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Poor state of diabetes care costs money and lives

Many patients not getting NICE-approved checks

Jo Carlowe

Wednesday, 14 January 2015

The poor state of diabetes healthcare in England is leading to avoidable deaths, according to a new report published today. 

Diabetes UK in its annual State of the Nation report reveals that little overall improvement in diabetes healthcare has been made in the past year.

According to the findings 40% of people with diabetes are still not getting the National Institute for Health and Care Excellence recommended checks that they need to manage their condition. 

And some aspects of care have got worse, such as the numbers of people with Type 1 diabetes receiving their annual checks, which has reduced from 43 to 41%.

This is despite the fact that spending on diabetes accounts for about 10% of the entire NHS budget. But Diabetes UK says the vast majority – about 80% – of this money is being spent on treating complications and not enough is being invested on the good care that could prevent them.

Examples of poor care highlighted in the report include:

  • Treatment targets for blood pressure, blood glucose and cholesterol only being met for a third of people with diabetes. Across the country nowhere is meeting all three targets well – the average is 36% and the best is 48%.
  • People with Type 1 diabetes are receiving considerably worse routine care than other people with diabetes and are less likely to have their condition under control, with just 41% receiving eight of the annual checks recommended by NICE, and 16% meeting the three recommended treatment targets.
  • Working age people are less likely to receive recommended care and meet treatment targets than older people. For example, in the under 40s, only 29% of people with Type 1 diabetes and 46% with Type 2 diabetes received their eight annual check.
  • Children and young people with diabetes are even less likely to receive routine care and have their condition under control. In 2012-13, only 12% of young people aged between 12 and 19 had all their annual care checks.  One in four had worryingly high blood glucose levels. 

Barbara Young, Diabetes UK Chief Executive, said: “This is not a question of spending more money. In fact, better ongoing standards of care will save money and reduce pressure on NHS resources.

“It’s about people getting the checks they need at their GP surgery and giving people the support and education they need to be able to manage their own condition. Doing this, together with improving diabetes care in hospital, would give people with diabetes a better chance of a long and healthy life, and save the NHS a significant amount of money. We want to work with local authorities to be able to help them put good practice into place.”

The report also highlights how preventing Type 2 diabetes needs to be a greater priority to help reduce the burden of the condition on NHS resources in the future. 

Diabetes UK has welcomed the announcement from NHS England of a national Type 2 diabetes prevention programme in England, which will be launched in partnership with the charity.

The report calls for clinical commissioning groups (CCGs) to set themselves performance improvement targets and implement diabetes action plans. The charity is also urging CCGs to ensure all people with diabetes have access to the support they need to manage their condition effectively, and that the local health system is designed to deliver this.

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