Service planning

Key differences across the UK nations

In Scotland, responsibility for local health service provision lies with regional NHS boards. The Scottish Diabetes Framework describes local planning arrangements. These include:

  • the identification of local clinical leaders to champion integrated diabetes services.
  • the appointment of local ‘diabetes co-ordinators’ to improve communications among local diabetes stakeholders, especially between primary and secondary care.
  • the retention (or creation) of local diabetes service advisory groups with a stronger role in driving change in diabetes services at regional level;
    the establishment of managed clinical networks in all regions by September 2004.

In England, responsibility for local health service provision lies with primary care trusts (PCTs). The National Service Framework for Diabetes: Delivery Strategy recommends an integrated approach to local planning. This includes:

  • a focus on the development of diabetes managed clinical networks;
    reshaping and strengthening the role of advisory groups as the link between the networks and PCTs, with accountability for decision-making;
    the appointment of a clinical champion, a diabetes champion and a network manager in each PCT;.
  • the identification of a small number of rapid learning sites to promote best practice in network development.

In Wales, responsibility for local health service provision lies with local health boards, which have the same boundaries as local authorities. The National Service Framework for Diabetes in Wales Delivery Strategy recommends an integrated approach to local planning, drawing on the Welsh national health strategy Improving Health in Wales. This includes:

  • developing local diabetes service advisory groups as the mechanism for NSF implementation, or setting up new multi-stakeholder groups  where LDSAGs do not currently exist.
  • the creation of a separate user reference group of people with diabetes for each LDSAG.

In Northern Ireland, responsibility for local health services and local social services lies with health and social care boards.