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 has made around £150 million of transformation funding available to support projects from individual 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.
The six principles of good peer support for people living with Type 1 diabetes
Peer support, or people drawing on shared experiences to help each other with knowledge, information and support, is a simple but powerful approach to health and wellbeing. Its value has long been recognised by people and carers, as well as by clinicians. It is particularly valuable for those with long term conditions such as Type 1 diabetes, as those newly diagnosed can learn from the experiences of others in gaining knowledge skills and confidence, which they often find value in passing on in their turn. The document ‘six principles of good peer support for people living with Type 1 diabetes‘ seeks to set out “what good looks like” for peer support – or what people should expect from a well-functioning group, with a specific focus on Type 1 diabetes.
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 disordered eating (T1DE)
We are working to improve care for people with type 1 diabetes-related disordered eating (known to health care professionals as T1DE and sometimes referred to as diabulimia) by supporting the expansion of the service in 2022/23 with two-years of funding for 5 additional T1DE sites across England. The first pilots were launched in 2019 and there is now a T1DE site in each NHS region of England and a total of 8 sites, delivered by local clinical experts and contributing towards more equitable provision across the country. The new sites are expected to commence delivery in early 2023.
In parallel to the delivery, NHS England is progressing with work to commission an independent in-depth evaluation of the existing and newly-launched T1DE services, to inform the approach and provide insight on the impact these services can have in supporting people living with type 1 diabetes-related disordered eating. The progress, achievements and challenges of the service will continue to be closely monitored by NHS England’s regional diabetes teams.
If you have any queries about the diabetes treatment and care workstream, please email firstname.lastname@example.org.