WESTERN SYDNEY DIABETES

1 WESTERN SYDNEY DIABETES YEAR-IN-REVIEW 20172 YEAR-IN-REVIEW 2017mobilising public support, and are now ready to present these to State and Federal governments and other parties. The October 2017 Productivity Commission Inquiry Report Shifting the Dial argues that primary prevention, secondary prevention and better health care management , integrated across the community and hospitals, will both improve health and save money all core priniciples of the WESTERN SYDNEY DIABETES Strategy. This report also states that current funding mechanisms, and the divide between State and Commonwealth, is inhibiting this implementation, and assumes that few regions will be able to replicate the effectiveness of leading innovators in integrated care, such as the WESTERN SYDNEY DIABETES initiative. With appropriate investment we would like to be an innovator and early adopter of these recommendations. While we were not at sufficiently large scale in 2017, we have continued to implement our framework with the resources at hand.

2 This report documents some of these Glen MaberlyDirector, WESTERN SYDNEY DIABETES EXECUTIVE SUMMARYThe WESTERN SYDNEY DIABETES 2017 Year-In-Review documents the achievements of the leadership, core team and partners working within our Framework for Action. Our main accomplishment over the past year has been building an alliance of more than 70 partners within government, business and the community. This alliance helps us understand the problems, and develop solutions to address the epidemic of DIABETES in our region. There is increasing awareness around the scale of this issue. As WESTERN SYDNEY Local Health District Chief Executive Danny O Connor says: This rising tsunami of DIABETES in SYDNEY s WESTERN suburbs threatens to overwhelm hospitals within 15 years. As we strive to define the magnitude of this problem, it becomes increasingly clear that our current efforts will not achieve our goal of taking the heat out of our DIABETES hotspot within 5 years.

3 A significant effort has therefore been directed towards articulating a more persuasive case for an urgent investment in a larger scale effort. We have produced the business case documentation for investments in primary prevention, secondary prevention and management , data for decision making and FRAMEWORK FOR ACTIONPRIMARY PREVENTIONSECONDARY PREVENTION AND MANAGEMENTMONITORING SURVEILLANCE EVALUATION ECONOMIC IMPACT RESEARCH PUBLICATIONADVOCACY MEDIA SOCIAL MEDIA PUBLIC AWARENESS MOBILISATION GRASS ROOTS SUPPORTAN ALLIANCE OF 70 PARTNERS ALL TIERS AND SECTORS OF GOVT PRIVATE SECTOR NGO UNI & EDUTAKING THE HEAT OUTOF OUR DIABETES HOTSPOTINVESTMENT OPPORTUNITY:PRIMARY PREVENTIONINVESTMENT OPPORTUNITY:SECONDARY PREVENTION AND MANAGEMENTBUILDING AN ALLIANCE AND TESTING THE STRATEGYDATA FOR DECISION MAKING:BUILDING A SURVEILLANCE SYSTEM TO MONITOR AND EVALUATEMOBILISING PUBLIC SUPPORT:BUILDING DIABETES AWARENESS AND ENGAGEMENTHbA1c TESTINGLIFESTYLE COACHINGJOINT CASECONFERENCINGHEALTHPATHWAYSGP SUPPORTLINEWSD APPCOMMUNITYPHARMACYPRACTICENURSE TRAININGIMPROVING FOOD CONSUMPTIONINCREASING PHYSICAL ACTIVITYBUILDING HEALTHY ENVIRONMENTSAVE ALEGCOMMUNITYEYE PROGRAMRAPID ACCESSCLINICCGM FORDIAGNOSTICSINTEGRATEDCAREHEALTH CARE HOMEIN-HOSPITALCAREEDUCATIONCENTRESSHARE D HEALTHSUMMARY BARIATRICOBESITY CLINICGOVERNMENT LEADING THE WAY3 Active Transport, Transport for NSW and Parklands Trust provided input into this planning.

4 A Workshop was conducted on 27th April, with key individuals from government, non-government and NGOs who have the capacity to set up their own groups to guide and implement local environmental changes. Four themes of liveable communities, urban design and greening, transport, and promoting community engagement were analysed, and a strategy for developing these initiatives was progressed. Relevant individuals, including councils, have now taken ownership of these themes and provide updates on progress and achievements both independently and at scheduled meetings. PROGRESSING INTERVENTIONS Blacktown Focus has been launched by the Mayor and General Manager of Blacktown and Mt Druitt Hospital (BMDH), with over 80 key stakeholders in attendance. The objective of this Focus is to implement a number of prevention and management interventions in a small area to demonstrate their efficacy, as well as enabling our stakeholders to work together and evaluate these interventions.

5 PRIMARY PREVENTIONThe 2017 focus for Primary Prevention was to refine our strategy, consolidate the alliance and define an investment opportunity. We also wanted to cement the value of the alliance by progressing some of the lower cost interventions. We therefore decided to take a smaller geographic area to focus our efforts, so we could harness the synergies of multiple interventions without overly stretching our very small team and limited Strategy and Interventions are documented in the 2017 Taking the Heat Out of Our DIABETES Hotspot and Investment Opportunity: Primary Prevention papers. The 2017 Plan focused on what we could do with existing resources, and the key outcomes against that plan are reported PLANNING Key expert consultation was carried out to define the focus of the urban strategy approach of the Alliance, and decide upon the most feasible objectives of a subsequent workshop. Organisations including the Greater SYDNEY Commission, Councils, Heart Foundation, WESTERN SYDNEY Regional Organisation of Councils (WSROC), universities, 4 Top left: Alliance members exchanging information at stalls.

6 Top right: Opening of the Blacktown Focus by the Mayor of Blacktown, Councillor Stephen Bali. Middle left: Sue-Anne Redmond, General Manager, BMDH. Middle right: Doug Thompson, DPC. Bottom: forum members: Sturt Eastwood, DNSW; Sue-Anne Redmond, BMDH; Councillor Stephen Bali, Blacktown Council; Doug Thompson, DPC; Charles Casuscelli, WSROC; Stephen Corbett WSLHD, Rajini Jayabulla, WSLHD, Amanda King, LLGA; Josephene Duffy, SAKGF; Dr Prabha Chandra, Blacktown GP Association; Walter Kmet, FOCUSYEAR-IN-REVIEW 20175 In total, a series of 9 working groups (5 x food, 2 x physical activity, and 2 x urban planning) and 3 combined workshops and strategy meetings have been held. These have been conducted with co-leadership from the DPC since 2016. The outcomes of these meetings were endorsed at the Strategy Meeting held on 26th October 2016. PwC have provided outstanding assistance in the preparation and facilitation of these meetings, which have allowed the ongoing networking of members and the implementation of joint programs.

7 The key reason for the meetings however, has been to produce an overall prevention strategy and cost benefit analysis of key interventions. Alliance members have contributed to this comprehensive prevention strategy as well as the identification of key interventions. This has been achieved through their attendance and contributions during planning meetings, along with the provision of commercial data in individual sessions. Their input has been paramount in enabling the production of a cost benefit analysis leading to an investment portfolio thus providing the greatest opportunity for bringing the prevention efforts in WESTERN SYDNEY to scale. This portfolio is now compiled and awaiting presentation to Government. All councils are now actively involved in the work of the Alliance, with scheduled regular information-sharing taking place. Blacktown Council, as well as attending all Alliance events, are actively contributing to the 2018 planning for the Alliance and the preparation of consumer engagement strategies.

8 All councils are involved with GP Walking Groups, and Blacktown and Parramatta Councils meet with WSD on a bi-annual basis for updates. The low cost interventions being progressed include: GP walking groups, SALSA youth forum, Stephanie Alexander Kitchen Gardens and community cooking classes. These initiatives involve working with a number of Alliance members including WSPHN, Heart Foundation, Department of Sport, Education Department, Police, Councils, Vinnies and Jamie s Ministry of Food. A School Working Group with multiple Alliance members has been assembled to provide programs to local primary schools. This group includes organisations committed to introducing amongst other things; school breakfasts, healthy canteens, healthy lunchbox, educational programs for parents and students, kitchen gardens and cooking classes for children. STAFF HEALTH AND WELLBEING PROGRAM A DIABETES awareness campaign including talks, demonstrations and screening took place, with over 200 staff being assessed for DIABETES risk.

9 High risk individuals were directed to the Get Healthy Service. Local inexpensive or free healthy living options have been identified, and a directory compiled for health professionals and consumers. This directory outlines an array of options associated with both healthy eating and physical activity. Local face-to-face programs and facilities, online programs, educational and community courses are described, which include relevant website links. This document appears on the WESTERN SYDNEY DIABETES website and requests for hard copies have been received from GPs. KEY COMMUNITY ENABLERS Psychological expertise has been incorporated into the Alliance through the addition of key personnel and NGOs. This is to address barriers to residents undertaking lifestyle modification, as well as helping to create referral pathways for programs. Community consultation has occurred in the development and identification of strategies and programs aimed at DIABETES prevention.

10 This has been achieved through active consumer participation in all meetings and workshops. Work has commenced with the WSLHD Consumer Council on training representatives to provide community education sessions. Membership of the Alliance has grown to 70 highly engaged members, with an average of over 80% attending all events. An additional 20 members have joined the alliance over the past 12 months. 6 A DIABETES Detection and management Service (DDMS) nurse at BMDH was appointed to follow-up selected patients identified with pre- DIABETES and DIABETES . All patients and GPs were sent information about the NSW Get Healthy program. The sign-up of patients identified from this program to Get Healthy accounts for 50% of the provider promoted registrations in WSLHD. PROMOTE DIABETES DETECTION AND COACHING BY THE GP Increased annual HbA1c testing was promoted during the Australian DIABETES Week and specifically with a number of GP practices located within Blacktown.