Type 1 care in Dorset could be moved to GPs
The care of 50 per cent of people with type 1 diabetes in Dorset could be handed to GPs in the area under new proposals.
It has suggested that “stable” people who have type 1 diabetes could be discharged from secondary care management, with commissioners monitoring practices’ referrals and admissions rates.
The CCG has said that the ‘”commissioning intention” it has issued is a first step before consultation with GPs.
The Adult Diabetes Service Model for Dorset also states that GPs and practice nurses will continue to act as ‘”care coordinators” and supervise multi-disciplinary care of a patient by specialists.
But it adds that “up to 50 per cent of type 1 and 90 per cent of type 2 people with diabetes will have their care provided in primary care with support, if clinically indicated, from the Dorset Diabetes Care Service (DDCS)”.
The document said: “All newly diagnosed type 1 people with diabetes will have a rapid initial assessment of treatment needs and referral to the Dorset Diabetes Care Service to agree a joint personalised care plan.
Shifting up to 50 per cent of type 1 diabetics into primary care, we just haven’t got the resources in terms of time, knowledge, or money
“It is expected that a significant number of these people will have their care provided within primary care with support from specialist services as needs change.”
The new proposed service will also include triage to all referrals, it will offer practices an annual visit by a consultant from the service in order to update on best practice and services and also monitor practices’ referral and admissions rates for diabetes.
It also highlights that: “Individuals will be discharged from specialist care and the discharge information will be shared with the person with diabetes and GP and include future management plan and indications for re-referral”.
Speaking to Pulse, Dr Nigel Price, a GP in Bournemouth, said: “Shifting up to 50 per cent of type 1 diabetics into primary care, we just haven’t got the resources in terms of time, knowledge, or money. Anything that’s required to deliver a safe service for our diabetics.”
Dr Andrew Green, who is the chair of the General Practitioner’s Committee’s clinical and prescribing subcommittee, said: “This is quite clearly a transfer of work into general practices and the absence of any mention of funding is simply flabbergasting.
“This proposal, and in particular the training requirements mentioned, go clearly beyond essential services and if adequate funds are not provided GPs should use the resources available from the BMA to ensure that their practices and patients are not damaged by this transfer of work.”
A spokesperson for NHS Dorset CCG told Pulse: “NHS Dorset CCG has issued a commissioning intention and is currently working with local providers, including primary care, to develop an implementation plan.
“The changing role and responsibilities of primary care providers will need to be supported through the release of resources from our current model of care.”