Ninjabetic – Back to basics
Back to basics
The 15 healthcare essentials… a check list for all patients with diabetes (devised by Diabetes UK) to show them what they should expect, in terms of basic care, from the HCPs (health care professionals) they see.
So what are the 15 healthcare essentials?
- HbA1c test
- Having your blood pressure measured
- Having your blood fats (cholesterol) measured
- Having your eyes screened
- Having your feet checked
- Having your kidney function monitored (blood and urine test)
- Having your weight checked
- Getting support to stop smoking
- Receiving a care plan for your individual needs
- Attending an educational course
- Receiving paediatric care if you are a child or young person
- Receive high quality care if you are admitted to hospital
- Specialist care if you are planning to become pregnant
- Seeing a diabetes specialist
- Emotional/psychological support
How many of these do patients get? Obviously not everyone will need all 15 (which makes fitting them in a little easier), but how many of us patients get everything we need once a year? Personally, I need 12 of the 15 and in the last year I’ve had 6.5 of these (I gave 1/2 a point as I get emotional support, but it’s not psychological), from my diabetes specialist team.
I attended a local conference for GPs and practice nurses recently and it was interesting to see how many hands were raised when the speaker asked how many of the 30 people in the audience could name all 15 Healthcare Essentials. The answer was none. The issue wasn’t so much with remembering the list, but when the speaker asked how many of their patients receive all 15, the answer was still none.
These 15 basic needs are, in my opinion, the foundations for good diabetes care, and no matter what, they should be offered. They allow an insight into how patients are managing their diabetes and highlight areas that need more attention. This, in turn, allows patients and HCPs to recognise possible signs of complications and to treat them in a timely manner. What about empowerment for patients? Access to care planning, although it may seem generic on paper, can give patients the basis to start self-managing; to set personal goals, to self-evaluate and allows for shared decision making with their HCPs. The 15 health care essentials allow us to identify the basic care that we should be receiving, but also to expand on areas if we feel it is needed.
What could prevent this from happening? Money? Time? Resources? Training? A lack of support or confidence? In the past few months I have seen numerous comments aimed at NHS Change Day and the 6Cs initiative, questioning why people are pledging to improve basic care needs that should already be happening. This isn’t restricted to diabetes care, but to care throughout the whole of the NHS, and what I, as a patient, have taken away from this is that there are some incredibly brave HCPs out there. Brave in the way that they have stood up and admitted that care has somewhat slipped and needs to be addressed. Brave to publicly admit this in front of their colleagues and patients. How many HCPs would do that? How many HCPs would just carry on as they were and paint a picture that all is rosy on their side of the patch? Where does that get their patients? As a diabetes patient, I would want to be cared for by those who are transparent and willing to say that they need to do better and to publicly make that promise to their patients and colleagues.
If HCPs see other colleagues grilling them as to why these basic needs are being addressed, might that put them off from making changes? Put them off from asking for help, asking to borrow and adapt others initiatives to improve their patient care? Should HCPs be made to feel that they have done something wrong by pledging to do better? If a HCP can, wholeheartedly, say that they are delivering every single basic care need, then maybe instead of grilling others for not doing so, they could offer support and show them how they can achieve great basic care.
So what can be done? A challenge to HCPs… look at your own practice and if it’s not delivering basic care then how can that be improved? What can help, and equally what can hinder, that progress?
The same to patients – find out why you aren’t getting the basic care you deserve. Find ways to work with your HCPs to ensure you do get it – Plan; use apps to make lists and set reminders, organise and prioritise what you want from your appointments in advance. If you’re restricted to 10-15 minutes per appointment (as I know many of you are), ask if there are other ways to communicate with your team. Do they offer email or phone contact? Do they have online care plans that you can download, complete and send to them? Can you see other HCPs who can help you with certain areas (GP, consultant, diabetes specialist nurse, practice nurse, dietitian, podiatrist…). If you have taken the time to attend an appointment then you may as well get as much from it as you can.
It can’t hurt for any of us to try…