Table 7 |
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Summary data of the (Type 2) diabetes related functional and structural characteristics of the practices |
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Structure of care provision |
N, frequency/service provider |
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Dedicated diabetes clinic |
71 practices |
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Frequency; duration |
43, weekly; 14, monthly; 14, n/r*; 1 to 2 half-day sessions |
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Appointment length |
Most frequently 20 to 30 mins |
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Who leads management? |
16, doctor; 49, nurse; 6, co-managed by doctor and nurse |
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Admin support |
29, dedicated member of admin team; 37, general admin team, 1, none; 4, n/r |
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Doctor available (if required) at clinic |
69, diabetes lead doctor; 30, Patient's own or duty doctor |
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Other staff available at clinic |
9, Diabetes specialist nurse; 16, dietician |
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Seen in routine appointments |
28 practices |
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Appointment length |
Most frequently 20 ro 30mins |
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Who leads management? |
8, doctor; 19, nurse; 1, co-managed by doctor and nurse |
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Admin support |
11, dedicated member of admin team; 13, general admin team' 4, n/r |
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General management of patients |
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Routine recall interval |
61, annual review; 34, 6-month review; 4, 3-month review |
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Who organizes recall? |
58, admin support; 36, nurse; 5, GP |
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Blood tests |
77, done in advance; 22, done on day of visit |
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Patient sees doctor routinely at review |
43, always for Annual review; 56, only 'if indicated' for any review |
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Insulin initiation |
50, in-house (16 by doctor, 26 by practice nurse, 6 by DSN**; 2, n/r); 49, in Secondary Care only |
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Patients on insulin managed in practice |
60, yes, only if stable on insulin; 39, secondary care only |
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Foot inspection |
58, in-house; 17, referred to podiatry services; 24, not reported |
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Use of guidelines for diabetes |
53, both national (most frequently NICE***) and local guidelines; 33, national guidelines only; 9, local guidelines only; 4, do not use guidelines |
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Patient education |
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Availability of Structured Patient Education Programme |
25, secondary care; 37, primary care; 4, location not specified. 33, no structured programme available |
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Practice provision of patient education |
26, provide 'in-house' education only; 73, refer patients for external education: 36, 'structured programme' (most commonly DESMOND); 37, refer to locally developed educational sessions. |
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Who provides in-house education |
75, nurse-led; 5, doctor-led; 19, shared |
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Materials |
55, use in-house leaflets; 68, use DUK**** leaflets; 11, use PCT leaflets. 39, refer patients to DUK website; 5, refer patients to local website; 6, refer patients to in-house website |
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Management aids |
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Diaries |
67, use patient diaries; 20, do not use diaries;12, n/r |
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Blood testing kits |
40, use with all patients/patients who request kits; 20, use only with patients on insulin; 9, do not use; 24, n/r |
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Urine testing kits |
21, use with all patients/patients who request kits; 5, use only with patients on insulin; 41, do not use; 32, n/r |
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Access to specialist support services outside of the practice |
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Diabetes Specialist Nurse |
53, via secondary care; 28, primary care; 18, n/a***** |
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GPwSI (in Diabetes) |
6, via secondary care; 14, primary care; 79, n/a |
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Dietician |
40, via secondary care; 17, primary care; 42, n/a |
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Podiatrist |
32, via secondary care; 30, primary care; 37, n/a |
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Retinal Screening |
29, via secondary care; 36, primary care; 34, n/a |
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Diabetes Centre in Secondary Care |
23, available to consult for advice |
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Specialist Diabetologist |
44, available to consult for advice |
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* n/r not reported; **Diabetes Specialist Nurse; ***National Institute of Health and Clinical Excellence; **** Diabetes UK; ***** n/a not available |
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Eccles et al. Implementation Science 2011 6:61 doi:10.1186/1748-5908-6-61 |
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