NHS urged to use £40m fund following report
Significant regional variation in diabetes care and support has been highlighted in a new report by MPs.
A spotlight has been shone on the current lottery of care for people with diabetes by postcode and type of diabetes as well as age in the report called ‘Diabetes Care: Improving Standards and Reducing Variation’.
They say too many people are missing out on the vital care and support they need to manage their condition properly.
The Secretary of State for Health, the Rt Hon Jeremy Hunt MP, spoke yesterday at the launch of the new report from a group of politicians.
The Health Secretary urged healthcare leaders to drive forward improvements in diabetes care to help deliver a sustainable NHS. He is backing the report’s findings and encouraging health leaders to bid for a share of an additional £40 million announced for diabetes care improvement in order to transform diabetes services in worse performing areas.
Treating diabetes already costs the NHS approximately £10 billion a year, yet 80 per cent of this is spent on preventable complications such as amputations and blindness. A clear example of the postcode lottery is seen in the amputation rate which is over eight times higher in the worse performing areas compared to the best.
In addition there is substantially worse routine care and treatment in younger people with type 1 and type 2 diabetes and in people with type 1 diabetes at all ages. Given the potential adverse consequences for these younger people of disability and premature mortality in middle life, putting in place better systems of care for them would yield considerable health benefits.
To reduce the amount of devastating complications and save the health service significant sums of money, the report urges Clinical Commissioning Groups in England to bid for the extra £40 million. The MPs say focusing on priority areas can dramatically improve diabetes care across the country, changing the lives of the millions of people currently living with the condition. These priority improvements are:
- High-quality conversations with the right healthcare professionals. Also giving people with diabetes tailored treatment plans and the ability to input into the decision-making process with their healthcare team.Tower Hamlets and North East Essex CCGs are named in the report as areas which are addressing this issue with healthcare professionals trained to run their consultation in a genuinely collaborative way, with time to have an in-depth conversation about the person’s priorities and goals for their own diabetes.
- Support people with diabetes to manage their condition. Berkshire West CCG is highlighted as an area leading the way by radically increasing the number of people attending structured education. They are investing in expanded provision with courses designed to be appealing to people with diabetes. This runs alongside a strong clinical network to encourage referrals helping people see the value of the course. Nottingham City CCG has expanded its education provision with a course that is available on weekdays, evenings and weekends.
- Access to key technologies.The report features the work of a network set up by the Academic Health Science Network for South London which helped increase the numbers of adults on pumps in south London by 31 per cent. They did this by bringing different trusts together. A partnership between hospitals in Leicester and a pump manufacturer delivered a huge increase in the number of children and young people on pumps. Amongst children the number reaching their HbA1c target (blood glucose) has risen from 18 to 58 per cent.
Chair of the All Party Parliamentary Group for Diabetes, the Rt Hon Keith Vaz MP said: “Our message is that variation is not a signal of despair; but of hope. It shows that good care can be achieved, and we’re tasking CCG leaders with making it happen everywhere to tackle the diabetes crisis.
Our message is that variation is not a signal of despair; but of hope. It shows that good care can be achieved
“CCGs and other health service providers need to have more staff who can educate patients about diabetes, as well as more diabetes specialists on hand to deliver NICE’s (National Institute for Health and Care Excellence) recommended yearly healthcare checks for people with diabetes. There are simply some providers who are just not delivering, so we hope CCGs will use this extra money to ensure there is better diabetes care in their catchment areas.”
Diabetes UK’s Chief Executive, Chris Askew, said: “Too few people with diabetes are being offered an education course and even if they are offered take-up is low. We want to see real change and quickly. Our aim is to see half of all people with diabetes attending a course by 2020. It is no exaggeration to say that these courses could mean the difference between life and death.”
Chief Executive of the Type 1 diabetes charity JDRF, Karen Addington, said: “People with type 1 diabetes are still routinely receiving poorer care when compared to people with Type 2 diabetes. This must change. Access to technologies such as insulin pumps needs to improve if we are to raise standards of care.”