and secondary care. He is the pioneer of the Super Six Diabetes Model which aims to deliver diabetes care differently. He is an avid user of social media such as twitter (@parthaskar) to engage with patients - and been recognised as a "Social media Pioneer" by HSJ in 2014. Recent innovations have involved the Hypoglycaemia Hotline, which was recognised in the Guardian Healthcare Awards 2013.

He is also the co-creator of TAD talks (Talking About Diabetes) and the Type 1 Diabetes comic (“Origins”)- while also involved in setting up a Type 1 Diabetes information portal (T1resources.uk)

Partha is Associate National Clinical Director, Diabetes with NHS England leading on the Right Care pathway.


Gerry Rayman

Automating Inpatient Glucose Control – addressing the unmet need in the general wards

Inpatient glycaemic control remains an important issue due to the increasing number of patients with diabetes admitted to hospital. Implementation in practice however is limited, due to increasing workload burden on staff and fear of hypoglycaemia. Automation of glucose monitoring and insulin delivery may provide a safe and efficacious tool for hospital staff to manage inpatient hyperglycaemia, whilst reducing staff workload.

The current recommendations and the unmet needs of inpatient glycaemic control will be reviewed. Evidence from recent studies using closed-loop and other diabetes technology will be presented, discussing its potential and implication for the future.

Learning outcomes:

  • Recommendations from professional societies and the current status of inpatient hyperglycamia in non-critical care settings
  • Limitations of current management strategies
  • Current status and evidence of the application of novel technology in diabetes care
  • Latest evidence on the safety and efficacy of automated glucose control using closed-loop in hospitalised patients
  • Future/on-going clinical studies in inpatient hyperglycaemia and potential implication for the future

Dr Hood Thabit
Consultant Diabetologist, Manchester Diabetes Centre, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust/University of Manchester

Hood graduated from University College Dublin in 2002 and received his specialist training in Ireland. During his training, he received an MD in 2010 from Trinity College Dublin for his research in the mechanisms of insulin resistance. He joined the Artificial Pancreas Group at the University of Cambridge in 2011, and completed a PhD in the field of closed-loop technology. His work in the field encompasses both type 1 and type 2 diabetes, and was the first to show the feasibility of closed-loop application in inpatient hyperglycaemia. He has published widely in the field, and has successfully collaborated in several multinational studies.

He is currently a consultant diabetologist at the Manchester Royal Infirmary, managing and developing a large insulin pump service in the area. His area of interest and expertise is in diabetes technology, specifically insulin pump therapy, continuous glucose monitoring and closed-loop systems.

What part can primary care play in increasing numbers that take up retinopathy screening invitations? What are the barriers to attendance?

  • What are our DNA rates
  • What we have done to try increase our rates
  • How primary care can play a part in this
  • Why we have a high DNA rate

Nikita Padda
NHS NWL Engagement Manager, North West London Diabetic Eye Screening Programme

One of my day to day roles consists of engaging with GPs to ensure they understand our programme, deal with any queries and also work together to ensure we have the best possible service for our patients.

Type 2 diabetes or walking deficiency syndrome

The human body evolved to be active in the search for food and the quest for survival. In the last fifty years the environment has changed dramatically as a result of the car and the Internet, and work has changed to require less activity. Many people are now required to sit eight hours a day at work, and spend an hour to and from work sitting on a train or car. Home workers do not even have the opportunity for exercise that commuting brings. Inactivity is often combined with stress which was a useful reaction in times in which fighting or fleeing was often helped by stress but stress combined with inactivity leads to inflammation.

Increasing activity is now being prescribed for many long term conditions such as type 2 diabetes but it is not enough simply to tell people to walk, more we need to change the design of cities and jobs to make activity easier for busy people.

Learning outcomes:

  • Understand the environmental changes that have decreased activity in modern life
  • Be able to describe the relationship between activity and stress
  • Be able to define brisk walking
  • Have down loaded the Active 10 app
  • Be able to think of some way in which people with type 2 diabetes in their community can be helped to reduce the inactivity caused by the modern environment

Professor Sir Muir Gray
Director, Better Value Healthcare and Oxford University Hospitals NHS Trust

Muir Gray entered the Public Health Service in Oxford in 1972 after qualifying in medicine in Glasgow. He now works one day a week as a consultant in public health in Oxford University Hospitals NHS Trust.

He has been working with both NHS England and Public Health England with the aim of increasing value for both populations and individuals and published How To Get Better Value Healthcare in 2007. The means of doing this through Systems and Personalisation is now called Population Healthcare and the aim of population healthcare is to maximise value and equity by focusing not on institutions, specialties or technologies, but on populations defined by a common symptom such as breathlessness, condition such as type 1 or Type 2 Diabetes or by a common characteristic, such as multiple morbidity.

Recently he has returned to his first public health mission - preventing the changes we assume are due to ageing and disease by getting the right attitude and fighting back against an environment that makes us inactive. His key books include Sod70! And, with Diana Moran, Sod Sitting, Get Moving!

MDI – CGM or Pump – CGM, What gives better results?


Awaiting speaker information

Young-onset diabetes subtypes in UK ethnic groups – how do we differentiate them?

This presentation will explore phenotypes of diabetes in people with young-onset diabetes across white, south Asian and African-Caribbean ethnic groups in the UK. It will explore the differences and similarities between type 1, type 2 diabetes, ketosis-prone type 2 diabetes and genetic forms of diabetes such as MODY and the challenge in assigning correct subtypes of diabetes. It will discuss how biomarkers and clinical information may assist in correct classification across all ethnic groups and provide practical guidance on how and when to investigate.

Learning outcomes:

  • Delegates will gain a broad understanding of the different subtypes of diabetes in people with young-onset diabetes
  • How these subtypes may differ in UK ethnic groups and how this impacts on classification
  • Explore the impact of misclassification
  • Understand that biomarkers that may assist in subtype classification
  • Appreciate the limitations and challenges in various approaches to subtype classification across ethnic groups

Dr Shivani Misra
Consultant in Metabolic Medicine, Imperial NHS Trust Healthcare College

Shivani is a Consultant in Metabolic Medicine and her clinical and research interest lies in differentiating phenotypes of young-onset diabetes across ethnic groups. In 2013 Shivani set up the MY DIABETES study, which has recruited over 1000 participants with young-onset diabetes across England and was funded by the Diabetes Research & Wellness Foundation. Data from this study has shown variation in the phenotypes of south Asian and African-Caribbean people with young-onset diabetes in the UK and this data is now being used to improve clinical pathways for people with young-onset diabetes.




Testosterone deficiency and sexual dysfunction – time for proper personalised patient care

Contemporary guidelines recommend that testosterone levels are measured routinely in all men with type 2 diabetes, especially those with sexual dysfunction. Recent studies strongly suggest that testosterone replacement results in significant symptomatic and metabolic improvement. This presentation questions whether our obsession with targets related to glucose control compromises our claims that we provide personalised patient centred care.

Learning outcomes:

  • ED and testosterone deficiency have been repeatedly shown to reduce quality of live in diabetes. Both are associated with increased mortality
  • PDE5 inhibitors and testosterone replacement both independently reduce all -cause mortality in multiple trials
  • PDE5 inhibitors and testosterone replacement both provide significant improvement of bothersome clinical symptoms that matter to our patients
  • The current obsession with glucose control addresses the agenda of the physician not the patient and the partner
  • The American college of endocrinology guideline recommends measurement of testosterone in all men with type 2 diabetes and all men with BMI over 30 or WC above 102cm – in the UK we do not do this
  • Are we really providing personalised are for men with T2DM?

Prof Geoff Hackett
Prof of Men’s Health, Department of Diabetes, University of Bedfordshire

Geoff is past professor of Men’s Health and Diabetes at University of Bedfordshire, and a Consultant in Urology and Sexual Medicine at Good Hope Hospital, Birmingham, UK, since 1994. He qualified in medicine in 1974 at King’s College Hospital, London, UK, and gained his MD from Keele University, UK, in 2000 on the links between erectile dysfunction (ED) and cardiovascular disease. He has 35 years experience as a primary care physician.

Professor Hackett has a major research interest in the role of testosterone in metabolic syndrome and type 2 diabetes and low sexual desire in women. He is the author of over 130 publications in sexual medicine, and 2 original books on male sexual health and andrology, as well as contributing chapters to several medical textbooks. He is lead author of the British Society for Sexual Medicine (BSSM) guidelines on ED, and the use of testosterone therapy to manage sexual problems in both men and women; co-author of the consensus guidelines on ED and coronary artery disease prediction, Princeton 3 guidelines; Oxford Textbook of Urology; and a panel member for the International Society for Sexual Medicine (ISSM) guidelines on premature ejaculation.

In 2012, he won the Zorgniotti-Newman research prize at ISSM for work on testosterone replacement in type 2 diabetes. Geoff is past-President (2005–07) and Treasurer of the BSSM (2009-2014), and a past member of the scientific committees of the International Society for Sexual Medicine, and a Chair of the 2015 International Consensus Panel in Sexual Medicine.

 

 

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Sponsors

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  • Glucorx 300
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Official Media Partners

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Event Partners

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Diabetes Professional Care 2017 Twitter Feed

Study finds paediatric to adult care transition in adolescents with #type1diabetes needs improving @Diabetescouk bit.ly/2g0yjso
Attending annual check-ups increases life expectancy for people with #diabetes, audit finds, via @Diabetescouk bit.ly/2v8N0gq
#DPC2017 WORKSHOP @Diabetescouk ‘Play your carbs right: the role of carbohydrates in #diabetes management’… twitter.com/i/web/status/9…
Involved in diabetes care? Then register now for #DPC2017 free-to-attend, CPD-accredited conference & exhibition… twitter.com/i/web/status/8…

Exhibition information

Diabetes Professional Care
+44 23 8081 1551

Wednesday 15 November 2017, 08:30-18:00
Thursday 16 November 2017, 08:30-17:00

Olympia London
Olympia Way
London
W14 8UW

Organised by

Organised by

Exhibition information

Diabetes Professional Care
+44 23 8081 1551

Wednesday 15 November 2017, 08:30-18:00
Thursday 16 November 2017, 08:30-17:00

Olympia London
Olympia Way
London
W14 8UW

Organised by

Organised by