Diabetes is one of the most common chronic diseases in the UK and its prevalence is increasing.

In 2013, there were almost 2.9 million people in the UK diagnosed with diabetes. By 2025, it is estimated that more than 5 million people in the UK will have diabetes.

In England, the number of people diagnosed with diabetes increased by approximately 53% between 2006 and 2013, from 1.9 million to 2.9 million. The life expectancy of people with diabetes is shortened by up to 15 years, and 75% die of complications i.e. stroke and heart disease.
The risk of foot problems in people with diabetes is increased, largely because of either diabetic neuropathy (nerve damage or degeneration) or peripheral arterial disease (poor blood supply due to diseased large and medium sized blood vessels in the legs), or both.

Peripheral arterial disease affects 1 in 3 people with diabetes over the age of 50. Diabetes is the most common cause of non traumatic limb amputation, with diabetic foot ulcers preceding more than 80% of amputations in people with diabetes. After a first amputation, people with diabetes are twice as likely to have a subsequent amputation as people without diabetes.

Mortality rates after diabetic foot ulceration and amputation are high, with up to 70% of people dying within 5 years of amputation and around 50% dying within 5 years of developing a diabetic foot ulcer.
If the early signs of an ulcer developing are not picked up or acted upon swiftly, the possibility of more significant problems leading to amputation can occur.
Against this background, a team from the Wessex Cardio-Vascular Network which is based in the local Southampton office of NHS England and covers Hampshire, the Isle of Wight and Dorset, reviewed all local services for good practice and to identify potential gaps in service. The aim of this was to reduce the overall incidence of patients’ suffering from ulceration and amputation.
The team’s work has now been recognised by the National Institute for Health and Care Excellence (NICE), the body which provides national guidance and advice to improve health and social care. NICE has published this work as the standard foot care guidance that should be followed by clinicians nationally, when providing care to people with diabetes.
As part of the National Diabetes Treatment and Care Programme, NHS England invested £42 million in 2017/18 in proposals to improve the treatment and care of people with diabetes, and is one of four key priority areas targeted by NHS England for diabetes transformation funding.
Sally Rickard, Associate Director, Clinical Senate and Networks, NHS England South, said: ” The team here, working with a number of our clinical colleagues across the area, have done a fantastic job in standardising what is now acknowledged by NICE as the best, standard practice for providing foot care to diabetic patients. This work will make a tremendous difference to patients, and at the same time will save the NHS significant time and money, through improved efficiency and effectiveness. We are all very proud of their achievement.”

Portsmouth and Southampton have been selected as one of eight areas in England to tackle mental health stigma locally after winning a bid to become one of 2019’s Time to Change Hubs.

Time to Change Southampton & Portsmouth will work to change the way we all think and act about mental health problems. It is an exciting partnership between Portsmouth and Southampton City Councils, local mental health charity Solent Mind and local people who are Time to Change Champions.  The Hub will support communities, workplaces and schools to end negative attitudes and behaviours towards people experiencing mental health problems in their communities.

Anna Fiers, a local Time to Change Champion, says, “I am thrilled at the news. As a Time to Change Champion, having access to the Hub will make it easier for me to connect with other champions, organise events and work together on voicing our important message.”

Each funded Hub is provided with £15,000 start-up budget along with £10,000 for a Champions Fund where local champions can bid for funding to run stigma-busting events and activities within their area.

Kevin Gardner, Solent Mind CEO, says, “I am delighted that Solent Mind is working in partnership with Southampton and Portsmouth City Councils to bring a Time to Change Hub to our area. This is a wonderful opportunity to achieve genuine change around how we think and talk about mental health. We will be harnessing the power of people’s personal experiences to tackle mental health stigma and discrimination.”

Councillor David Shields, Cabinet Member for Health and Community Wellbeing, Southampton City Council, said, “This is great news for our city. Being a Time to Change Hub will enable us to build on the good work taking place at the council and in our communities, and particularly, in ensuring that those with lived experience can use their skills and talents to lead local action on tackling mental health stigma. Mental health issues affect one in four of us, and touches many of us throughout our lives. That’s why we need to engage with all sections of society — families,  businesses, education establishments, public services, community organisations, unions and faith groups – to address stigma and discrimination ‎in our city.

“Southampton City Council has demonstrated a strong commitment to tackling mental health stigma for a number of years, including our support of Time to Talk Day and signing the Time to Change Employer Pledge last year, to address mental health issues in the workplace.”

Councillor Matthew Winnington, Cabinet Member for Health, Wellbeing and Social Care at Portsmouth City Council, said, “I’m thrilled that Portsmouth and Southampton have jointly been chosen to become a Time to Change Hub. There is still a lot of misunderstanding and stigma around mental health and it’s an issue that I’m passionate about. Through becoming a Time to Change Hub we’ve got a real opportunity to get people across the city talking about mental health, and in doing so positively change how people think and act around it.

“To further demonstrate our commitment to supporting people with their mental health I’m pleased to be taking on the role of Mental Health & Wellbeing Champion within the council and am looking forward to this being one of many projects we’re involved in to make it easier for people in the city to look after their mental health and wellbeing.”

Time to Change, the national campaign run by charities Mind and Rethink Mental Illness, launched its first regional Hubs in March 2017.

The announcement of eight further funded Hubs, including Portsmouth and Southampton, is part of the campaign’s three year plan to establish a network across England to provide a focus for local campaigning work.

The 2019 Different Conversations survey is now open and we need your input!

The way we deliver health and social care is changing. Part of this change is about making sure that the people we support receive personalised care that works for them. This survey will help improve our understanding of how confident the people of Portsmouth are about making choices about their own care.

The survey is available for individuals and carers, with individuals rating their own care and carers completing it with the view of them being the carer for someone else and how their knowledge, skills and confidence supports the individual they care for. In 2018 140 individuals completed the survey, with 24 carers also taking part –  Portsmouth City Council and Portsmouth CCG are working together to carry out the 2019 Different Conversations survey, hoping to involve even more participants this year in order to get an even better idea of patient activation levels in Portsmouth.

To take the survey now, click here

For more information on this survey and why understanding levels of patient activation is important, please visit the NHS website here

 

HIVE Portsmouth is a project bringing together people from the statutory, voluntary and community sectors to build a healthier, happier and more connected city.

As well as finding innovative ways to deliver services for the people of Portsmouth, HIVE Portsmouth will also provide information, advice and support. We’re creating a shared office space in the lower ground floor of Portsmouth Central Library.

My Time, a service providing support for unpaid carers and Social Prescribing Portsmouth, a service providing non-clinical support to people struggling with a range of issues, will be first to move in.

To find out more click here

Personalised care means people have increased choice and control over the decisions that affect their own health and wellbeing.
There is no ‘one size fits all’ model for personalised care with the emphasis on empowering individuals who access health and care services in a way that fits them as an individual and the goals they set themselves.
Personalised care includes,
• Shared decision making – people are supported to understand the care, treatment and support options available and the benefits and consequences of the options

• Supported self-management – people are supported to develop the knowledge and confidence to manage their health and wellbeing through health coaching or peer support

• Social prescribing and community based support – people can access community connection projects to enable them to be connected in to community based support

• Personalised care and support planning – people have a personalised conversation and plan based on what matters to them including identification of their needs and their health and wellbeing

• Personal health budgets – an agreed  amount of money to support an individual’s health and wellbeing needs as identified by the personalised care and support plan

Here is just one case of how this has worked well:

Mrs A:

Client is a 93 year old female who lives alone in the North of the City.

She was referred to the Community Connector Service via the Red Cross.

Client suffered a stroke in 2017, after a long hospital stay she was discharged home with support from the Red Cross. Red Cross discharged and referred to the service.

Resulting from the stroke this client has reduced sight, which she finds frustrating. She has had a recent diagnosis of breast cancer and has had a bad fall in her garden; all this have impacted on her feeling vulnerable. The client has not been out of her home alone since July 2017. She is lacking in confidence and has anxiety.

Client’s mobility is restricted, she mobilises with a four wheeled trolley and walking stick indoors. She was issued a three wheeled walker for outdoors from hospital discharge but due to living on the hillslopes and having several steps to get in and out of her home it was restricting her to use the three wheeled walker, it was unused and kept in the shed.

There were several restrictions to her being able to get out of her home which creates a barrier for her to be able to access the community independently and safely. She has lived in her property for many years and does not feel that she would like to move from her family home.

Client used to mobilise independently, socialise with friends, enjoying shopping and having lunch, she was confident to use public transport but on referral feels lonely and isolated, having to rely solely on her friends to take her out.

Client does not feel safe to go out on her own and was anxious of falling again.

Goals

• To regain confidence and reduce anxieties.
• To join a new group and meet new people.
• To be less reliant on her friends.
• Improve her skills to use her walking aid.
• To reengage with the Salvation Army Befriending service

Intervention

• Community Connector assessed the property and arranged adaptations to be completed to the outside of the property to make it safer and accessible to get outside, this included installing clamp rails, grab rails, rehanging of garden gate and concrete infill to outdoor steps.
• After discussion with client it was evident that she was unable to use the three wheeled walker due to its weight. A four wheeled rollator was ordered.
• Supported to reengage with Salvation Army Befriending service.
• Supported with walking practice with rollator and to regain confidence to use public transport and taxi service.
• Mrs A was supported to join a new social group in the area she lives.
• Mrs A was supported to arrange Meals on Wheels.
• Referral to Good Gym for a befriender.

Outcome

Client’s confidence has grown to use the four wheeled rollator.

Using the newly installed rails makes her feels less anxious about falling and enabling her to access the outdoor space to the property independently also to be able to enjoy her garden again.

After confidence practice sessions to use the bus she felt that due to the distance to the bus stop and living on the hill slopes that she would feel happier to take a taxi

Client now attends a local social group, has met new people and enjoys the company, conversation and activities. She is now arranging to meet friends for lunch independently.

The Salvation Army Befriending service have reengaged and continues to visit, they have arranged for an old friend to visit for afternoon tea and client is waiting to be paired to a befriender from the Good Gym.

Client reports she now feels that she is enjoying socialising again, feeling less lonely and no longer feels that she is isolated. Client said that she feels a “great sense of achievement”.