Barking and Dagenham Clinical Commissioning Group: Tackling inequalities in diabetes care in Barking and Dagenham – local improvement scheme

The 37 practices in Barking and Dagenham CCG have improved their care of diabetic patients with 67.2 per cent of patients receiving the eight care processes recommended by National Institute of Health and Care Excellence in March 2018, against a starting point of 28.4 per cent two years earlier.

This represents a value to the health economy of £3.8m over five years – against an investment of £1.2m. The estimated number of undiagnosed diabetics fell from 1,642 in 2012-13 to 624 in 2017-18 and the number of patients identified as pre-diabetic increased more than seven fold.

This was achieved through sharing data and a spirit of healthy competition among practices as they sought to improve. Within each practice clinical and administrative leads for diabetes were identified who helped drive improvement while keeping the service patient-centred.

Around £100,000 was spent on technological innovation and clinical facilitation. Sharing good practice and practice networking was also important. The approach is being extended to other long-term conditions.

Read a detailed case study about this project at HSJ Solutions


  • Medway Foundation Trust: Diabetes Specialist Nurse Professional Forum 
  • North Staffordshire Combined Healthcare Trust: Healthy Minds Integrated Long Term Condition Service
  • Outta Skool working with NHS Oldham and TRUSTECH: Let’s Get Active
  • Sheffield Teaching Hospitals FT: Transforming Inpatient Diabetes Care
  • Southport and Ormskirk Hospital Trust: Paediatric Diabetes Team: Solution Focused Brief Therapy approach improves health and well-being of patients and families with diabetes 
  • Tameside and Glossop Integrated Care FT: Denton Diabetes Diverters 100 day challenge