Improving outcomes and the integration of diabetes care for adults is a National Health Service ambition. In north east Essex, United Kingdom, an innovative interprofessional community-based diabetes service (North East Essex Diabetes Service (NEEDS)) was developed to provide a single point of access and continuity of care across an integrated, interprofessional care pathway. The aim was to evaluate how NEEDS was embedded into Primary Care, and gain insight into how it works from the perspective of staff delivering the service and from those receiving care. A mixed methods approach was used. Retrospective data from GP surgeries involved in NEEDS were analyzed. Online surveys (n = 21) and focus groups (workforce n = 23; service users n = 6) were conducted. A clear pathway of diabetes care across an integrated, interprofessional care system was demonstrated. Standard care processes and patient outcomes were higher than those recorded for other GP surgeries across England. Service users reported that they received support with more control over their care. The workforce reported a reduction in bureaucracy, blurring of professional boundaries, and thus autonomy to develop the service. The “virtual ward” provided a true interprofessional team approach. Patients and the workforce reported feeling empowered, demonstrating a holistic high-quality approach to patient care.