abstract: 'ContextIn 2019, NHS England and Diabetes UK convened an Expert Working

  Group (EWG) in order to develop a Model and recommendations to guide

  commissioning and provision of mental health care in diabetes pathways

  and diabetes care in mental health pathways. The recommendations are

  based on a combination of evidence, national guidance, case studies and

  expert opinion from across the UK and form other long term conditions.

  The case for integrationThere is good the evidence around the high

  prevalence of co-morbidity between diabetes and mental illness of all

  severities and, the poorer diabetes and mental health outcomes for

  patients when this co-morbidity exists. Detecting and managing the

  mental health co-morbidity improves these outcomes, but the evidence

  suggests that detection of mental illness is poor in the context of

  diabetes care in community and acute care settings and that when it is

  detected, the access to appropriate mental health resource is variable

  and generally inadequate. The Model of integrated care for diabetesThe

  EWG developed a one-page Model with five core principles and five

  operational work-streams to support the delivery of integration, with

  examples of local case studies for local implementation. The five core

  principals are: Care for all-describing how care for all PWD needs to

  explore what matters to them and that emotional wellbeing is supported

  at diagnosis and beyond; Support and information-describing how HCPs

  should appropriately signpost to mental health support and the need for

  structured education programmes to include mental healthcare

  information; Needs identified-describing how PWD should have their

  mental health needs identified and acted on; Integrated care-describing

  how people with mental illness and diabetes should have their diabetes

  considered within their mental health care; Specialist care-describing

  how PWD should be able to access specialist diabetes mental health

  professionals. The five cross cutting work-streams for operationalising

  the principles are: Implementing training and upskilling of HCPs;

  Embedding mental health screening and assessment into diabetes pathways;

  Ensuring access to clear, integrated local pathways; Ensuring addressing

  health inequalities is incorporated at every stage of service

  development; Improving access to specialist mental health services

  through commissioning. Discussion and conclusionsThe Model can be

  implemented in part or completely, at an individual level, all the way

  up to system level. It can be adapted across the life span and the UK,

  and having learnt from other long term conditions, there is a lot of

  transferability across all long term conditions There is an opportunity

  for ICBs to consider economies of scale across multiple long term

  conditions for which there will be a significant overlap of patients

  within the local population. Any local implementation should be in

  co-production with experts by experience and third sector providers.'
affiliation: 'Sachar, A (Corresponding Author), Imperial Coll Healthcare NHS Trust,
  Charing Cross \& Hammersmith Hosp, Liaison Psychiat Serv, London, England.

  Sachar, A (Corresponding Author), West London NHS Trust, London, England.

  Sachar, Amrit, Imperial Coll Healthcare NHS Trust, Charing Cross \& Hammersmith
  Hosp, Liaison Psychiat Serv, London, England.

  Sachar, Amrit, West London NHS Trust, London, England.

  Ng, Sze May, Southport \& Ormskirk NHS Trust, Paediat Dept, Southport, England.

  Ng, Sze May, Univ Liverpool, Dept Womens \& Childrens Hlth, Liverpool, England.'
author: Sachar, Amrit and Breslin, Niki and Ng, Sze May
author-email: amrit.sachar@nhs.net
author_list:
- family: Sachar
  given: Amrit
- family: Breslin
  given: Niki
- family: Ng
  given: Sze May
da: '2023-09-28'
doi: 10.1111/dme.15029
earlyaccessdate: JAN 2023
eissn: 1464-5491
files: []
issn: 0742-3071
journal: DIABETIC MEDICINE
keywords: 'commissioning; diabetes pathway; integration; mental health; mental

  illness; psychological; self care'
keywords-plus: 'IMPROVE GLYCEMIC CONTROL; PSYCHOLOGICAL INTERVENTIONS;

  PSYCHIATRIC-DISORDERS; RISK; PEOPLE; ADULTS; METAANALYSIS; DEPRESSION;

  OUTCOMES; ILLNESS'
language: English
month: APR
number: '4'
number-of-cited-references: '55'
orcid-numbers: Ng, Sze/0000-0002-3449-0541
papis_id: 90eac81200ca20cbfa1d66e4d50d5f25
ref: Sachar2023integratedcare
researcherid-numbers: Ng, Sze/E-2646-2012
times-cited: '1'
title: 'An integrated care model for mental health in diabetes: Recommendations for
  local implementation by the Diabetes and Mental Health Expert Working Group in England'
type: article
unique-id: WOS:000913167500001
usage-count-last-180-days: '3'
usage-count-since-2013: '3'
volume: '40'
web-of-science-categories: Endocrinology \& Metabolism
year: '2023'