Since my last communication in May 2018, there have been significant developments both within the ABCD and nationally related to diabetes. We continue to make progress on the core priorities for the ABCD which the executive team has been working on and well supported by our efficient secretariat.
Our website redevelopment is a priority, making everything accessible from abcd.care. This work was undertaken as a priority and has been completed and the new website went live during the month of August. This has been a significant piece of work and thank you to all involved, especially my colleague Bob Ryder and Heather and Tricia at Red Hot Irons.
The ABCD supported the ‘Clinical and Commissioning News Live’ event which took place in July with a slightly different format. The programme was of high quality but unfortunately the meeting was poorly attended. While ABCD continues to look at the sustainability of this event to get the best value for money for the members, one positive outcome has been the planned round table meeting of experts in November to explore how ABCD and the Diabetes Technology Network (DTN) can help increase the uptake of technologies to help people who have diabetes manage their condition more successfully. With the imminent announcement of five-year funding for the NHS, the professional associations need to give a clear steer to the NHS as to how we can spend the resource wisely to get the best outcomes.
The first meeting was held at the University of Wolverhampton which I was privileged to attend and open. Unfortunately the planned second pilot event on 18 October in Yorkshire had to be postponed and is now planned for 6 February 2019 at York race course. The final detailed programme will be available online soon.
ABCD–RA collaboration continues to be strong. After producing key guidelines which have been endorsed by the Royal College of Physicians and Diabetes UK (DUK), ABCD and the Renal Association have recently agreed to produce guidelines for post-transplant diabetes and have recently written to the British Transplant Society asking them to support this new development and collaborate with ABCD and the Renal Association.
ABCD contiues to produce position statements on a regular basis and the three previous commissioned statements are ready for publication. These will cover important areas around the use of SGLT-2 inhibitors in Type 1 Diabetes, use of Biosimilar insulins in Diabetes and Cardiovascular impact of GLP-1 analogues.
The funding for the Association is dependent on corporate support and successive treasurers have designed schemes that comply with ABPI regulations to cover the whole range of activities. We had a very vibrant and successful meeting where all our sponsors were invited for the first time, compared with previous years where the executive team met with gold sponsors only. The ABCD Executive discussed with corporate sponsors the support for future years and various options which will be of mutual benefit to our corporate partners.
ABCD will collaborate with the Society for Endocrinology Clinical Committee to work together in light of ‘Shape of Training’, and ongoing concerns about recruitment to Endocrinology & Diabetes specialty training. The plan is to ensure that we push for protected specialty training time for Endocrinology & Diabetes trainees to enhance their training and experience in our specialty.
ABCD continues to support the ExTOD/PEAK exercise annual conference and the event for this year will take place in Manchester on 19 October 2018. The Spring Meeting of ABCD is taking place in Enterprise Park in Loughborough in May 2019 and I am delighted that Professor Peter Grant will be delivering the second John Wales Memorial Lecture which has become an important part of the programme for the Spring ABCD meetings.
This brief report is an excellent opportunity for me to extend my personal thanks to my friend, Dr Rob Gregory, for his ongoing support and the executive team which includes Andy Macklin, Russell Drummond and Dipesh Patel for discharging their responsibilities so well and so conscientiously. Professor Hugh Jones continues to lead the academic sub-committee and we have plans to refresh the research sub-groups and also add on to the activities this group has undertaken in the past years and online tools for the application for various funding schemes and including future succession planning. Professor Dev Singh continues in his role as leadership on professional development. The education sub-group is also in the final stages of selecting two deputies to work alongside Professor Dev Singh to ensure that we plan for future sustainability of this excellent programme, the funding for which has been secured.
My thanks also to all the ABCD committee members for their commitment and support. The trustees have backed the executive team and ABCD activities financially and with wise advice. I must also thank the ABCD secretariat and Red Hot Irons – Tricia, Elise, Jen and Heather – who remain the backbone of the back room functions for the Association, and Joyce for ensuring that our finances are up to date.
I am looking forward to my first ever trip to the Houses of Parliament to represent the ABCD at the Diabetes Awareness Day on 31 October, an event hosted by the All Party Parliamentary Group on Diabetes and supported by our corporate sponsor Novo-Nordisk.
Goodbye until next time.
The winners of this prestigious competition received their award at the Association of British Clinical Diabetologists’ Spring meeting on 23 May 2018 from Dr Umesh Dashora (Lead, Safer Insulin Prescribing Group) and Dr Dinesh Nagi (Chairman, ABCD). Dr Stuart Ritchie and Tracey Rapson on behalf of the Western General Hospital team received the award for the development of a diabetes dashboard which led to reduction in hypoglycaemia and improvement in the treatment for hypoglycaemia. Dr Charlotte Boughton and Dr Danielle Dixon on behalf of the King’s College team received the runner-up award for their initiative which helped reduce hypoglycaemia during treatment of hyperkalaemia by mandating personalised dose of dextrose with insulin added to it.
Following calls for a funding increase ahead of its 70th birthday, the Prime Minister, Theresa May MP, has announced that NHS England is to receive an average annual 3.4% rise in real-terms funding over the next five years, an extra £20 billion per year. This is understood to be frontloaded at a 3.6% (above inflation) increase in the first two years. The details on how this will be funded will be announced in the Autumn Spending Review, although the Prime Minister hinted that this would be achieved via a ‘Brexit dividend’ and from tax increases. The funding increase will also be accompanied by an NHS England plan for delivering key clinical priorities, including improving cancer outcomes shortly. The Association of the British Pharmaceutical Industry (ABPI) welcomed the announcement, highlighting that the settlement will enable partners to work together and focus on improving services, delivering better health outcomes and ensuring greater access to treatment. The King’s Fund also welcomed the announcement, but highlighted that the funding falls short of the 4% increase that most health think-tanks had called for. They also called for more detail from Government on funding areas currently outside of the NHS England ring-fence, such as public health, capital investment and staff training.
https://www.bbc.com/news/health-44495598
The Office for National Statistics (ONS) published its ‘UK Health Accounts: 2016’. The report reveals that the total current healthcare expenditure in 2016 was £191.7 billion, an increase of 3.6% on spending in 2015, when £185 billion was spent on healthcare in the UK. This represents 9.8% of gross domestic product (GDP), higher than the median for OECD (Organisation for Economic Co-operation and Development) member states but second lowest of the seven nations in the G7, a position which has remained unchanged since UK health accounts were introduced for 2013. Also of note, Government-financed healthcare expenditure accounted for 79.4% of total spending, £152.2 billion. Spending on health-related long-term care was £35.5 billion in 2016, with an additional £10.9 billion spent on long-term social care outside the health accounts definitions. Government spending accounted for 62% of all spending on long-term care, with most other long-term care spending financed by out-of-pocket payments.
NHS Digital has launched a new year-long audit across all acute hospitals in England to collect data on four harms that can occur to inpatients who have diabetes. The four harms included are severe hypoglycaemia, diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state and foot ulcers. Although insulin safety has not been identified as one of the four major harms, medication errors could be included in data on severe hypoglycaemia and DKA.
http://diabetestimes.co.uk/nhs-launches-new-inpatient-harms-audit/
NHS England’s flagship Diabetes Prevention Programme (DPP) has strengthened its digital workstream. Up to 5,000 people living with type 2 diabetes will be recruited over a six-month period, with access to the digital interventions for up to 12 months.
The Young Diabetologists and Endocrinologists Forum is the trainee and young consultant wing of Diabetes UK, with over 20 years of experience supporting Diabetes & Endocrinology (D&E) SpRs. It will probably be well known to many readers, some of whom would have attended our events. Despite a long track record, we are continually looking to innovate in order to meet our mission of ‘enabling high quality care for people with diabetes and endocrine conditions by delivering excellence in specialist education and providing an effective voice for our members’.
Over recent months we have been joined by four new committee members to create a diverse committee of 10 people that we hope reflects the trainees we represent. Our new committee members are:
We are particularly keen to look at recruiting more committee members from the North of England, so if you are an interested trainee or know any keen motivated trainees, please do get in touch and make sure you apply during the next round of committee applications prior to Diabetes UK 2019.
We have recently launched an exciting new website, available at www.youngdiabetologists.org.uk. We hope that this will provide a valuable resource both for current trainees and those considering a career in D&E. Please do take a look and feel free to start a thread on our new online forum.
High quality training events are at the heart of YDEF’s activities. We ran a successful ABC of D&E for new registrars in Birmingham. Our ambition was to provide a theoretical foundation to life as a D&E SpR. The feedback received was exceptionally strong, and this will now be a regular fixture on the YDEF calendar.
Eight trainees were selected by YDEF to attend the North European Young Diabetologist Conference in Egmond aan Zee in Holland. They presented their research alongside participants from Holland, Denmark and Belgium. Particular congratulations to Ioannis Spiliotis who won the overall conference presentation prize with his research examining lowdose sulfonylureas in patients with type 2 diabetes. We are also particularly grateful to Dr Hermione Price from Southern Health NHS Foundation Trust, the UK’s senior member who represented the UK in the senior debate ‘Is it justified that metformin is first line drug in type 2 diabetes?’ YDEF has been pleased to further support research through the provision of European Association for the Study of Diabetes Conference bursaries, which were hotly competed this year, and we hope those who were successful have an enjoyable and educational time in Berlin.
Under the stewardship of our current Chair, Myuri Moorthy, we have many more exciting events planned soon including a Taster Day in London for those considering a career in D&E and a retinopathy course in the West Midlands for those already committed to this exciting and dynamic speciality.
Recruitment and retention remains a challenge across many medical specialities, and it will be important to monitor and assess the impact of the new 3-year Internal Medicine curriculum being introduced by the Royal College of Physicians. YDEF, however, hopes that it will be able to continue to provide inspiring events, valuable resources and a voice to D&E trainees for many more years to come. We would like to thank all those consultants, sponsors, supporters and Diabetes UK staff who make that possible .
Integrating Motivational Interviewing into Diabetes Consultation
29th October, 2018 BirminghamA course allowing trainees to excel in developing their counselling skills and empowering patients to change their behaviours to gain better control and self-management of their diabetes
YDEF Retinopathy Course
10-11th December, 2018 BirminghamA 2 day residential course covering the basics and advanced detail of the diagnosis and management of retinopathy in diabetes, benefitting from the use of the facilities at the Retinal Grading Labs in Heart of England Retinal Screening Centre
YDEF Annual Day
5th March, 2019 LiverpoolYDEF Annual Day brings over a hundred specialist registrars and young consultants from across the UK on the eve of Diabetes UK Annual Processional Conference to attend an excellent, free day of lectures and workshops
Dr Tim Robbins
Email: timothy.robbins@nhs.net