Diabetes treatment and care programme

Managing the growing incidence of diabetes in England is set to be one of the major clinical challenges of the 21st century. Estimates suggest that the number of people with diabetes is expected to rise to 4.2 million people by 2030, affecting almost 9% of the population.

The NHS Diabetes Prevention Programme is delivering a systematic approach to reducing the risk of individuals developing diabetes. However, it is equally important that the outcomes for those with diabetes are improved and unjustified variation is reduced.

The importance of improving outcomes for individuals with diabetes is reflected in the inclusion in the CCG Improvement and Assessment Framework (CCG IAF) of indicators covering:

  • Diabetes patients that have achieved all the NICE recommended treatment targets: Three (HbA1c (blood sugar), cholesterol and blood pressure) for adults and one (HbA1c) for children’
  • People with diabetes diagnosed less than a year who attend a structured education course

These have been selected because they are recognised evidence-based measures of whether patients with diabetes are being supported to successfully manage their condition.

As part of the CCG IAF, a support offer is being developed for each of the clinical priority areas within it. For diabetes, the support offer will form part of a wider treatment & care programme which will work in conjunction with regional commissioning operation teams, clinical networks and NHS Right Care to promote an integrated approach to supporting improvement in diabetes outcomes.

The final shape of the programme, together with details of resources to further support implementation, is subject to approval within NHS England, but is proposed to include:

  • The development of optimal diabetes pathways, for use by NHS RightCare, regional teams and clinical networks in working with CCGs
  • Supporting CCGs to work with GPs to increase participation in the National Diabetes Audit (which is the data source for the CCG IAF diabetes indicators)
  • Supporting CCGs to ensure that structured education attendance is accurately recorded and to increase attendance levels
  • A possible procurement process or development of a national framework to increase capacity and promote consistent quality and costs of structured education
  • Supporting CCGs to work with GPs to identify actions to promote improvement against the treatment targets and reduce variation

The National Diabetes Treatment and Care Programme transformation funding bidding process has been published. CCGs are now invited to bid for funding to support improvement in four areas: improving uptake of structured education, improving achievement of the 3 NICE recommended treatment targets, developing new or expanded multi-disciplinary footcare teams and developing new or expanded diabetic inpatient nursing services.

A summary of the nationally available data and a detailed training pack for CCGs is available on request: please email england.diabetestreatment@nhs.net.