Diabetes healthcare in England has drifted into a "state of crisis" where less than half of people with the condition are getting the basic minimum care they need, a new report has warned.
According to the State of the Nation 2012 report, published today by Diabetes UK, there are some areas where just six per cent of people with diabetes are getting the regular checks and services recommended by the National Institute of Health and Clinical Excellence (NICE).
Rise in rates of complications
The report details how the large number of people not getting these checks has helped fuel a rise in rates of diabetes-related complications such as amputation, blindness, kidney failure and stroke, all of which dramatically reduce quality of life and can lead to early death. These complications account for about 80 per cent of NHS spending on diabetes and are one of the main reasons that treating diabetes costs about 10 per cent of the entire NHS budget.
National Service Framework
The report also highlights how a National Service Framework for diabetes – which sets out the healthcare people with the condition should be getting – has been in place for 11 years, but has yet to become a reality.
According to the report, the Government urgently needs to deliver a plan to implement these standards; to introduce more effective risk assessment and early diagnosis so people can either avoid Type 2 diabetes or get the healthcare they need to manage the condition and avoid complications; and for all people diagnosed with diabetes to have access to education to support them in self managing their condition to prevent complications.
As well as the large number of people not getting the checks they need to manage their diabetes, the report offers a comprehensive overview of diabetes healthcare in England. It revealed that, from diagnosis through to managing the complications of the condition, the approach to diabetes is in need of wholesale change.
The issues highlighted in the report include:
- A quarter of children and young people with Type 1 diabetes are only diagnosed when they already need emergency treatment
- There are some areas where just half of people with diabetes are thought to have been diagnosed
- Just 49.8 per cent of people with diabetes are getting the nine basic health checks and services recommended by NICE; this figure ranges from six per cent in the worst-performing areas to 69 per cent in the best-performing areas
- 40 per cent of people with the condition are not meeting their blood glucose targets
- The situation is even worse for children and young people with diabetes: just four per cent get all their annual checks, while 85 per cent are not meeting their blood glucose targets.
Barbara Young, Chief Executive of Diabetes UK, said, "We already know that diabetes in costing the NHS a colossal amount of money, but this report shows how in exchange for this investment we are getting second-rate healthcare that is putting people with diabetes at increased risk of tragic complications and early death.
"Whether showing the number of children with Type 1 diabetes who are only diagnosed at accident and emergency, or highlighting the thousands of preventable diabetes-related amputations performed every year, the report shows that diabetes healthcare has drifted into a state of crisis.
"Compelling case for change"
"It is a compelling case for change. Above all, the wide variation in standards of care shows the need for a national plan to be put in place for giving people with diabetes the kind of healthcare that can help prevent complications, as well as a greater focus on preventing Type 2 diabetes.
"This does not necessarily require more money, as we know that about 80 per cent of NHS spending on diabetes is going on preventable complications. By taking the longer-term approach of investing in making sure people get the basic checks and services, we could save money by reducing the number of complications and make life immeasurably better for people with diabetes.
"This kind of approach is the only way to prevent what is a looming national health disaster. With the number of people with diabetes rising so rapidly, unless urgent action is taken now, this rising tide threatens to sink the NHS."