Design for Social Change : Case Study

Manchester Diabetes Centre

BACKGROUND

Professor Steve Tomlinson, an innovative leader of change and improvements specially recognised in diabetic care, was a great ambassador and forward thinker. He understood the benefits for members of the health care services and the patients to be listened to in order to find where problems and frustrations lay and improve process for both. He was also a great strategist and influencer. He often used patient stories to educate health professionals and always saw an opportunity to bring health care systems, staff and patients together in order to design and facilitate system change. He was also my doctor and a great teacher who engaged me in the process of change at the diabetes centre.

Challenge

As a patient with adult-onset Type 1 Diabetes, I had been complaining about how services were disconnected. I was working full-time in media, which was demanding, and the discombobulated nature of each of the services required in diabetes care meant lots of appointments and time away from work. Sat in waiting rooms for up to 2 hours awaiting separate services, one appointment delay threw out the next and the next. And sitting with many older patients facing the consequences of their diabetes was just depressing. For health care, it was not much better; 15 minutes didn’t hit the spot when dealing with more complex problems and arranging to follow up in a fractious and individualised system failed both staff and patients.

The Manchester Diabetes Centre was the first in the UK (established in April 1988) to provide high quality care and education for people with diabetes throughout the North West. The centre is also very active in teaching, training and research.

SOLUTION & APPROACH

For our part, we created a patient advocacy group of all ages and organised ourselves to get feedback from the patient communities who were in their care in order to redesign services.

I had already worked out if all appointments could be in one place, most checks could all be done in about an hour once every 3 months and doctors would not be required to refer across locations. Nurses and even volunteers could be engaged in helping and supporting desperately over-subscribed services. If it could be done, it would be cost-saving, time-saving, and effective, including new patient education – all in one place!

Our research with patients helped create the architecture of the new Diabetes Centre.
We established a community of patients and staff to share and develop ways of improving care, not only at that centre, but across the north west. (Best practices.)
We created a training platform for doctors to understand patient perspectives.
We launched several patient/peer groups to work with youth.
We integrated patient stories to influence the development of services.
The project inspired the inclusion of patient representatives in the development of services.
The centre became a beacon for the development of more centres across the UK. This is now the norm.

MY REFLECTION

Change requires several factors to occur. Legislative, legal and funding changes inspire focus and enable pathways to change.
Health care and community champions create particular focus.
Communities of interest can get on board to support, influence and help design the right change. The richer the tapestry of communities engaging in change models themselves the greater the number of innovative new solutions.
Convening these communities with a purpose inspires change.