Scrutinising Diabetes: It’s more than just about the numbers!

By Cllr Ketan Sheth

This month we will be celebrating World Diabetes Day. We are all familiar with some of the frightening numbers around diabetes: 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. Also, 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 the situation which in many areas is daunting in scale and complex? Well, recently my committee did just that and I want to share with you what I learned.

Firstly, I found out that Brent is at the sharp end of the problem. Prevalence of diabetes is higher than the national average: recent estimates suggest that about 8.5% of the population, or 25,000 people, have type 2 diabetes in Brent, with the national average being around 5.82% of the population. Public Health England estimates that there are approximately 7,500 undiagnosed patients in Brent, who do not even know they have the condition. Part of the underlying reason for the high numbers is that there are many people in the borough who are in high-risk groups. So, the situation in Brent is frankly very challenging.

When we discussed the situation at committee I wanted to bring together everyone involved in treating, diagnosing and preventing diabetes. That included clinicians from the CCG, the Director of Public Health, and general practitioners. We also had input from Brent’s cabinet member for public health. The clinicians and director of public health were excellent and I think we were able to have a discussion in which everyone could be frank about the scale of the problem and allow the members to unpick how different 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. It was clear to me that diabetes is an area of collaboration between the local authority and the NHS. So, my next learning point was that at committee there has to be input from the local authority and the NHS when discussing this complex topic.

However, I also wanted to widen the discussion to hear from those directly affected by the condition. Some members may have their own personal experience of diabetes or have been made aware by friends and family who have the condition, but many do not have firsthand experience. In Brent there is a project called Diabetes Community Champions, run by the council’s Public Health team, which works to promote awareness about diabetes at the grassroots. The community champions go out and about, talking to people, and giving out information, and Brent now has 40 community champions from a wide range of backgrounds. So, I invited two of them to the committee meeting. I have to say that it worked extremely well.

Everyone is aware of the numbers, but as a member there’s nothing like being able to take on board firsthand testimony alongside the data. It was absorbing to hear one of them describe her personal experience of being diagnosed with borderline type 2 diabetes and how she works to share her knowledge of the condition. We also heard from Charlotte Summers, the chief operating officer of diabetes.co.uk, a website which supports people with the condition. Again, it was interesting to hear what they are doing. So, my third learning point is that for this type of scrutiny topic, I think that if it is being discussed at committee you need that firsthand testimony 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. So, I would say that 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 firsthand experiences make our understanding of a condition like diabetes real and tangible.

ketanCllr Ketan Sheth is Brent Council’s Chair of the Community and Wellbeing Scrutiny Committee and an Ambassador for the All-Party Parliamentary Group for Diabetes.

 

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