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Implementing a service redesign to deliver expedited, optimised care for Patients with Type 2 Diabetes following acute coronary syndrome supporting continuity of care across all service sectors in Lincolnshire

A Joint Working Project between Boehringer Ingelheim Ltd (BIL) and United Lincolnshire Hospitals  NHS Trust (ULHT) to test a new model of care aiming to identify opportunities to optimise the management of patients with Type 2 Diabetes (T2DM) who also develop an acute coronary syndrome (ACS).

The NHS Long Term Plan commitment to tackle Cardiovascular disease (CVD) and the largest cause of premature death in deprived areas, is to ensure ‘where individuals are identified with high risk conditions, appropriate preventative treatments will be offered in a timely way’. Similarly, for patients already diagnosed with diabetes a continued investment to enable more people to achieve the recommended diabetes treatment targets, and drive down unwarranted variation in care to minimise their risk of future complications. Further, for those who periodically need secondary care support we will ensure that all hospitals in future provide access to multidisciplinary teams and diabetes inpatient specialist nursing teams to improve recovery and to reduce lengths of stay and future readmission rates1. The MINAP 2019 summary report underlines the association between cardiovascular events and diabetes, and the increasing prevalence of diabetes in the heart attack audit population2.

The Joint Working Project will implement a new cardio-metabolic care pathway for patients with T2DM and ACS with the aim to;

  • Optimise the way in which cardio-metabolic management is delivered in order to address the needs of patients in Lincolnshire 

  • To support the implementation of the evidence base for cardio-metabolic management utilising a multi-skilled workforce

  • To design a multi-specialty model of care to provide a timely, optimised delivery that offers improved continuity of care to patients, delivered by Cardiology Advanced Clinical Practitioners (ACPs) and Diabetes Specialist Nurses (DSNs), with consultant supervision

  • To enable patients with T2DM and ACS to have improved access to cardiometabolic guideline-directed treatments

  • Enable timely secondary preventative interventions to be realised and reduce the need for further unplanned NHS care, to support the case for recommissioning following the end of the Joint Working project

The project commenced in November 2020 and will complete end of September 2023.

BIL is pleased to collaborate with ULHT and explore the challenges and support needed to design and deliver an innovative, high-quality model of care for a high-risk cohort of patients, utilising Advanced Care Practitioners - an evolving expert role in the NHS.

References

1. The NHS Long Term Plan. Access date: April 2023. NHS Long Term Plan v1.2 August 2019 

2. Myocardial Ischaemia National Audit Project 2019 Summary Report (2017/18 Data).  NICOR. Access date: August 2020. https://www.nicor.org.uk/wp-content/uploads/2019/09/MINAP-2019-Summary-Report-final.pdf

 

 

NP-GB-103594 April 2023