We asked 23 GPs, practice nurses and practice managers how to improve diabetes prevention. Here’s what you said.

1. More time is needed for practice nurses, managers and GPs to:

• Talk to patients
• Learn new processes and plan how to go about things
• Find things (resources, websites, templates etc.) quickly
• Do things properly with patients without being under constant pressure

2. Insufficient staffing impacts on new initiatives, dependent on:

• The number of staff available within a practice
• The space available within a practice environment either for extra staff and/or extra activities
• Availability of skilled practice staff
• Interest areas of practice staff – including GPs and practice nurses. This can impact on the type of care patients receive.
• How often practice nurses are pulled away to do other things on an ad-hoc basis which are not on the list for the day

There are constant demands placed on practice nurses. This was not evident in the survey results, but came through very strongly in verbal discussions.

3. The referral pathways for diabetes prevention programs are not clear

• There is much confusion about referral pathways from all GPs, practice nurses and practice managers, but in particular within the GP group.
• GPs would like the steps clearly identified, easily found & promoted, and the profile of the diabetes program raised.
• Everybody would like the referral process to be as simple as possible.
• There is confusion about the rules for MBS items, for referral to groups & the necessity of doing an OGTT.
• Practice staff would like to see the profile raised of both diabetes prevention programs

4. All practice staff wanted to know who and what is out there

• More information about providers; who are they, what do they do?
• More information about diabetes prevention
• More information about care plans
• More stats on diabetes and costs to community and what is happening locally
• More resources for practices – posters, brochures, patient information kits
• What are the local supports available for GPs to refer to?
• How do practices get on to these supports?

5. Need help to identify patients at risk

• Some would like practice nurses to use the PEN cat tool
• Some would make a designated person responsible for identifying patients in the practice who are at risk, and for that person to drive the approach
• Some would like to identify a trigger for GPs to remember to screen patients at risk
• There was a suggestion to align diabetes week with practice activities in identifying at risk patients

6. Please BDDGP … simplify, tailor and change the way information is provided

• Practices want simple, fast, small chunks of information
• Keep the information coming
• Raise the profile of new programs and initiatives
• Practice nurses in particular want to know about the software requirements
• Suggestions for BDDGP to provide information packages for staff and for patients (about diabetes prevention programs)
• From this small survey, it appears that GPs prefer to use the website, practice nurses may favour the mid-week news and practice managers might like email best because “it’s in your face!”

7. Division practice visits don’t suit everybody

• Practice visits from the division – great, but difficult to fit into a normal day
• Practice visits were seen as a good way to build relationships and to keep in touch, for input and updates and education (selected), but only in the way the practice finds it useful
• Face-to-face and 1:1 visits were preferred by some, while others liked group sessions.
• 3 respondents talked about how much time Division visits can take and the impact this has on their own planning and meeting times, even though the Division visits are generally considered useful.

8. Ambivalence about education on new programs, new government stuff

• Education was considered highly important by practice managers (5/6)
• GPs were half and half in how they saw this (4/9)
• Practice nurses did not see education as a highly desirable way to get information about new initiatives (2/8)
• Suggestions were to have education sessions on site; after hours in different venues; coupled with other events and for the Division to consider different ways of learning such as “walking through something (with practice staff so they had the opportunity) to see and hear it.”

Stay tuned for the next article where we tackle these issues.

Tags: diabetes