Collaborating for improving diabetes care in Ealing, London: a time for cautious optimism, years 2011 to 2018

May 2019

In 2011, providers and commissioners met to review diabetes care in Ealing, London, UK. The needs assessment showed that there was: a high prevalence of diagnosed and undiagnosed people with diabetes; a projected 50% increase in diagnosed people with diabetes during the ensuing decade; a lack of resources deployed in meeting the needs of people with diabetes; a necessity to involve people with diabetes to shape local diabetes care; and, worryingly, outcomes were poor.

This paper describes how to integrate different contributions to health and care at community level – community-oriented integrated care – as has been advocated worldwide for many years. Community-oriented integrated care is complicated because it requires a whole system approach, involving collaboration between commissioners and providers, specialists and generalists, and a range of local organisations, patients and citizens. Commissioners and providers in Ealing collaborated with its neighbouring clinical commissioning groups between 2011 and 2018, in a significant number of initiatives, in improving diabetes care that enabled the achievement of certain initiatives more cost-effectively, and at scale and pace.