New toolkit sets out proven approach to transforming diabetes services
A newly published resource outlines an integrated, evidence-based approach to improving diabetes services across primary, community and specialist care.
The Diabetes Model of Care Toolkit (2012-2025) reflects more than a decade of collaboration between NHS Leicester, Leicestershire and Rutland (LLR), University Hospitals of Leicester NHS Trust (UHL), National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) East Midlands and EDEN to create a practical model for diabetes care.
Since 2012, it has focused on prevention, structured education (such as DESMOND and DAFNE), and proactive management of complications, while strengthening workforce through EDEN training and mentoring – a key factor in its success.
Delivering care closer to home and embedding specialist expertise within GP practices and community services, the model has enhanced patient outcomes, reduced unwarranted variation, and generated savings of £83 per patient per year – with potential national savings of £276 million.
People benefit from higher completion of the nine care processes, better attainments of treatment targets and greater empowerment through education and digital tools.
By strengthening care at the community level while supporting NHS priorities, this approach aligns seamlessly with the Fit for the Future: 10-Year Health Plan for England.
Offering a scalable, evidence-based framework, the toolkit supports commissioners, providers and policy leaders in delivering sustainable, equitable and person-centred diabetes care.
It builds on the collective expertise of clinicians, commissioners, educators, researchers and public representatives who have worked tirelessly to tackle rising diabetes prevalence and reduce inequalities in care.
Professor Sam Seidu, Professor in Primary Care Diabetes and Cardio-metabolic Medicine at the University of Leicester and toolkit contributor, said: “This toolkit is grounded in evidence-based principles that integrate prevention, structured education and proactive complication management across all care settings.
“By combining patient empowerment, multidisciplinary collaboration and data-driven decision making, it provides a robust framework for improving clinical outcomes while reducing variation in care.”
He added: “It demonstrates how structured, coordinated approaches at the community and primary care level can deliver measurable benefits for patients and the health system alike.”
Laura Willcocks, toolkit contributor and Assistant Director of Integration, Education and Innovation at the Leicester Diabetes Centre and EDEN, said: “We hope this a tool that can be useful for systems to look at their diabetes and long-term condition services with a range of how to tips.
“We would be very happy to have a conversation with anyone who wants to talk further about this.”
The Diabetes Model of Care Toolkit (2012-2025) is now available for healthcare teams to adopt and implement in practice.
To access the toolkit, click here. For more information, please email Laura Willcocks on laura.willcocks5@nhs.net.