23 June 2022
CNWL’s Professional Nursing Council meeting on Tuesday 14 June heard about a great project that improves healthcare for vulnerable people with diabetes and heart conditions.
Working with other specialists in cardiac care, the Hillingdon Diabetes Team have reduced the number of people requiring emergency care or having to go to hospital with hypoglycaemic events.
The presentation can be found below and Bal Sandhu, Diabetes Team Lead, who presented the work with local GP specialist Dr Hurton, explains more.
Bal, a Diabetes Specialist Dietitian has worked in the NHS for 25 years, coming to CNWL about five years ago. She leads the Diabetes Team of 15 staff in Hillingdon. Dr Hurton, a GP with Speciality in Diabetes, supports the team two days a week.
Praising her deputy and Diabetes Specialist Nurse, Erika Ayling, Dr Hurton and the Cardiac Team Leader, Georgina Priestly, Bal says:
“This is making a big difference, delivering what’s required; it’s innovative and provides a new approach to an old problem. There is a class of medications called sodium–glucose co-transporter, (SGLT2s), commonly used to manage Diabetes, and recent evidence has shown that these agents also help to prevent primary and secondary hospitalisation due to heart failure and cardiovascular death.”
Collaborative working in Cardiac Care and Diabetes management
About a year ago they noticed an increase in the number of hypoglycaemic events and ambulance call-outs for some heart failure patients who also had diabetes.
The initiation of SGLT2s by cardiology teams was resulting in a further reduction of blood glucose levels in patients already on medication to manage their diabetes. This was causing hypoglycaemic episodes in the community and often resulted in the calls for ambulances.
They realised that both specialist teams needed to consider the joint impact they were having and that they lacked the expertise each other could provide.
So in November 2021 a joint training event was arranged where each team provided more skills about diabetes and cardiac care associated with the use of SGLT2s.
Picture shows: Dr P Hurton, GP with Special Interest (GPSi) in the Hillingdon Community Diabetes team, speaking at the November joint workshop.
This has continued with multidisciplinary monthly meetings, where the Cardiac and Diabetes teams discuss patients.
Since then there have been no ambulance call outs for these people, showing how marshalling expertise in a slightly different way brings better health for patients, clinical safety and better use of resources for the NHS.
Bal hopes to extend the work further. She believes there could be scope to replicate this joint working model, for example, in renal care with diabetes.
She also believes much more is needed around mental health. “Many people with diabetes also experience depression, so we’re working on a plan that addresses both physical and mental aspects of diabetes care. It’s also a major issue with people with a serious mental illness so we hope to rise to that challenge too!”