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Much of NHS £10bn diabetes spend ‘wasted’

Most waste is on treating complications that good care could have prevented

Louise Prime

Wednesday, 07 May 2014

The NHS is wasting an ‘eye-watering’ amount of money on treating diabetes complications that could have been avoided, Diabetes UK has warned. It said that attempts to save money in the short term are leading to increased spend in the long term, as well as having a ‘devastating’ impact on the lives of people with diabetes.

The charity claims in its latest report The cost of diabetes that the ‘vast majority’ of the £10bn that NHS spends each year on diabetes care is being used ineffectively because it is being spent on treating complications that good healthcare could often have prevented. It gives examples of ‘arbitrary’ limits on prescription glucose testing strips leading to potentially fatal diabetic ketoacidosis and hypoglycaemia, and to long-term complications; and of people with foot ulcers not being referred to specialist teams – then their ulcer deteriorates so badly that they need an amputation.

Diabetes UK’s chief executive Barbara Young said: “The NHS is spending an eye-watering amount on diabetes but the money isn’t being used effectively, which is running up a huge bill for the future …

“Too often, the focus is on cutting costs in the short-term such as by cutting diabetes specialist nurses, restricting access to blood glucose test strips and poorly planned transferrals to primary care. But this is making it difficult for those with diabetes to manage the condition and is offering poor value for money for taxpayers.”

Diabetes UK suggests that the NHS implements a series of measures that it says would reduce costs as well as allowing people with diabetes to live longer and healthier lives. It points out that:

  • Just one in 10 people newly diagnosed with diabetes are offered education – yet one structured education programme saves an estimated £2200 per patient over a decade, by helping them effectively manage their condition and so reduce their risk of costly and debilitating complications.
  • The NHS is estimated to spend over £600m on foot care for people with diabetes. Trusts that have introduced multidisciplinary foot care teams have reduced amputations by over half and can save over four times their cost.
  • People with diabetes have a 3-day longer stay in hospital, on average, and regularly experience medical errors, especially medication errors, and avoidable deterioration in their condition. Hospitals with specialist teams have been shown to reduce complications and make financial savings.

Diabetes UK is also calling for more pooling of budgets across primary, secondary and community care – and more joint work between commissioners and providers – because the costs of investment in one area often leads to savings in another.

Barbara Young said: “With the NHS operating in a period of flat budgets and with the number of people with diabetes rapidly increasing, it is really important that Trusts and commissioners implement these changes because the current approach is unsustainable and is having a significant impact on NHS resources. One of the benefits of a national system for health ought to be fast and universal adoption of good practice but the NHS is failing to capitalise on this in the case of diabetes care.”

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