diabetesJFHC Editor Penny Hosie went along to Parliament to attend the launch of Diabetes UK’s State of the Nation report and found that good diabetes care is variable and costing lives.

Imagine you’re young, active and are just starting to enjoy your career – in effect, you have your whole life ahead of you. Then one day you wake up and just can’t see.

This was the dramatic experience of one of several young women I met while attending the launch of
Diabetes UK’s State of the Nation report last month. Diabetes was an illness that suddenly happened, out of the blue – but for all of these women it was a diagnosis that changed their lives forever.

All of them explained that although the care they’d received from diabetes specialists was exemplary, this wasn’t translated to the care they received from some other health professionals in the community. In fact one nurse openly admitted to one of the women that this was because she didn’t know enough about the illness.

Imagine how you would feel if you were a child or young person who was diagnosed for the first time?

State of the Nation highlights poor care

According to Barbara Young, Chief Executive of Diabetes UK, part of the problem is that few people are offered or attend diabetes education, have personalised care plans, or have access to emotional support and specialist psychological care.

It is clear this has to change because the poor state of diabetes healthcare in England is leading to avoidable deaths, record rates of complications and huge costs to the NHS.

The charity’s annual State of the Nation report highlights there has been very little overall improvement in diabetes healthcare in the past year, with 40 per cent of people with diabetes still not getting the National Institute for Health and Care Excellence recommended checks that they need to manage their condition. Some aspects of care have got worse, such as the numbers of people with Type 1 diabetes receiving their annual checks, which has reduced from 43 to 41 per cent.

This is despite the fact that spending on diabetes accounts for about 10 per cent of the entire NHS budget. But Diabetes UK has warned that the vast majority – about 80 per cent – of this money is being spent on treating complications and not enough being invested on the good healthcare that could prevent them.

Why does this matter? In the UK there are around 3.8 million people who have diabetes. There are 3.2 million people living with Type 1 and Type 2 diabetes, and around 630,000 more who have Type 2 diabetes but don’t know they have it because they haven’t been diagnosed. As many as 11.5 million people are at high risk of developing Type 2 diabetes and if current trends continue, an estimated 5 million people will have diabetes by 2025.

Examples of poor care highlighted in the report include:

● Treatment targets for blood pressure, blood glucose and cholesterol are only being met for a third of people with diabetes. Across the country nowhere is meeting all three targets well – the average is 36 per cent and the best is 48 per cent.

● People with Type 1 diabetes are receiving considerably worse routine care than other people with diabetes and are less likely to have their condition under control, with just 41 per cent receiving eight of the annual checks recommended by the National Institute for Health and Care Excellence, and 16 per cent meeting the three recommended treatment targets.

● Children and young people with diabetes are even less likely to receive routine care and have their condition under control. In 2012-13, only 12 per cent of young people aged between 12 and 19 had all their annual care checks. One in four had worryingly high blood glucose levels.

● Working age people are less likely to receive recommended care and meet treatment targets than older people. For example, in the under 40s, only 29 per cent of people with Type 1 diabetes and 46 per cent with Type 2 diabetes received their eight annual check

The report also highlights how preventing Type 2 diabetes needs to be a greater priority to help reduce the burden of the condition on NHS resources in the future (a point emphasised by Health Secretary Jeremy
Hunt at the event).

Young stated: ‘This is not a question of spending more money. In fact, better ongoing standards of care will save money and reduce pressure on NHS resources.’

In a rallying call Young advised everyone attending who works in primary care to copy examples of good practice throughout the country, saying ‘Go out and plagiarise good care!’

She added: ‘It’s about people getting the checks they need at their GP surgery and giving people the support and education they need to be able to manage their own condition. Doing this, together with improving diabetes care in hospital, would give people with diabetes a better chance of a long and healthy life, and save the NHS a significant amount of money. We want to work with local authorities to be able to help them put good practice into place.’

Despite the negative thrust of the report Young believes that with the right levels of care it is not too late to reverse the rise of Type 2 diabetes. This positivity was highlighted by her as she welcomed the recent announcement from NHS England of a national Type 2 diabetes prevention programme in England, which will be launched in partnership with the charity.

The report calls for clinical commissioning group (CCGs) to set themselves performance improvement targets and implement diabetes action plans. The charity is also urging CCGs to ensure all people with diabetes have access to the support they need to manage their condition effectively, and that the local health system is designed to deliver this.

Following the launch Prime Minister David Cameron responded to questions posed by Adrian Sanders MP, Chair of the All Party Parliamentary Group for Diabetes during Prime Minister’s QT. In his reply Cameron promised to look over the report, saying: ‘I will certainly look at this report, because of all the health care conditions diabetes is one of the ones where, if we act on it fast, we could have a huge knock-on effect on the NHS.

‘If we look at the costs of things such as amputations and other treatments because people are getting diabetes, we see that we could make an enormous impact. The hon. Gentleman raises the issue of people being able to self-regulate. An enormous amount of exciting new technology is coming forward on diabetes, and I want to make sure that that technology is rapidly adopted by the NHS.’