Diabetes

Overarching aim: The London Diabetes Clinical Network (LDCN) provides clinical leadership, subject matter expertise and plays a strategic role in reducing care variations across London. We support local healthcare systems to improve diabetes care and health outcomes by connecting commissioners, healthcare providers, professionals, those living with diabetes and the public to share best practice and ideas. We also measure quality and outcomes, reduce variation and drive improvement.

 

Key Contacts

  • Clinical Director: Dr Stephen Thomas, Consultant in Diabetes and Endocrinology and Clinical Director, Guy’s and St Thomas’s Hospital
  • Project Management Support: Joe Fraser
  • Email: england.diabetes-ldncn@nhs.net

 

Lived experience of diabetes? We want to hear from you!

The London Diabetes Clinical Network wants to hear from people living with diabetes, or who care for an adult living with diabetes, about the things that matter to them. You can become a member of our Patient Leadership Group, or speak to us informally about your views and experiences of diabetes care in London. To find out more about how to get involved please view this guidance document.

 

Sub-Networks

Type 1 Network

The Type 1 Network works to drive forward transformation and change within the type 1 clinical community. The focus is on: Structured education including Treatment and Care bid implementation, Commissioning Type 1 diabetes services, Type 1 patients not accessing specialist care, Access to and funding for technologies, Resources required for Type 1 care.

  • Chair: Dr Nick Oliver
  • Working Groups: Type 1 Outpatient Implementation Framework

Inpatient Network

The Inpatient Network will lead on and ensure that inpatient care for people living with diabetes is incorporated into the wider Treatment & Care agenda and other national diabetes priorities. The aims of the group are to: reduce harm for people with diabetes admitted to hospital, build capacity within London’s in-patient diabetes teams, drive improvement and reduce inequalities in outcomes for people with diabetes admitted to hospital.

  • Chairs:
  • Working Groups: Mental Health; Emergency Care

Patient Leadership Group

The Patient Leadership Group is a forum to gather feedback from service users to highlight any issues and contribute to ongoing projects. Members of the group are Diabetes Champions, and their role is to ensure that the views from a wide range of patients, carers and families are taken into consideration whenever decisions that affect patient care are made.

  • Chair: Ken Tait
  • Working Groups: Diabetes Eye Screening Programme (DESP) letters project

Foot Network

The Foot Network leads on transformation and clinical improvement programs related to footcare. The network focuses on: MDFT peer reviews, Amputation RCAs, Management of care by health professionals and multi-disciplinary teams, Equity of access to footcare services, Patient experience and Patient education.

  • Chair: Dr Richard Leigh
  • Working Groups: Steering group

Primary Care Transformation Network

This network tackles variation in primary care settings, inequalities, and differences in how care is set up.

  • Chair: Dr Neel Nasudev
  • Working Groups: Healthcare Workforce Education; Mental Health

2025/26 Focus Areas

Bring together ICBs and London region to develop pathways for weight management drugs to reduce risk of inequality following publication of the NICE Technological Appraisals.

Actions:

  • Develop suitable communications for patients and health care professionals for adaptation within ICBs
  • Support the development of pathways within ICBs to ensure the most equitable delivery of weight management drugs and lifestyle programmes across London within a very restricted financial envelope
  • Support a Stakeholder Group to develop common approach to support use of weight management drugs across London.

This will:

  • Support ICBs to feel confident and capable to coherently deliver weight loss medication while managing patient demand
  • Reduce unwarranted variation
  • Improve patient experience and outcomes

 

Lead, in collaboration with a lead ICB, the development of guidelines for Continuous Glucose Monitoring Systems (CGMS) for Type 2 Diabetes.

Actions:

  • Convene stakeholders from the ICBs involving the following user groups: pharmacy representatives, diabetes professionals and primary care. Develop a common approach for patients with Type 2 diabetes largely supported in primary care for equitable access to CGMS where appropriate
  • Support ICBs presentation to local Integrated Medicines Optimisation Committees (IMOCs) based on the approach which led to equitable access to CGMS technology across ICBs in Type 1 diabetes.

This will:

  • Improve patient access to appropriate technological support, thereby improving experience and outcomes
  • Reduce unwarranted variation
  • Reduce unscheduled care due to diabetes emergencies

 

Support delivery of appropriate Hybrid Closed Loop (HCL) insulin pumps for Type 1 diabetic women in pregnancy.

Actions:

  • Work with the South London HIN to convene Type 1 Diabetes specialists to develop pan-London approach to use of HCL in pregnancy
  • Develop guidance around use/ non-use of licenced-HCL pump technology to ensure the best clinical outcomes for Type 1 pregnant women and their babies 

This will:

  • Ensure equitable access to licensed HCL pump technology for pregnant women with Type 1 diabetes
  • Improve patient access to appropriate technological support, thereby improving experience and outcomes
  • Reduce unwarranted variation
  • Improve perinatal outcomes

 

Offer support for Primary Care where patients are being treated with new pathways and technologies in that setting

Actions:

  • Help develop appropriate signposting to resources and guidelines to support primary and community staff to deliver care for diabetes and weight management populations.
  • Support the move to community care and enable greater access for all populations. A particular focus will be working age populations from disadvantaged groups who currently have the worst outcomes and greater premature morbidity and mortality.

Key documents