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NHS England vision for tackling diabetes in 2014
NHS England has set out a vision for how it wants the growing problem of diabetes to be tackled in 2014.
The new plan, Action for Diabetes, outlines how it would like to see better prevention of Type 2 diabetes, earlier diagnosis of all diabetes, and support for people to manage their diabetes better and improve their quality of life.
It shows how NHS England is rising to the challenge of an increasing population with long-term conditions – in particular the growing issue of diabetes, which is linked to an excess 22,000 deaths a year and sees 100 people a week lose a limb.
Professor Jonathan Valabhji, national clinical director for obesity and diabetes at NHS England, said: “Diabetes is a growing problem and is a good example of why we need new thinking about how to provide integrated services in the NHS in the future.
“We are seeing huge increases in type 2 diabetes because of the rising rates of obesity, and we clearly need a concerted effort on the prevention, early diagnosis and management of the disease to slow its significant impact not only on individual lives but also on the NHS.
“Type 1 diabetes on the other hand is not related to obesity or other life style issues. We meet fewer targets for patients with Type 1 diabetes than Type 2 so there is clearly more work to do to meet the specific needs of those with Type 1 diabetes, particularly where those needs differ from those of people with Type 2.
“There is more to do on the individual management of both Type 1 and Type 2 diabetes patients in the community, on hospital care, on services being integrated around patient needs and wants, and, underlying all of that, care being safe.
“The UK was recently shown to have the lowest rates of early death due to diabetes out of 19 comparable countries, however, there is much more we can do to reduce the numbers of people getting Type 2 diabetes and to improve the care that all people with diabetes receive.
“In the future, we want to see fewer people developing Type 2 diabetes, and we want to see all people with diabetes having the support to manage their condition, with access to specialist care when they need it.”
Action for Diabetes sets out the breadth of activity NHS England is undertaking as a direct commissioner of GP and other primary care services and as a support to secondary and community care commissioners to enable these improvements in outcomes for all people with and at risk of diabetes to be seen.
For people with diabetes, if their condition is not diagnosed early and managed properly they can potentially suffer life-limiting and even life-threatening complications like blindness, kidney disease, foot disease, heart disease, and stroke.
The vision pledges that NHS England will continue to work with Public Health England on the roll out of NHS Health Checks, a programme aiming to prevent and diagnose thousands of cases of Type 2 diabetes each year.
It also details how GPs will be helped to provide good care and best practice, and outlines resources available to commissioners of hospital-based care to improve treatment for people with diabetes.
The report is for Clinical Commissioning Groups and the wider community interested in diabetes care to see what action NHS England is taking in this important area to improve care for people with and at risk of diabetes.
It makes some further key points:
- NHS England’s work to improve diabetes care will be based on the ‘House of Care’ model of integrated services around the needs of the individual, as part of a wider long-term conditions management programme.
- NHS England has tasked NHS Improving Quality to work with primary care services to trial and roll out new tools to help ensure earlier diagnosis across a range of conditions including Type 2 diabetes, to work on projects to reduce the high death rates associated with diabetic foot disease whether it be due to Type 1 or Type 2 diabetes, and on the transition of young people to adult services.
- NHS England recently published an additional 40 general practice level indicators on the NHS Choices website, of which eight are directly related to diabetes care, in a new accountability area designed to provide information to people who want to get involved in conversations about their local health services.
Professor Valabhji added: “New thinking about how to provide integrated services in the future is needed in order to give individuals the care and support they require in the most efficient and appropriate care settings, across primary, community, secondary, mental health and social care, and in a safe timescale. Action for Diabetes shows the direction of travel NHS England is taking to support these improvements in outcomes, and we will continue to work hard to ensure improved care and outcomes for all people with long-term conditions, including diabetes.”
NHS Scotland has an initiative – My Diabetes, My Way, which encourages individuals to actively manage and take control of their diabetes by giving access to all of their monitoring information. Is this something NHS England are considering?
I’m looking forward to seeing a decline or an interruption in the slope of Diabetes prevalence world wide.This is achievable.
I strongly believe that we need to target the untold millions that are still untold.
We need to reach out more to the un-reached. Free blood test and advice in town centres, places of worship, neighbourhoods and schools. Diabetes day would create national awareness.
I found this posting very interesting as we, in North Africa and specially in Tunisia, are doing workshops and meetings to find out better solutions for the improvement of health status and specifically diabetes prevention and outcome. One of the most ideas that was approved here by healthcare providers and also authorities is to launch “houses of healthcare”. We are still in the beginning of the project, and obviously we need the UK experience in such field.
Dr Ines Slim
Professor assistant in Diabetes and Endocrinology, Farhat Hached University Hospital, Sousse, Tunisia
An important and welcome document, thank you. I look forward to helping make the vision a reality.
Disappointed that the plan seems to be all about symptoms management and very little – and very vague – about prevention and root causes. NHS England needs to look urgently at public health advice on ‘healthy eating’ – advice to base meals on starchy carbohydrates is a disaster for people with poor blood sugar control and pre diabetes let alone those with T2 diabetes. Sweden has now changed its advice to low carb high fat diet for T2 diabetes based on evidence from 16,000 papers. How about it NHS England?