Health Improvement Programme for
Doncaster 2000 - 2003

Strategic Direction

The strategic direction aims:

To achieve the greatest possible improvement in the health of people with diabetes in Doncaster through promoting health widely and commissioning high quality, effective health care within available resources.

Target

Local targets have been set based on the goals of the World Health Organisation. These are:

• 100% of general practices and hospital clinics will contribute the appropriate data to the district wide diabetes register by April 2000.
• In any calendar year, at least 70% of people with diabetes will have a full annual diabetes check, as defined by the district diabetes register by March 2002.
• To put in place a formal district wide screening programme for diabetic retinopathy by 2002.

General Commentary

There are around 5,500 people with diabetes in Doncaster, a prevalence of 1.8%. The incidence of type I is known to be rising in young children who will be more prone to the late complications of diabetes. It is now accepted that strict metabolic control and aggressive management of hypertension prevents late microvascular complications. There is also increasing evidence supporting the benefits of looking for and actively managing cardiovascular risk factors such as smoking, hypertension, obesity and physical inactivity in addition to regular review of patients for management of complications arising from diabetes.

Annual reviews are frequently incomplete, an example being diabetic retinopathy screening. This is recorded in only 30% of cases in primary care (target 70% by 2002), highlighting a clear need for formal organised retinopathy screening. A working group is addressing diabetic retinopathy screening to ensure comprehensive screening of high quality for all patients with appropriate treatment of complications. Other current initiatives include the development of a diabetes long term service agreement, further development of Doncaster Diabetes Guidelines and education of professionals, patients and carers to promote strict metabolic control and aggressive management of blood pressure. Future developments will focus on raising awareness among the public of the symptoms of diabetes, raising awareness of the implications of diet, smoking, alcohol, exercise and contraceptive issues, particularly in high risk groups. Developing support for diabetics in a range of settings and developing an appropriate, accessible service and continuing the emphasis upon regular structured surveillance of patients through the annual review mechanism.

Further information can be obtained by downloading the full text version of the Health Improvement Programme for Doncaster 2000 - 2003.

Any comments of this section should be submitted to the theme lead, Dr Jennifer Dunn, Senior Registrar in Public Health Medicine, Doncaster Health Authority, White Rose House, Ten Pound Walk, Doncaster, DN4 5DJ
email: jennifer.dunn@doncaster-ha.trent.nhs.uk