The NHS is not recruiting enough diabetes specialist nurses (DSNs) to keep pace with the growing number of people diagnosed with diabetes, according to a new analysis published today by Diabetes UK, the Royal College of Nursing (RCN) and TREND-UK.
The analysis, calledDiabetes Specialist Nurses: Improving Patient Outcomes and Reducing Costs, sets out the strong evidence that DSNs are vital for good patient care and can also save the NHS money because they help reduce the length of time people with diabetes stay in hospital.
In the long term, they also support people with diabetes to help reduce their risk of health complications that are both personally devastating and which account for 80 per cent 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 per cent 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 per cent say their posts had either been downgraded or were being reviewed.
"Serious impact" on quality of healthcare
Put together, these factors mean the profession is in crisis and there are now real doubts about the future of DSNs. The three organisations have warned this could have a serious impact the quality of diabetes healthcare and they are calling on the NHS to make DSNs an integral part of their future plans to ensure the number of them increases along with the rise in people with diabetes. They also want 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.
“Ultimately, their work helps to shorten hospital stays and prevent devastating diabetes-related complications so whether you are looking at this from the point of view of people’s health or the NHS’s finances, the stagnating DSN staffing levels is deeply worrying.
"When you combine this with the figures showing half of all DSNs expecting to retire within 10 years there is a real fear of a black hole opening up in diabetes care. Unless the number of DSNs starts to rise along with the rising number of people with diabetes, their work will be spread increasingly thinly and this will have a serious impact. Together with the gradual erosion of their professional status, this will mean they will not be able to offer a good standard of care to all their patients.
"Urgent need to end recruitment freezes"
“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: “Diabetes continues to have an increasingly devastating effect on both the nation’s health and the budget of the NHS, and shows no sign of slowing down its grip on public health. That is why it is vital that we address this dramatic shortage in specialist nurses who help support the 3.2 million people in the UK living with the condition.
"Worrying short-term approach"
“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.
“Nursing staff have a pivotal role when caring for people living with diabetes and provide essential support to enable them to manage their condition and avoid complications. We need to act now to ensure this care improves across the UK.”
June James, a spokesperson for TREND-UK, said: “Specialist nurses working in diabetes are clinically and cost effective in promoting self- management skills and in the reducing of avoidable hospital admissions.
"Shortsighted" freezing of posts
“The loss or freezing of posts when the numbers of people with diabetes is escalating is shortsighted; this will lead to significant gaps in direct patient care, clinical expertise and training for future generations to come.”
As well as calling for an increase in DSN numbers, the three organisations want the NHS to adopt a consistent job title for DSNs, as at the moment there is no one unified definition of a DSN. Because of this, DSNs often do not have the same professional status as other types of specialist nurses.