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The tackling inequality in diabetes Lab challenges

Our Challenge Question: How can we tackle inequality in diabetes? 

Our 2021 cohort of Lab participants delved deeper into their respective communities to establish who the underserved populations are and what challenges they are facing in diabetes care. From this information, our participants used insights to identify the areas for their focus and framed them as Lab Challenge questions. 

Here's a summary of their Challenge questions:

South East London

How might we increase the uptake of diabetic eye screening by at least 15% by the end of March 2022 by targeting non-attenders (patients with low indices of multiple deprivation (IMD) scores, non-white, older and working-age patient groups) at Tessa Jowell GP surgery?

Uptake on the diabetic eye screening clinic at the Tessa Jowell GP surgery in East Dulwich has been low, with attendance below the National Achievable Standards of 85%. This lab group has been exploring the inequalities that lead to non-attendance and have been working alongside the GPs and people living with diabetes to help provide solutions, including the trial of a one-stop-shop appointment for all the diabetes-related tests. 

This group have advanced to the next level of the Lab and are ready to start testing out their solutions (prototypes).

How might we increase foot health service uptake among certain ethnic groups across Southwark?

Southwark has a diverse population with a large percentage from Black and minority groups. However, there is a lack of engagement and attendance from these groups with the Diabetic Foot Health Service. This Lab group has been interacting with Southwark council members, social group leaders and faith leaders to engage with people living with diabetes to promote foot health and understand existing barriers to the service. 

This Lab group is currently in the development phase and is looking for additional team members. If you are passionate about diabetes and tackling inequality in the uptake of foot health services in Southwark please email changelabs@diabetes.org.uk 

North West London

How might we improve the diabetes knowledge and ability to self-manage among 50-100 people within the North West London Somalian community?

The African and African-Caribbean communities living in the UK are at increased risk of type 2 diabetes. They are a diverse community whose sub-population groups have different needs and experiences of the NHS healthcare provision. This Lab group recognises the need for providing more specific services to each population group and is using the Lab as a pilot case to engage with the Somalian community. Their learnings will then be used to continue providing tailored services to other population groups. 

The Somalian community in North West London have reported that they feel underserved by healthcare providers. This Lab group have been exploring how best they can work with the Somalian community to increase engagement and ensure equitable care by co-producing bespoke information that meets their needs, recognises their beliefs and is culturally sensitive and specific.

This group have advanced to the next level of the Lab and are ready to start testing out their solutions (prototypes).

How can we improve access to Central London Community Healthcare (CLCH) diabetes services for Black African, Black Caribbean and Pakistani groups?

The CLCH diabetes services have observed underrepresentation of Black African, Black Caribbean and Pakistani groups within their services, despite the higher risk factor for developing diabetes and the higher expected prevalence for diabetes within these communities. This Lab group has been investigating whether this indicates an inequality of access and if so, what these barriers to accessing healthcare services are. From these insights, this group will be able to test solutions to ensure equitable care can be delivered and received. 

This group is currently engaging with the community and researching the root causes of this inequality. These insights will then be used to select their focus for the challenge. 

Norfolk

How might we improve clinical outcomes (reduction in HbA1c, reduction in Body Mass Index, reduction in escalation of diabetes medication) for our 70 Polish patients living with diabetes registered with Grove Road Surgery & School Lane Surgery, Thetford, Norfolk, by increasing access to structured education?

Engagement in primary care services and awareness around diabetes has been found to be lower among the Eastern European population and those experiencing larger degrees of deprivation from this region. This Lab group have been meeting patients, local networks and support groups to help identify how this population group can be engaged with, and how to tailor specific diabetes-related material to aid education and understanding. 

This group have advanced to the next level of the Lab and are ready to start testing out their solutions (prototypes).

Sussex

How might we improve uptake of the National Diabetes Prevention programme in South Asian communities in Crawley and ensure they are aware of the risk factors for developing type 2 diabetes?

In comparison to other areas of Sussex, Crawley has a large South Asian population with a high level of deprivation. Research has shown that both of these factors are associated with a higher risk of developing Type 2 diabetes. However, there is a low level of engagement with primary care from this population. This Lab group engaged with the community and local faith groups which led to insights on how to increase their accessibility and improve uptake to the National Diabetes Prevention Programme. 

This group have now exited the Lab but will be continuing to tackle inequality in diabetes within their community.

This page is a living document and will continue to be updated as the challenges evolve. 

This is a Diabetes UK project. Boehringer Ingelheim have partnered with Diabetes UK and provided funding for this project and input into its development. There was no involvement or influence in its conceptualisation or delivery.

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