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Government watchdog finds little improvement in the delivery of adult diabetes care

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A report by a government watchdog on diabetes healthcare for adults in England has found that there has been very little improvement in diabetes healthcare in the past three years. It has also warned that 22,000 people with diabetes are dying early each year from diabetes-related complications that potentially could have been avoided.

The report by the National Audit Office (NAO), published today (Wednesday 21 October), follows on from a heavily critical report they published in 2012. The 2012 report found that despite the NHS spending millions on diabetes each year, this money is often used ineffectively with the vast majority being spent on treating complications that often could have been prevented.

Today’s report finds progress has been made in reducing the risk of death for people with diabetes and the risk of some complications but that there has been no improvement in the number of people with diabetes getting the annual checks recommended by NICE (National Institute for Health and Care Excellence) and achieving recommended treatment targets, which can help reduce risk of complications and early death.

For example, in 2012-2013, 40 per cent of people with diabetes didn’t get the eight recommended checks, and treatment targets for blood glucose, blood pressure and cholesterol levels were only being met by a third of people with the condition and these figures have remained static over the last three years. Other examples of poor care highlighted in the report include:

  • Very few people newly diagnosed with diabetes are receiving education that could help them to manage their condition and reduce the risk of developing complications.
  • The delivery of diabetes healthcare is still marked by significant variation with the percentage of people with diabetes receiving the eight recommended care processes ranging between 30 per cent and 76 per cent across different geographical areas.
  • Young people with Type 1 and Type 2 diabetes are receiving considerably worse routine care than other people with diabetes, and are less likely to have their condition under control. This is a huge concern as it means they are at greater risk of complications later in life.

To improve the delivery of diabetes care, the report recommends that the NHS sets out how it intends to hold clinical commissioning groups, who are responsible for organising local NHS services, to account for poor performance in delivering the key checks and the three treatment targets.

Chris Askew, Diabetes UK’s Chief Executive, said: “We welcome the spotlight the National Audit Office has again put on the need to improve diabetes healthcare. While there have been some improvements in the delivery of diabetes healthcare over the past three years, the NHS is still failing to provide a large number of people with diabetes with the basic recommended level of care that is critical to their health.

“This has serious implications as people who are not getting their annual checks and are not being supported to reach their treatment targets are, as a result, put at increased risk of developing serious diabetes-related complications, such as amputation, heart disease, kidney failure and stroke. These complications have a devastating impact on people’s lives and are also fuelling the 22,000 early deaths we are seeing in people with diabetes each year.

“Beyond the human suffering, these complications are extremely costly to the health service. The NHS spends 10 per cent of its entire budget managing diabetes, and unless we get better at supporting people with diabetes to stay healthy, by providing quality care across the board, this figure will rise to unsustainable levels, placing an even more immense burden on our health service.

“This report must act as a wake-up call to the NHS and the government to take action. With the NHS facing a huge funding shortfall and the number of people with Type 2 diabetes rapidly increasing, and in turn the number of diabetes-related complications rising, the NHS and the government must commit to improving diabetes healthcare as a priority now.”

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