Scrutinising diabetes: not just about the numbers

More people than ever have diabetes and are at risk of type 2 diabetes. If nothing changes, warns Diabetes UK, more than five million people will have the condition in the UK by 2025; the costs to the NHS of treatment and care are rising.

So, how do elected members on overview and scrutiny committees get to grips with understanding a situation that in many areas is daunting in scale and complex? Recently, my committee did just that and I want to share with you what I learned.

First, I found that Brent is at the sharp end of the problem. Prevalence of diabetes is about 8.5 per cent (25,000 people with type 2 diabetes) compared with a national average of 5.82 per cent.

“We were able to have a discussion in which everyone could be frank about the scale of the problem

Public Health England estimates there are around 7,500 undiagnosed patients in Brent. Part of the underlying reason for the high number is that many in the borough are in high-risk groups. So, the situation here is, frankly, very challenging.

When we discussed this at committee, I wanted to bring together everyone involved in treating, diagnosing and preventing diabetes. That included colleagues from the clinical commissioning group, the director of public health, GPs, and Brent’s cabinet member for public health.

We had a discussion in which everyone could be frank about the scale of the problem, and allow the members to unpick how the parts of the ‘system’ work together around prevention and treatment.

The discussion was wide ranging, from food and exercise to Brent’s prevention programmes such as Slash Sugar, which raises awareness of hidden sugar in food. Diabetes is clearly an area of collaboration between the local authority and the NHS, so there has to be input from both when discussing this complex topic.

I also wanted to widen the debate to hear from those directly affected by the condition. Some members may have personal experience of diabetes or have friends and family with the condition – many do not.

In Brent, we have 40 diabetes community champions from a wide range of backgrounds, who go out and about talking to people and giving out information; I invited two of them to the committee meeting.

It worked extremely well. Everyone is aware of the numbers, but as a member there’s nothing like being able to take on board first-hand testimony alongside the data. It was absorbing to hear one of the champions describe her personal experience of being diagnosed with borderline type 2 diabetes and how she works to share her knowledge of the condition.

For this type of topic, you need to hear these examples of real experiences to help the members make sense of it all.

At scrutiny, members are often told about ‘triangulation’ or, to put it simply, comparing and weighing up different pieces of evidence as a whole, rather than separately. What I learned above all is that triangulation is more than just weighing different datasets, as important as they are. It is also about listening to people whose own experiences make our understanding of a condition like diabetes real and tangible.

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