Commissioning and the future of diabetes care

Abstract

The creation of clinical commissioning groups has provided a unique opportunity for diabetes specialist teams and other stakeholders to collaborate directly with local commissioners to rationalise and improve diabetes care provision. We describe here the process by which the diabetes service in the Vale of York has been redesigned and a community diabetes service has been commissioned to help embed the new model of care. The process has involved getting key personnel in place to identify and drive change, creation of a model of care that is simple, removes artificial barriers and is based on clinical need rather than financial structures. Engaging and listening to stakeholders, particularly patients, was critical to the development as was participation of influential board level representatives to act as champions. Facilitative negotiation of the content and provision of the service helped build the business model to complement the clinical model. Developing a unified brand and image that would associate both commissioner and provider helped cement the alliance and provide patients with a single needs-based service.