Introduction
How common is diabetes?
At least 2.5 million people live with diabetes in the UK. 500,000 have not had their condition diagnosed. Diagnosed prevalence doubled between 1994 and 2003, and in England is forecast to rise to 5.05% of the population by 2010.
Current policy focus
Both the Department of Health White Paper Our Health, Our Care, Our Say, and the Welsh Assembly Government’s (WAG) Designed for Life strategy have built on the aims of the National Service Framework’s (NSF) for England and Wales of supported self-care and patient-focused services, emphasising that care should:
- be delivered closer to home
- provide support for self-management
- be designed around the individual
- be focused on prevention and user involvement
- ensure the wellbeing of the individual including emotional wellbeing.
The themes are common to both England and Wales. The specific themes of patient choice in access to services, and practice-based commissioning are currently on the agenda in England but not in Wales.
Aim
A key part of Diabetes UK’s influencing strategy is to work closely with Primary Care Trusts (PCT) to improve service delivery and to reduce the postcode lottery in access to care. Regional and National officers will use the information from this survey to engage and work with PCT, Local Health Boards (LHB) and diabetes networks to identify gaps in service provision and where services are going well. This survey has been carried out annually for the past five years, and allows for changes to be tracked over time.
As such, this information is useful to PCTs to monitor their own levels of service delivery. For your local PCT results, please visit Diabetes InfoBank. Where examples of shared practice have been identified, these can be viewed here. You can view a list of the PCTs that don't have relevant awareness and early identification programmes in place here.
Key findings
- PCTs must improve access to education, insulin pumps and information at diagnosis.
- The ratio of paediatric diabetic specialist nurses (PDSN) to children with diabetes continues vary widely and many do not meet the Royal College of Nursing recommendation.
- In the last year, PCTs have improved their provision of early identification programmes of Type 2 diabetes, retinal screening, podiatry care and emotional and psychological support.
Method
A paper questionnaire was sent to all diabetes leads in 152 PCTs in England and 22 LHBs in Wales in September 2008. The questions addressed Diabetes UK care priorities (early identification, education, retinal screening, emotional and psychological support and children’s services) and were informed by the wider policy context. The analysis was carried out using the Statistical Package for Social Sciences (SPSS v16) and Microsoft Excel.
Results
52% of PCTs responded (base:80) and 45% of LHBs (base:10). The results for both the PCTs and LHBs have been presented below and where possible comparisons have been made.