Improving outcomes for people with diabetes in East and North Hertfordshire

A young person with two healhtcare professionals looking at their feetSince April 2017, NHS England has made £105 million of diabetes transformation funding available to improve treatment and care for the 2.8 million adults and children diagnosed with Type 1 or Type 2 diabetes across England.

For NHS East and North Herts Clinical Commissioning Group (CCG), East and North Herts NHS Trust (ENHT) and Hertfordshire Community Trust, this funding has enabled an expanded Multi-Disciplinary Footcare Team (MDFT).

Emily Byway, Project Manager at East and North Herts CCG, explains how the diabetes transformation funding is improving outcomes and for people with diabetes in East and North Herts: “Prior to November 2017 – and pre-NHS England diabetes transformation funding allocation – there was limited MDFT availability for the population of East and North Hertfordshire.

“The acute trust, ENHT, provided consultant-led MDFT clinics but these are not available every day which impacted on the ability to see the most at-risk patients within the NICE guidance timeframe of urgent referrals being seen within 24 working hours.”

Prior to NHS England funding, the MDFT clinics were delivered at:

  • Hertford County Hospital – ¼ session weekly
  • QE2 Hospital – 1 session weekly
  • Lister Hospital – 1 ¼ session weekly

The funding received allowed the existing MDFT to be extended to provide a seven day a week service and clinics increased to:

  • Hertford County Hospital – 2 sessions weekly
  • QE2 Hospital – 2 sessions weekly
  • Lister Hospital – 6 sessions weekly

Emily continued: “There was also a need for education to primary care regarding when to refer patients and how to complete a successful foot check as part of the eight care processes.

“The consultant from ENHT has delivered education talks on the diabetic foot at the target days for all areas in the locality including common foot presentations, requirements for a foot examination and an update on the expanded foot service. 332 primary care staff have received this training so far with further sessions planned. A patient satisfaction survey was also introduced to support the service to improve over the lifetime of the project.”

The National Diabetes Inpatient Audit identified that 58.3% of patients were seen by the MDFT within 24 hours in 2016. From April 2018 to December 2018, with the new, expanded service, 86% of patients were seen within 24 hours.

Emily concluded: “This is slightly short of the target of 95%, but still shows a significant improvement.

“MDFT clinics are now being delivered five days a week with weekends covered by the diabetes outreach team and we are thrilled to report that the service is now NICE compliant.”For more information, please contact Emily Byway, Project Manager at East and North Herts CCG on