Diabetes UK: NHS has sleepwalked into unacceptably poor diabetes care – the time for action is now
by Barbara Young, Chief Executive, Diabetes UK
When you consider that there are now 3.7 million people with diabetes in the UK and that another 700,000 people are expected to be added to this total by the end of the decade, it is self-evident that, for the good of the nation’s health, we need to deliver excellent diabetes care.
But today’s report by the Public Accounts Committee (PAC) into adult diabetes services in England shows that not only are we failing to deliver excellence, but that that NHS care for people with the condition is failing badly. It is so poor that thousands of people a year are developing entirely preventable diabetes-related complications, including amputation and blindness, and dying before their time.
The report show how a postcode lottery of care has been allowed to develop that means in some parts of the country the number of people getting the nine checks and services recommended by the National Institute for Clinical Excellence is shamefully low.
This is completely unacceptable as these basic checks and services are vital in highlighting potential complications early enough to do something about them.
This is a tragedy for those people and their families but it is also a waste of public money. The NHS spends around £10 billion a year on diabetes – that’s 10 per cent of its entire budget – and 80 per cent of this goes on managing diabetes complications, many of which could be prevented by delivering the right care in the first place.
This tragically short-termist approach of treating complications rather than preventing them, combined with the growing number of people with the condition, means diabetes threatens to bankrupt our health service in addition to its terrible human cost.
We simply cannot understand why the NHS has sleepwalked into this situation. Certainly, there is nothing controversial about how to deliver the quality healthcare that is desperately needed. In fact, a National Service Framework that sets out what good care looks like has been in place for over a decade but has never been implemented.
The time for action is now. We hope this new report spurs the Government and the NHS into finally giving diabetes the priority it deserves. Firstly, we need to focus on prevention of Type 2 diabetes, which is why we are pleased the PAC report calls for the kind of public health campaign that has already proved effective for other conditions. We also need to get better at diagnosing diabetes because the sooner someone is diagnosed, the better their chances of living a long and healthy life.
At the moment half of the people with Type 2 diabetes already have serious complications by the time they are diagnosed. The NHS Health Check is fundamental to early diagnosis but less than half of those who should have been screened have.
Then as soon as they are diagnosed people with diabetes should get the tailored education that gives them the tools they need to manage their condition. We also need to ensure they get every year the 15 Healthcare Essentials that set out what care they should be getting to help prevent complications. Lastly, the NHS needs to deliver diabetes healthcare in a way which is properly integrated and underpinned by the kind of networks that have been so successful in improving cancer care.
Everyone agrees that this is the way to improve the situation. We just need for the Government to prioritise and monitor this happening, for the NHS to make it a priority to deliver and for action to be taken where services don’t meet the standards. The consequences of failing to do so are barely imaginable.
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