CCGs under fire over missed diabetes targets

CCGs are facing criticism over diabetes care after a national audit found just one in five diabetes patients receive all required annual checks in parts of England, but GP leaders have questioned the findings.

Diabetes patients are missing out on checks such as foot examinations, the report said (Photo: iStock)
Diabetes patients are missing out on checks such as foot examinations, the report said (Photo: iStock)

Just 38.8% of diabetes patients achieved a BP of 140/80 mmHg, or 130/80 mmHg with comorbidities, figures from the National Diabetes Audit 2011/12 show. Poorly controlled BP raises the risk of patients with diabetes developing MI, heart failure or stroke.

Although there was an improvement on the previous year, when 36.2% of patients reached this goal, CCGs were told the figures show 'how much scope there is' to reduce complications achieving the targets.

A charity said some CCGs' poor performance in providing the full range of annual diabetes checks should be a 'wake-up call'. It urged commissioners to act now to improve provision of checks at GP surgeries.

But GPC deputy chairman Dr Richard Vautrey said the audit was a 'blunt tool' and that QOF figures showed the number of checks performed by GP practices was 'extremely high'.

The audit examined the care of almost 2.5m people with diabetes in 2011/12 and included data from 88% of GP practices.

It found that 56.8% of people with type 1 diabetes and 37.4% of those with type 2 disease did not receive all diabetes checks in 2011/12.

Only a third, 34%, of young people received all the checks, which include BP, BMI, cholesterol and serum creatinine.

But the report found large differences in provision of the checks between CCGs, ranging from under 20% in one area to over 75% in another.

Barbara Young, chief executive of Diabetes UK, said the variation was 'concerning'. 'If the NHS in one area can achieve this then why can’t it do so in others?'

She said too few people with diabetes were attending education courses to help them manage the condition. 'We hope that in areas where not enough people with diabetes are getting the checks they need or are successfully managing their condition, it acts as a wake-up call for CCGs to make diabetes a top priority and to put in place an action plan to improve the situation.'

Dr Bob Young, clinical lead for the audit, said: 'Today’s audit shows how much scope there is for reducing heart disease and stroke in people with diabetes by achieving the BP treatment target more often.'

In 2012, a DH review investigated differences between the uptake of QOF targets for the care checks and the findings of a previous National Diabetes Audit.

Dr Vautrey said: 'When it was looked at, the differences between the audit and QOF results were down to data recording rather than whether the necessary checks for diabetes are being done.'

He said the national audit uses different codes and reporting arrangements to QOF. 'Uptake in QOF is extremely high and the achievement in results represents that. I think the audit is a much more blunt tool.'

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