Are you fully involved in your care planning? Do you feel there’s more to good diabetes management than a ‘good’ HbA1c?
As part of their comprehensive commissioning pack, the London Diabetes Clinical Network includes a type 1 care consultation tool (developed by Health Innovation Network and King’s Health Partners), which can be used in the management of people with type 1 diabetes.
The Type 1 Diabetes Consultation Tool will help the person with diabetes (PWD) and the consultant to plan individualised care where the patient is fully involved in the process.
The first page is completed by the PWD either before they attend clinic or in the waiting room. It asks the user to note down things such as specific issues they wish to discuss, hypo awareness, confidence in carbohydrate counting, and the burden of diabetes.
Pages 2 and 3 will be completed by the PWD and consultant. Page 2 covers everything that should be in an annual review. Page 3 plots a comprehensive picture of their diabetes control, noting HbA1c along with hypo risk and living with diabetes (or diabetes distress score). There is space for treatment decisions and plans to be noted down. The consultant then takes a copy of the tool, leaving the original with the PWD to take home.
As we mention in our Better Clinic Appointments page, decisions made in an appointment might be remembered differently by the doctor/nurse and the PWD, so this tool will help solve that problem. It also makes clear that a good HbA1c alone is not the mark of successful diabetes management.
If you think this tool might help your clinic appointments, why not print this page and show your clinic? Experience amongst staff in the London Diabetes Clinical Network shows that whilst it initially takes a little longer for an appointment, it gathers all the data that should be kept anyway, and soon becomes a welcome tool for efficient and high quality care. They suggest a clinic trials the tool with a few PWD before adopting it for every PWD with type 1.
A note of caution: the living with diabetes (or diabetes distress score) section will help clinicians who are not psychologists to spot distress which may have impact on the PWD’s glycaemic control. Many issues can be suitably managed by handling this well in the consultation room. However, if issues are identified which need psychology assessment and support, it would be unfair to uncover these issues and not act on them. The tool is based on research and referenced so that clinicians can make a considered decision on whether or not to adopt it and how to do so safely.
The explanation sheet for PWD can be found here.
The consultation tool is here.
The full commissioning pack is here.