Diabetes treatment and care
Managing the growing incidence of diabetes in England is set to be one of the major clinical challenges of the 21st century. Currently over three million people are living with diabetes in England and estimates suggest that that number is expected to rise to 4.2 million people by 2030, affecting almost 9% of the population. It is also estimated that around five million people in England are at high risk of developing type 2 diabetes.
The NHS Long Term Plan set out a range of actions that the NHS is taking to reduce variation in access to services and patient outcomes, improve quality of treatment and outcomes for people living with type 1 or type 2 diabetes.
Since 2017/18, NHS England and NHS Improvement has made around £150 million of transformation funding available to support projects from individual Clinical Commissioning Groups (CCGs), CCG collaborations and Integrated Care Systems (ICSs) to reduce variation in access to services and improve outcomes for people living with diabetes, focussing on four evidence-based intervention areas:
- Ensuring patients have access to specialist multidisciplinary footcare teams with an aim of reducing amputations
- Ensuring patients have access to diabetes inpatient specialist nursing teams in hospitals to improve the quality of their care
- Reducing variation in the achievement of the three NICE recommended treatment targets (HbA1c (blood sugar), cholesterol and blood pressure) for adults and one treatment target (HbA1c) for children
- Expanding provision of structured education (including digital options) to better support patient self-management.
From 2020/21, in line with the transition to the new operating model for the NHS and to best support system-led prioritisation, funding is now allocated to ICSs with funding amounts reflecting the proportion of the population in each area diagnosed with diabetes.
Funding is used in each ICS based on regionally assured strategic plans which set out how the funding can be used for these four priorities to best meet need and improve outcomes, and address inequalities in each system.
NHS Low Calorie Diet Programme
The NHS Long Term Plan made a commitment to test an NHS programme supporting low calorie diets for people living with obesity and type 2 diabetes. The NHS Low Calorie Diet Programme is undertaking a number of pilots to test at scale approaches that have been shown to put type 2 diabetes in remission in those recently diagnosed with the condition.
NHS Diabetes Weight Management Service
The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes or hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme. People can access it via a smartphone or computer with internet access.
Type 1 Diabetes and Eating Disorders (sometimes referred to as diabulimia)
We are working to improve care for those with type 1 diabetes and eating disorders (sometimes referred to as diabulimia) by supporting two pilots to test, trial and evaluate the effects of integrated diabetes and mental health pathways for the identification, assessment and treatment of diabulimia. One pilot is in London and the other on the South Coast.
NHS England and NHS Improvement has commissioned an in-depth evaluation to assess the impact of these pilot services. The progress, achievements and challenges of these pilot sites will be gathered and closely monitored by NHS England and NHS Improvement’s regional diabetes teams to provide insight into the impact these services can have in supporting people living with type 1 diabetes.
If you have any queries about the diabetes treatment and care workstream, please email firstname.lastname@example.org.