We started with the call to develop a Northamptonshire Diabetes Care Pathway involving commissioners and stakeholders in 2009. We explored the complexity of the pathway development that evolved with the realisation of the different aspects of diabetes care that needed to be considered. This process enabled the service provision that crossed organisational boundaries to be identified and the responsibilities of the different service providers, this informed the development of the Northants Diabetes MDT – the glue between primary and secondary care and made clear the responsibilities of each service.
There followed a mass recruitment and a need for a very small team to suddenly develop new team members and provide an equitable cross county service. The advertising of this newly developed pathway and exciting specialist community based team opportunity attracted some talented individuals and enabled the team to develop itself very quickly and form relationships in primary and secondary care to enable collaborative working.
A detailed referral criteria was created which with hindsight we can see helped us and our stakeholders understand our role and purpose but was rather unwieldy. Team members identified this as an issue and were enabled to create a much simplified tool and implement this. This was just one example of facilitating leadership behaviour within our team.
We considered the potential threat of creating Job Plans for our team and turned this into a positive, finding a plan that specialist teams could identify with considering what we thought was achievable (cross referencing with SMART) and including essential non patient facing activity and then asking the team to try it out and see if it represented their working week, which it generally did.
We talked about the competencies the team have that are lifted from the TREND nursing competencies and how using these along with dietetic and podiatry competencies has enabled us to develop our Diabetes Specialist Support Workers who can practice at an advanced diabetes specialist level as they are supervised and supported and have much job satisfaction. A model we feel could be copied elsewhere.
The team generate a small income by providing competency based education to private care homes and agency staff and this enables us to fund our own external specialist development needs with several staff members being funded to attend the Diabetes Counselling course held locally at Knuston Hall as well as various national conferences.
Talent within the team has been identified and nominated for trust awards and a senior nurse has been encouraged and supported in her membership of the Queens Nursing Institute, the team also won team of the year in 2012.
The “Big Team” meet quarterly where business type agenda items are referred to and team members are encouraged to read this from our shared drive, leaving the meeting free for networking, development of objectives, team development, feedback on study days, significant events and lessons to learn across disciplines. Team members are encouraged to take an active part in these meetings as they are to their own monthly “Sharing Best Practice” meetings which enable junior team members to identify learning needs and have ownership of organising the meetings (which are scheduled year on year and attendance is mandatory!).
Diabetes is a complex condition and is the second most common long term condition in the world. Our Multi-disciplinary Team members all have leadership responsibilities that engage their talents, we all lead on the various aspects of the service we provide.
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