Diabetes cuts threaten achievement on proposed indicator

Cuts to community diabetes services could undermine GP achievement on a proposed QOF indicator and force practices to fun costly services in-house.

Diabetes UK told GP it has ‘huge concerns’ that patients could lose access to diabetes education schemes in NHS cuts.

NICE’s QOF advisory committee recently approved an indicator for such schemes. But the committee admitted funding cuts could mean no local services exist to which GPs can refer patients.

The proposed indicator would pay GPs for sending patients with a new diagnosis of diabetes to a structured education programme, such as Desmond or Dafne.

But during pilots of the indicators, four in ten practices were forced to provide in-house diabetes education because local services were unavailable.

If the indicator is adopted by GP negotiators, it would require many practices to invest in staff training to meet strict programme standards.

A NICE report from the pilot said: ‘If practices were unable to refer to Desmond and this indicator became part of live QOF, then practices felt that their practice nurses would need particular training around diets in different cultures.’

Gavin Terry, head of healthcare policy at Diabetes UK said a number of Desmond and Dafne schemes were closing due to funding restrictions.

‘It is of huge concern that access to such schemes could be impacted by funding cuts,’ he said.

‘We know education services could be one of the first areas to be cut under the current cost saving measures and the health reform proposals.’

NICE also did not back indicators for weight management advice and waist size measurement at its meeting in London earlier this month.

It claimed there was a lack of evidence for cost effectiveness for the proposals.

But Hertfordshire GP Dr David Haslam, chair of the National Obesity Forum, rejected the decision and described the evidence base as ‘excellent’.

‘QOF should reflect the immense amount of benefit we can provide to our obese patients by identifying, engaging, screening, managing the inevitable BP, lipids and dysglycaemia we uncover, rather than obsessing whether we can induce a weight loss of 2kg,’ he said.


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