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Shocking variation in diabetes care across UK

Diabetes UK shocked that NHS fails to provide full care to thousands

Louise Prime

Thursday, 25 November 2010

Almost a quarter of people with diabetes are not getting the foot checks they need, and diabetes results in about 70 amputations a week in England, 80% of which were potentially preventable, shows a Government report out today. The NHS atlas of variation in healthcare shows that the amputation rate varies twofold between different strategic health authorities (SHAs).

But in areas with integrated multidisciplinary specialist diabetes foot teams (MDT), the amputation rate has fallen dramatically. In Ipswich, it fell over an 11-year period to only a fifth of the rate before the MDT was established.

The Atlas also showed that only 50.8% of people with type 2 diabetes, and 32.2% of those with type 1 diabetes, had received all nine of the key care processes that are recommended in diabetes, including blood pressure measurement and eye and foot checks.

Barbara Young, chief executive of Diabetes UK, told Radio 4’s Today programme this morning: “We very much want to shine a spotlight on those areas with poorer care but also to inform patients about the level of care they should expect right across the country.”

She later added in a statement: “Diabetes UK is seriously concerned that less than half of people with diabetes have received all nine health checks. This demonstrates that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery.

“With access to high quality care, patient education and effective diabetes management, there is no reason why people with diabetes should not live long and healthy lives. The devastating impact on some of the 2.3 million people in England with diabetes must not be dependent on geography.

“Most people with diabetes see their healthcare team only once a year for a few hours. The annual review is vital for picking up any health changes and signs of complications and can often be the only chance for people to discuss their management and treatment with their healthcare professionals. The nine checks are the minimum gold standard of diabetes care.

“The existing situation around foot care and amputations is shocking, given that the majority of amputations can be prevented. Diabetes is the single most common cause of lower-limb amputation in the UK . Foot checks as part of the annual review should be a given and any injuries or ulcers that are detected need to be assessed as soon as possible by an expert team. The longer they are left untreated, the greater the risk of deterioration and loss of the limb.

“Good diabetes care relies on a team of specialist healthcare professionals to provide the care and to empower the people they care for. People across the country should have a right to expect standard levels of good practice to support them with their serious condition.”

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