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Is diabetes care getting any better?

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Robin Hewings, Diabetes UK Head of Policy, looks at a new report into the delivery of adult diabetes healthcare in England, and finds that little has changed in the past three years:Robin Hewings, Diabetes UK Head of Policy, looks at a new report into the delivery of adult diabetes healthcare in England, and finds that little has changed in the past three years:

"This week’sreportfrom the Government’s spending watchdog, the National Audit Office (NAO), about the delivery of adult diabetes care on the NHS, is the latest in a long line of reports over the past five years highlighting that the NHS is failing to provide the basic recommended level of care to the millions of people living with the condition in England.

"It follows on from their investigation into poor diabetes care in 2012, then led by the Public Accounts Committee chairwoman Margaret Hodge MP. They were scathing of the way the NHS spends billions on treating complications that could have been prevented if the person had received good healthcare in the first place.

"Diabetes UK contributed data and analysis to the latest NAO report – though their conclusions are very much their own. They found that while there have been some improvements, such as the reduction in the numbers of people with diabetes dying early and developing some complications, there has been very little overall improvement in the last three years.

"In particular, the numbers of people with Type 1 and Type 2 diabetes getting the eight NICE recommended checks has remained static at around 60 per cent, despite the fact that these checks can spot and identify problems early enough to do something about them. Only a third of people with diabetes are meeting the recommended treatment targets for blood pressure, blood glucose and cholesterol. This is putting people at higher risk of diabetes complications.

"Diabetes care is still a postcode lottery. For example, the percentage of people with diabetes receiving the eight NICE recommended checks across different geographical areas, ranged from 30 per cent to 76 per cent in 2012-13.

"Another worrying example of poor care highlighted in the report is that younger people or working age, living 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 massive concern as it means they are at greater risk of complications later in life.

"So what needs to be done?

"The NAO recommends that NHS England should set out how it intends to hold local health leaders to account for poor performance. This is a good start.

"But what the NHS needs is to get radically better at supporting people to manage their own condition. Few areas have a serious plan to ensure everyone receives an education course about how to manage their diabetes. As the report notes, at the moment just 16 per cent of people newly diagnosed with diabetes are offered access to a formal course covering how to effectively manage their condition.

"More and more people are living with diabetes. And if we continue like we are the costs of treating the complications of diabetes will become overwhelming. That means we need to take radical action to prevent Type 2 diabetes. But with over three million people already living with all types of diabetes, healthcare needs to get much better at enabling people to manage their diabetes day to day.

"The NAO’s report shows the need for more accountability to raise standards. We need the leaders of the health system to turn this into reality. Diabetes UK is working ever more closely with the NHS and the government to help them achieve this so that everyone living with diabetes has the best possible chance of living a long and healthy life."

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