Quality of Life in People with Type 2 Diabetes in Relation to Deprivation, Gender, and Age in a New Community-Based Model of Care

Table 1

Comparisons of key differences in approaches between the secondary care focussed model of care to a community model of care for patients with Type 2 diabetes.

Parameter	Previous	New model
Setting of diabetes care	Hospital based (secondary care)	General practitioner surgery (Primary care)
Access to care	Mixed community/secondary care	Community
Structure	IT systems	IT systems to support annual review, recall, and management systems introduced
Care provided	Annual Screening and review of clinical parameters	Annual screening and review of clinical parameters; Followup appointments for management of clinical parameters; greater empowerment of self-care
	Laboratory results sent onto GP with recommendations for action	GP receives laboratory results directly and acts accordingly
	Recommendations to GP for change in prescriptions	GP alters prescriptions and initiates necessary therapies
	Review by dietitian, podiatrist, and diabetes specialist nurse at annual review that may require considerable waiting times	Review by dietitian, podiatrist, and practice nurse at annual review as part of a one stop shop so no waiting between professionals
	Management of diabetes and related risk factors	Management of diabetes, related risk factors within a holistic context
	Referral to specialist services as required for example, renal physicians	Referral to specialist services as required for example, renal physicians
Educational preparation	Staff have significant clinical expertise in diabetes with or without recognised qualifications	Staff all required to undertake a credit-rated qualification in diabetes
Retinal screening	Secondary care	National level directed