The East Coast Area Diabetes Shared Care Programme (ECAD) has been in operation since 2002. There are 10 practices with 11 GPs in ECAD and approximately 500 patients with Type 2 Diabetes are enrolled. Each patient is reviewed by their GP, community Dietitian and Diabetes Nurse Specialist (DNS) at least twice per year while an annual assessment is performed at one of the following hospitals:
St Vincent’s University Hospital (SVUH)
St Michael’s Hospital (SMH)
St Columcille’s Hospital (SCH)
Communication between Primary Health Care (PHC) and the hospital Diabetes Day Centres (DDCs) of the 3 acute hospitals listed above characterises ECAD. This is facilitated by the aforementioned Dietitian and DNS who attend weekly endocrinology team meetings at SCH and SVUH. In addition, information on each patient is communicated by a computeriseddatabase between PHC and the DDCs. It includes information relating to patients’ medical/surgical history, medications and bio-chemical parameters. In this way patients are known to both PHC and hospital DDCs with both having contemporaneous patient information. In addition, patients where necessary have access to other specialists within the hospital setting via the DDC.
On joining ECAD, PHC-based health professionals were funded to undertake the ICGP modular distance learning course in Diabetes. Funding is provided for regular education updates. Topics covered are identified by participants themselves. Generally, education is delivered by hospital-based health professionals.
Audits of ECAD were conducted in 2005 and 2007 to assess process and outcomes of care. Overall, the audits demonstrate positive results, most notably the outcomes which compare favourably with international targets and patients attending hospital only.
Anecdotal evidence suggests that job satisfaction is enhanced for the health professionals involved in ECAD. Likewise, anecdotally patients are satisfied with the opportunity to receive multidisciplinary Diabetes care from familiar personnel within their own GP practice which is generally close to where they live / work. Also, reduced waiting times and more frequent follow up are appreciated.
An expansion of ECAD is currently being discussed.