Agenda item

Dr. Wikum Jayatunga, Public Health Consultant, Camden and Islington Public Health was present and made an presentation to the Committee, copy interleaved

During consideration of the presentation the following main points were made –

·         Diabetes is a life-long condition that causes a person’s blood sugar level to become too high

·         There are two types of diabetes Type 1 and Type 2.Type 2 diabetes is the most common, and is associated primarily with excess weight, which is increasing in prevalence amongst the population

·         Diabetes affects 3.8m adults and accounts for 10% of all NHS spending, and these are expected to rise

·         4.8% of the LBI population has a recorded diagnosis of diabetes but it is estimated that around 7.7% of the population has diabetes prevalence

·         Managing the condition is key as it can lead to other more severe problems. This means that 38% of residents may have unknown diabetes. This is important as the condition needs to be managed to alleviate more severe complications and conditions

·         64% of residents have other long term conditions in addition to diabetes, which are mainly hypertension, and heart disease

·         Diabetes risk increases by age and slightly more males have diabetes than females across all age groups

·         Diabetes level are higher in the more deprived areas, in the fifth most deprived areas the prevalence is 8.4%

·         In Islington black and Asian communities are more than double at risk of diabetes than other ethnic groups

·         Risk factors for diabetes include smoking, diet, physical inactivity, weight, wellbeing and healthcare

·         NHS health checks are carried out for adults between 40 -74 years of age. This is to identify early signs of certain conditions, including diabetes

·         COVID has led to delays and reduced activity in carrying out these checks, however from Q2 payments to GP’s have been resumed to carry out these checks. During COVID some cases of diabetes may have been missed or treatment delayed

·         NHS diabetes prevention programme is a programme to identify those at risk of Type 2 diabetes and focuses on exercise, nutrition and an action plan to maintain long term changes. The service has had to adapt during the pandemic and new approaches include self-referral pilot, digital/remote delivery, centralised referral project, and ongoing projects

·         Product examples – centralised referrals highlights specific use of population health data for targeted case finding and reducing health inequalities. From GP health records patients identified to BAME patients who have a long term condition and likely to develop diabetes. Invitations/texts sent to them to

tell them of risks and to contact GP or be referred to NDPP. Referrals increased 70% during the project

·         Diabetes structure education – this is an evidence based education programme for people newly diagnosed with diabetes to determine how they can live with a long term health condition, usually in the form of group based educational courses. Key findings included lack of consistent offer/lack of capacity, unmet linguistic and cultural needs, low quality referrals and lack of awareness, complexity. Recommendations included adopting a hub model, increased language offer, engaging with primary care and expanded digital provision

·         Forward look – Diabetes community engagement and testing events, Healtheintent using population health data, NCL long term condition locally commissioned service, NCL diabetes and weight management network

·         Diabetes system overview – Prevention -healthy catering commitment, obesity reductions and prevention, ‘one you’ providing lifestyle advice, making every contact count. Detection – NHS Health checks, National diabetes prevention programme, locally commissioned services, ‘know your risk’ online health tool assessment. Treatment and care – locally commissioned services, low calorie diet service, structural education, flu immunisations for people with long term conditions, diabetes eye screening, intermediate diabetes specialist service, diabetes in patient specialist nurses, multi-disciplinary foot team hot clinic

·         In response to a question it was stated that some residents, particularly younger residents did not visit their GP regularly and therefore did not always get tested

·         Noted that diet plays a large part in diabetes in younger people, and that the issue of child obesity was a complex one, and likely to be exacerbated by the cost of living crisis. It was important that the Council’s free school meals programme included healthy options, and that physical activity was promoted

·         Concern was expressed at the unmet linguistic/language capacity and that this should be an issue that should be addressed by NCL

The Chair thanked Dr. Jayatunga for attending

Whittington NHS Trust

Members were informed that evidence from the Whittington NHS Trust had  been circulated, and that if Members had any questions thereon these should be notified to the Chair

It was stated that there were some concerning statistics in the report for Islington on female life expectancy, mental health and COPD and respiratory illness

Discussion took place as to whether an additional witness session should be arranged for the Whittington to discuss this evidence, given the need to ensure the report is completed before the next meeting on 17 March, or to consider the report as written evidence

It was noted that a meeting had been arranged on 28 February at 5.30 p.m. to consider recommendations for the scrutiny report