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NHS missing chances to improve diabetes care and save money as well as lives

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The NHS is failing to learn from clear evidence that interventions to improve diabetes care can save the NHS money as well as give people with diabetes longer and healthier lives, according to a new Diabetes UK report that highlights a series of measures that improve care and reduce costs.

The new report shows that while the NHS is spending £10 billion per year on diabetes care, this money is too often being used ineffectively, with the vast majority spent on treating complications that could often have been prevented if the person had received good healthcare in the first place.

In a period of tight financial restraints in the NHS, the report, based on conclusive research based evidence,  outlines measures that Trust and commissioners can implement that have been shown to improve the quality of care for people with diabetes and reduce costs.Examples include:•    Education can help people with diabetes effectively manage the condition and so reduce their risk of costly and debilitating complications. But just one in 10 of those newly diagnosed are offered education. This is despite the fact that over a 10-year period, one structured education programme saved an estimated £2,200 per patient.

•    People with diabetes are at risk of developing serious problems with their feet that lead to amputation if not managed properly. The NHS is estimated to spend over £600 million on foot care for people with diabetes. Trusts that have introduced multidisciplinary foot care teams have reduced amputations by over half and can save over four times their cost.•    One in every seven hospital beds is occupied by someone with diabetes.  Hospital in-patient care for people diabetes is all too-often poor and is contributing hugely to costs to the NHS. People with diabetes have a longer length of stay in hospital on average by three days and regularly experience medical errors, especially medication errors, and avoidable deterioration in their condition. Hospitals with specialist teams have been shown to reduce complications and make financial savings.

"The NHS is spending an eye-watering amount on diabetes"

The charity says that while it can be difficult to invest in one part of the health service if the resulting savings are in another part, some of the interventions highlighted in the report have been shown to make savings quickly and in the same organisation.Where the savings occur in different parts of the healthcare system to the one the investment is made in, this underlines the need for more pooling of budgets across primary, community and secondary care and more joint work between commissioners and providers.

With the number of people with diabetes projected to rise to 5 million by 2025, Diabetes UK says that the NHS needs to get better at learning from evidence-based demonstrations of good diabetes care and is calling on Trust and commissioners to implement the measures highlighted in the report.

Barbara Young, Diabetes UK Chief Executive, said: “The NHS is spending an eye-watering amount on diabetes but the money isn’t being used effectively, which is running up a huge bill for the future.

"Too often the focus is on cost cutting"

“This report shows how dealing with problems early, such as by improved inpatient care and effective care planning, costs could be greatly reduced and more people would live longer and healthier lives.

“Too often, the focus is on cutting costs in the short-term such as by cutting diabetes specialist nurses, restricting access to blood glucose test strips and poorly planned transferrals to primary care. But this is making it difficult for those with diabetes to manage the condition and is offering poor value for money for taxpayers.”

"The NHS needs to implement the measures highlighted in the report"

“With the NHS operating in a period of flat budgets and with the number of people with diabetes rapidly increasing, it is really important that Trusts and commissioners implement these changes because the current approach is unsustainable and is having a significant impact on NHS resources.  One of the benefits of a national system for health ought to be fast and universal adoption of good practice but the NHS is failing to capitalise on this in the case of diabetes care."

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