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NHS diabetes care at ‘breaking point’ warns report

End recruitment freezes on diabetes nurses, say experts

Jo Carlowe

Thursday, 13 March 2014

The NHS is not recruiting enough diabetes specialist nurses (DSNs) to keep pace with the growing number of people diagnosed with diabetes.

This is the finding of new analysis published today by Diabetes UK, the Royal College of Nursing (RCN) and TREND-UK.

The report, called Diabetes Specialist Nurses: Improving Patient Outcomes and Reducing Costs, sets out the evidence that DSNs are vital for good patient care and can save the NHS money by reducing the length of time people with diabetes stay in hospital. In the long term, DSNs support people with diabetes to help reduce their risk of health complications which account for 80% of the £10 billion a year the NHS spends on diabetes. 

The analysis suggests that staffing levels have been allowed to stagnate – with a third of hospitals now having no specific diabetes inpatient specialist nurse – because of short-term budget pressures. With the number of people diagnosed with diabetes increasing by more than 100,000 a year and with about half of DSNs expected to retire within the next 10 years, the three organisations have warned that DSN staffing levels will soon become unsustainable.

This is being made worse because of changes to the role of DSNs. According to a survey of DSNs conducted as part of the analysis, 20% are spending less time with patients because they have more administrative work to do; about half struggle to access training to improve their skills; and nearly 40% say their posts had either been downgraded or were being reviewed.

The three organisations warn that these factors mean the profession is in crisis and there are now real doubts about the future of DSNs. This, they say, could seriously impact the quality of diabetes healthcare and they are calling on the NHS to end any recruitment freezes on DSNs.

Barbara Young, Chief Executive of Diabetes UK, said: “Diabetes specialist nurses are the lynchpins of quality diabetes care. As well as being a vital link between hospitals and community services, they train other healthcare professionals about diabetes care, give people the education they need to manage their own condition and help make sure people with diabetes get the hospital care they need.”

She added: “The NHS urgently needs to recognise the importance of DSNs and to end the recruitment freezes that are happening in far too many places. We then need to see NHS organisations take action to ensure we increase the number of them in the short term and then start planning for a future so we can meet the minimum recommended staffing levels and so help make sure people with diabetes get the quality of healthcare they need.”

Dr Peter Carter, chief executive and general secretary of the RCN, said: “The lack of investment in specialist diabetic nurses shows a worrying short-term approach to diabetes care provision by many trusts, illustrated by the news that a third of hospitals have no specific diabetes inpatient specialist nurse. This is actually a key area of health care where investing now can actually save the NHS money in the long term, while at the same time offering people with diabetes the care that they deserve. Short-term cost cutting in this area can have devastating effects.”

June James, a spokesperson for TREND-UK, described the loss or freezing of posts “when the number of people with diabetes is escalating” as “shortsighted”.

“Specialist nurses working in diabetes are clinically and cost effective in promoting self-management skills and in the reducing of avoidable hospital admissions.

“This will lead to significant gaps in direct patient care, clinical expertise and training for future generations to come,” she said.

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