To ask the Minister of Health to outline (i) the steps he is taking to address the backlog of diabetes patients who are waiting for appointments; (ii) the way in which diabetes care is audited; (iii) the steps being taken to train more health staff in diabetes-specific care; and (iv) how emotional support for diabetes patients has been factored into the Mental Health Strategy.

My Department published a Strategic Framework for Diabetes in Northern Ireland in 2016. The Framework, which was developed in partnership with a range of stakeholders, including Diabetes UK and people living with diabetes, included a 3-year action plan which aimed to improve outcomes and services for people living with diabetes or at risk of developing diabetes.

The Diabetes Network supports the implementation of the Diabetes Strategic Framework and action plan and provides strategic direction for diabetes treatment and care in Northern Ireland. It brings together people living with diabetes, carers, and health and social care professionals working in partnership with Diabetes UK. The Network aims to enable people living with diabetes and frontline experts in diabetes care to work in partnership to co-design services for future diabetes care and improvements in the long term health for people living with the condition.

The COVID-19 pandemic has posed unprecedented challenges for the planning and delivery of health and social care services, including services for people living with diabetes. I recognise the impact that this has had on patients across Northern Ireland who have been affected by this.

The pandemic has also meant changes to how diabetes services are delivered. For example, there has been more use of virtual clinics, zoom consultations, or follow up via telephone, with urgent face to face contacts where necessary; new phlebotomy hubs were established, blood clinics and “drive through” clinics also put in place for bloods taken and structured diabetes education programmes were delivered online with educators trained to deliver more services remotely.

To support access to diabetes services and appointments, the Diabetes Network secured funding to provide IT hardware to support virtual consultations across all HSC Trusts. This equipment has enabled access to on-line provision to support a backlog of diabetes appointments amid COVID pressures.

The Diabetic Eye Screening Programme (DESP), delivered by the Belfast Health and Social Care Trust in conjunction with the Public Health Agency, was paused in March 2020 with a risk management approach adopted so that the most urgent patients were issued appointments during 2020/21. Those at lowest risk of diabetic eye disease were placed on a 24 rather than 12 month recall in line with other programmes in the UK.

Unfortunately due to restrictions associated with reducing COVID risk, the programme continues to run at a significantly reduced capacity within screening clinics and there remains a backlog of patients requiring screening appointments. The programme is maximising appointment capacity through overtime, skill mix, additional in-year funding and other measures. The PHA continues to work with Belfast HSC Trust to develop a recovery plan to address this.

Primary care teams have continued to look after their patients with diabetes throughout the pandemic. GPs have continued to diagnose newly diabetic patients and treat them appropriately. Consultations have been carried out face to face as well as by telephone. Specific diabetes services have continued including for example, podiatry, blood monitoring and medication review. Primary care teams have also been immunising diabetic patients against COVID -19 and Influenza.

(ii) The Diabetes Network is supportive of an audit in respect of diabetes in Northern Ireland. Network representatives met with representatives from Diabetes UK in July 2021 to discuss the National Diabetes Audit and data requirements.

The Diabetes Network will continue to work with Diabetes UK to scope and consider what is possible to support an audit approach in Northern Ireland. This will include consideration of what form such an audit would take.

A key area of work being progressed by the Network through its ‘New models of care’ work stream, is to develop a standardised pathway for Type 2 diabetes in Northern Ireland and ensure that Type 2 treatment matches best practice as well as developing and supporting the diabetes workforce. The Network is also working with my Department to inform a Programme of Care Workforce Review for Diabetes. A working group has been established to consider the preliminary work required before such a review can be undertaken. This includes service mapping and the development of the diabetes pathway. It is anticipated that the Workforce Review will commence in the next financial year, subject to the provision of the required preparatory work.

I am conscious of the vital role that mental health services perform for those who may be suffering from physical ill health, including those who have been diagnosed with diabetes. The new 10 year Mental Health Strategy is person-centred and provides a vision that people will receive care and treatment when they need it. This includes people with diabetes who have mental health needs. Action 22 of the Mental Health Strategy highlights the creation of effective pathways from physical healthcare into mental health services. This is to ensure those with a physical illness, such as diabetes, can receive the support that they require for any resultant mental ill health.

Moving forward, the strategy outlines the aim that those with physical health problems that lead to mental ill health will be provided with the care and treatment they need. In practice, this would include further integration of psychology in multi-disciplinary teams, to ensure that psychological support is mainstreamed across physical health. It also includes training those working in physical health teams where mental ill health is common among clients, in identifying mental health needs and responding to such needs.