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More evidence on diabetes postcode lottery

Report shows huge regional variation in quality of care for people with diabetes

Louise Prime

Thursday, 14 June 2012

Diabetes care has yet again been shown to vary enormously in quality across the country. Less than a month after the National Audit Office published its report citing evidence of a postcode lottery in standards of diabetes care across England, today’s National Diabetes Audit has further exposed the variation in care for people with diabetes across England and Wales.

The latest audit shows that in 36 primary care trusts in England in 2010-11, fewer than half of patients with diabetes were recorded as having had all their annual checks. In Wales, the proportion varied from 51% to 65% for different local health boards.

But these overall figures mask huge variations between regions and PCTs. People in some areas were four times as likely to have had all nine of the required checks as those in other areas.

In the worst performing PCT, just 16% of patients with diabetes had had all their checks, compared with 71% in the best performing PCT.

The report also reveals that people younger than 55 who have diabetes are less likely than older patients to have had all the checks they should. The authors say that poor attendance may account for some of the regional and age-related variation, but that care provision is also a factor.

It showed that:

  • overall, 54% of patients were recorded as having had all nine checks – a three percentage point improvement on the previous year; in Wales, the figure was 60% – two percentage points up
  • 59% of people with type 2 diabetes aged 55 and over received all nine care processes compared with 47% of under-55s; in Wales the figures were 64% and 53% respectively
  • 52% of people with type 1 diabetes aged 55 and over received all nine care processes compared with 33% of under-55s; the figures for Wales were 53% and 33%.

Dr Bob Young, who was clinical lead for the audit, said: “The small overall improvement is welcome but quite insufficient. The high performing localities show that this core essential care can and should be delivered much more reliably.”

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