Issue - meetings

To consider a report of the Deputy Director of Public Health.

The aim of this report is to inform Scrutiny Members about Type 2 Diabetes, to explore the impact of this condition and highlight the activities that are taking place in Stockport to address this.

Scrutiny members are invited to assess their personal risk of type 2 diabetes in advance of the meeting: http://riskscore.diabetes.org.uk/start?_ga=1.205835029.722794865.1476350383

The Scrutiny Committee is asked to receive the report and consider how we can

•        Create a culture and environment that promotes the benefits of walking more and snacking less

•        Support the delivery of enhanced social media messages

•        Encourage professionals working in health and social care set an example to the public of Stockport by taking steps to reduce their risk – walking briskly (or equivalent physical activity) for at least 20 minutes a day and reducing their glucose intake

•        Ensure systematic identification of people at risk of Type 2 diabetes, developing a register of patients with non-diabetic hyperglycaemia

Officer contact: Vicci Owen-Smith, 0161-474-3928,

vicci.owen-smith@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) informing the Scrutiny Committee about Type 2 Diabetes, to explore the impact of this condition and highlight the activities that weere taking place in Stockport to address this.

The report only covered Type 2 diabetes, as Type 1 was to a significant degree a different disease, but Type 2 was largely a preventable condition. It was emphasised that risk was under-estimated and may be as high as 33%. Put simply, if people moved more, and snacked less, this would have a significant impact on the problem.

The following comments were made/ issues raised:

·         There was evidence to suggest that by engaging with those at risk of developing Type 2 diabetes this could dramatic reduce costs.

·         Further information was requested about the implementation of care provision through neighbourhood teams. In response it was stated that modelling on risk and deprivation, and capacity of neighbourhoods to absorb this work.

·         Concerns were expressed about whether GPs were doing enough to prevent diabetes related amputations. In response it was stated that amputations were caused by specific issues. NICE had 9 care targets but only 50% of patients in Stockport received this level of service, although care overall was good. Partners were doing good work with engagement and training, but demand out-stripped resources. It was important to ensure that all professionals appreciated the scale of the challenge.

·         Anecdotal evidence suggested that attendees at amputee clinics were almost exclusively there due to diabetes. This was a powerful message of the impact of diabetes and the dangers of poor lifestyle. In response, this was acknowledge, and it was emphasised that lifestyle changes did not have to be dramatic to have lasting benefits.

·         There were relatively simple things that could have an impact on health, and reduce diabetes risk, such as walking 10,000 steps per day. In response it was acknowledged that this was a good means of being active but that 10,000 steps could be difficult to achieve for many people.

·         There was ambiguity about what constituted being overweight, and what effect it could have. In response it was stated that clothing sizes had increased so while people were becoming bigger they would not necessarily realise it. 67% of the population was overweight, so a person’s peers were also likely to be larger, making it difficult to know what the new norm was. The Stockport String was a good way of raising awareness.

·         Given the greater risk of diabetes amongst the BME community, what more was being done to raise awareness, as leaflets were unlikely to be sufficient. In response, the challenge was acknowledged.

·         There needed to be a strategy to target those who did not engage with GPs, given how little is actually required to make a difference. In response, it was emphasised that there was a significant culture shift needed to make a healthy lifestyle easier to achieve.

·         The relative ease with which people could do some form of physical activity was discussed, particularly given the access to good quality outdoor space in Stockport. The primacy given to the car and driving, particularly to school, was highlighted as a particular challenge.

·         How would those hard to reach but high risk individuals be identified? In response it was stated that systematic analysis of GP records showed that 95% of people had visited the GP in last 2 years, providing opportunities to screen and intervene. Workplaces were another key area for targeting public health messages.

RESOLVED – That the report be noted.