English approaches to integrated diabetes care : the East Cambridgeshire and Fenland Diabetes Intergrated Care Initiative : a multiple provider approach

In England, there have been several approaches to replace the hospital based, medical consultant - led diabetes clinic. The rationale behind these new models has varied. In some cases, there was a genuine desire to improve access to more specialist levels of care by reducing demand, through diversion of patients with less complex needs to other clinicians with diabetes management skills, beyond those of the average general practice. In other cases, initiatives have upskilled and supported existing practices across an area to deliver care "closer to home," and within the holistic care than can be provided by the "medical home" delivered by quality general practice.