Service planning

What can local planning groups achieve?

Goals and principles

Clinical networks and collaborative planning groups should be central to the achievement of the core outcomes of diabetes treatment, education and care, i.e.:

  • integrated care
  • improved clinical outcomes
  • cost-effective services
  • improved patient experience
  • equity of service provision.

It will, however, take considerable resources, time and effort to make these planning mechanisms work. In all the national frameworks there is commitment to the principle of engaging all stakeholders in diabetes networks and planning groups. This is ambitious because it cuts across professional roles, sectoral roles (i.e. NHS, local authority and voluntary sector) and the professional-user divide.

When you bring together professionals with different interests, or professionals and users with very different perspectives, the process of building a shared vision and strategy is never straightforward. Nonetheless, it is arguably only by trying to understand the interests of others that a common, integrated approach to diabetes services can be developed. User involvement is crucial to this process precisely because so many professionals still find it hard to fully value user views.

Another important principle for these planning mechanisms is the creation of clear lines of accountability. They will only be effective if there is genuine power behind their decisions. This is why their close relationship with local primary care organisations or health boards is so important.

Core tasks

The core task of all diabetes planning groups is the implementation of the national diabetes frameworks. This requires a systematic approach, including:

  • service assessment, i.e. identification of the strengths and weaknesses of local diabetes services.
  • needs assessment, i.e. identification of the particular needs of people with diabetes in the area.
  • specification of quality standards for local diabetes services, drawing on the national frameworks
  • priority-setting, taking account of local needs, service framework requirements and other national priorities, local service gaps and resources
  • development of strategy and operational plans/service specifications for all partner organisations, with specific objectives and targets
  • leadership in promoting diabetes care and championing the needs of people with diabetes.
  • development of local information systems and population-wide registers of people with diabetes.
  • monitoring progress in the achievement of local targets;
    evaluating the effectiveness of local approaches.
    In practice, these task do not always take place in this order. Planning typically involves trying to advance on various fronts at once. Local service provision cannot wait for the completion of a needs assessment, for example. Furthermore, there are usually a range of existing plans or development ideas in play when any new mechanism is established. Consequently, planning often involves a negotiation between existing priorities and new priorities. The national frameworks are valuable in providing a very clear focus for this negotiation.