Successful recommissioning of community diabetes services in West Hampshire


  • Kate Fayers West Hampshire Community Diabetes Service, Lyndhurst, UK
  • Hermione Price West Hampshire Community Diabetes Service, Lyndhurst, UK



Introduction: The West Hampshire Community Diabetes Service replaced traditional hospital-based diabetes outpatients in 2010 and has been successfully recommissioned, one of the first community diabetes services to complete the commissioning cycle.

Method: The successful introduction of traditional diabetes services into the community requires clear leadership and a strategic vision. Unlike many hospital-based services, the community setting is at the frontline of Clinical Commissioning Group (CCG) targets for recommissioning. Thus, the threat of change is relentless and must be embraced rather than feared. As a result, the community setting can offer a new approach to the management of long-term conditions, with healthier and more productive partnerships between healthcare professionals and patients. We have identified four success criteria: skills for leadership, strategic vision, stakeholder partnerships, and shared learning.

Results: The success of the diabetes service redesign in West Hampshire is reflected in successful recommissioning of the service by the West Hampshire CCG. This is one of the first such services to be successfully recommissioned in the country.

Conclusions: Relocating general diabetes services into the community has been a catalyst for improved integration between specialist and primary care in West Hampshire. The process of service redesign and recommissioning is not widely communicated between consultant diabetologists, who will be pivotal to developing and delivering high-quality community care. Communicating these messages to doctors in training will ensure newly-appointed consultants have the skills required to lead change in local diabetes services and ensure high performing services are recommissioned successfully.


The King’s Fund (2014) Commission on the Future of Health and Social Care in England. Available at: (accessed March 2015)

NHS England (2014) Five Year Forward View. Available at: (accessed March 2015)

The Kings Fund (2014) Community Services. Available at: (accessed March 2015)

Diabetes UK (2015) State of the Nation Challenges for 2015 and Beyond. Available at: (accessed March 2015)

Holman RR, Paul SK, Bethel MA, Neil HA, Matthews DR. UKPDS 81 long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med 2008;359:1565-76.

Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. UKPDS 80 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008;359:1577-89.

Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabet Med 2012;29:855-62.

Diabetes UK (2014) The Cost of Diabetes. Available at: (accessed March 2015)

Guthrie B, Payne K, Alderson P, McMurdo ME, Mercer SW. Adapting clinical guidelines to take account of multimorbidity. BMJ 2012;345: e6341.

National Institute for Health and Care Excellence (2014) Multimorbidity: the assessment, prioritisation and management of care for people with commonly occurring multimorbidity. Available at: http://www. (accessed March 2015)

National Institute for Health and Care Excellence. Clinical Guidance on Diabetes CG15: Type 1 diabetes: Diagnosis and management of type 1 diabetes in children, young people and adults and CG66:Type 2 diabetes: the management of type 2 diabetes (update).

National Diabetes Audit Executive Summary 2009-2010. Available at: (accessed March 2015)

National Institute for Health and Care Excellence. Quality Outcome Framework (QOF). Available at: (accessed March 2015)

Partha Kar. The Super Six model: Integrating diabetes care across Portsmouth and south‑east Hampshire. Diabetes & Primary Care 2012;14: 277-83.

Nuffield Trust (2013). Evaluation of the first year of the Inner North West London Integrated Care Pilot. Available at: http://www. (accessed March 2015)

Rea RD, Gregory S, Browne M, et al. Integrated diabetes care in Derby – new NHS organisations for new NHS challenges. Available at: espdi/file/September%202011/Rea%20online%20+%20charts.pdf (accessed March 2015)

ABCD/Diabetes UK/RCP Diabetes and Endocrinology National Manpower Report (Consultant Survey for the year ending 30th September 2013). Available at: (accessed March 2015)

Wagner EH. Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice 1998;1:2-4.

NHS England. Enhancing the quality of life for people living with long term conditions- The House of Care. Available at: March 2015)

The Myers Briggs Foundation. Available at: March 2015) (accessed March 2015)

Department of Health (2011) Operational guidance to the NHS: Extending Patient Choice of Provider.

NHS Institute for Innovation and Improvement. Quality and Service Improvement Tools Plan, Do, Study, Act (PDSA). Available at (accessed March 2015)

Public Health England. Healthier Lives: Diabetes. Available at: March 2015)






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