Cuts and lack of leadership blamed over poor diabetes care
Frontline NHS doctors and nurses say a combination of cost-cutting measures and a perceived lack of local and national leadership are contributing to poor outcomes for people with diabetes, a new report has found.
The findings were made in A Diabetes Snapshot, which brought together research from clinicians, policy makers, and patient representatives, and was published by the Association of the British Pharmaceutical Industry’s Pharmaceutical Diabetes Initiative (PDI).
The collection of 50 in-depth interviews, commissioned from independent market research firm ComRes, reveals a confused picture for diabetes care, including:
- Diabetes being a lower national priority caused by a perceived local and national leadership vacuum.
- Diabetes grouped with other long-term conditions, resulting in the dissolution of valuable representative groups, such as NHS Diabetes
- Tensions between GPs and commissioners, as GPs are faced with the pressure of reducing costs while managing the condition in a holistic way. Often the two contrast starkly and the report points to clinical decisions being overridden by short-term cost-cutting
- A confused state of clinical guidance, resulting in a lack of support for GPs treating people living with diabetes
The report reinforces that despite national guidance and innovative treatments and technologies being made available, people diagnosed with diabetes in 2015 may not receive the care they need. Some GPs claimed that they are being prevented from prescribing clinically effective newer agents due to pressure from CCGs and local prescribing bodies to prescribe the cheapest treatments.
The PDI is calling on the government to ensure people with diabetes get the appropriate treatment at the right time in their patient pathway. The report also calls for more support for GPs in managing the condition, through a clear and integrated community pathway for diabetes care and greater local and national leadership.
Dr David Miller-Jones, Chair of the Primary Care Diabetes Society (PCDS), who contributed to the report, said: “GPs are now carrying more responsibility for managing diabetes than ever before. The PCDS provide education and national leadership, but our aims of supporting GPs should be strengthened by a renewed national NHS policy commitment to tackle diabetes.”
A Diabetes Snapshot indicates GPs are already facing major issues dealing with this condition
The report was released amid a consultation period of a number of Type 1 and Type 2 clinical NICE guidelines. The latest Type 2 guideline consultation, which has now closed, is proposing changes to the current guidelines of care, which would take diabetes care back by a decade, according to diabetes specialists and healthcare professionals alike. Leading clinician Professor Anthony Barnett and a collection of diabetes specialists from across the country concur that whilst the proposed Type 1 guideline is sensible, in contrast some of the recommendations included in the Type 2 guideline are ‘paradoxical in the extreme’ and demonstrate a ‘distinct failure of common sense’.
Suzie Collett, Director of Policy, Communications and External Affairs at MSD and Chair of the ABPI PDI said: “A Diabetes Snapshot indicates GPs are already facing major issues dealing with this condition. This matters because keeping the growing number of diabetes patients well is not just good for them, it also saves costly acute hospital care. The draft guidelines produced by NICE unfortunately outline a short-sighted approach, ignoring and restricting the use of modern therapies, just at the moment where the NHS needs to get on top of diabetes care at every level.”
To view the report, click here.