The report reviews recent NHS reforms, and the manner in which they have been implemented, suggesting that they have been dominated by addressing acute conditions, rather than the growing epidemic of chronic disease.
The MODEL group argues that while diabetes care must be efficient and cost-effective with the projected increase in numbers of people with the disease (diabetes population to increase by 200,000 up to 2.5 million by 2010) society must invest properly in keeping people with diabetes well and preventing the costly complications associated with the disease.
Prof Matthews: "We've seen many policy initiatives but they're not translating quickly enough into the significant improvements on the ground that patients need. All too often local examples of excellence are due to individual entrepreneurship rather than 'designed in' excellence, and are put at risk due to short term budgetary constraints, local conflicting priorities."
"Recent targets and initiatives have brought about improvements, but they're just the beginning. A job done, tick-box attitude won't solve the diabetes crisis."
"An excellent response to the challenge of diabetes needs an approach of investment for long term returns rather than short term rationing. Among professionals we need collaboration and not a competition culture; seamless care, delivered by appropriate expertise, allowing patients to move between different members of a diabetes team. All too often patients experience boundaries rather than free movement.
In 2001 the National Service Framework for Diabetes set out 12 standards for diabetes care to be reached by 2013. These included ensuring that patients can effectively manage their disease and that they receive the support necessary to optimize their blood glucose control. However, the Healthcare Commission has recently found that only 11% of people with diabetes in England have been on an education course and in 2005/6 only 61.8% of patients achieved the target level for blood glucose (an increase of 3% over 2004/5). Compared with the strong progress in tackling cancer in the UK the patient experience of diabetes has not been similarly transformed.
Dr Clare Davison: "Diabetes demands a holistic approach both to the challenge to society of growing numbers and to individuals with this lifelong disease. Personalized care is essential to ensure that patients can control their condition and their quality of life is not allowed to deteriorate. The aim is for patients to continue to live a normal, productive life, living with diabetes rather than suffering from it, fitting the disease to their life rather than their life to the disease. To achieve this, as well as the best treatment they also need appropriate information and here, far too often, we're failing."
MODEL believes that achieving the NSF standards by 2013 is the minimum that patients should expect, but that without renewed energy, attention and investment they will not be met. Through bringing together a range of stakeholders and arguing for the pursuit of universal excellence the group hopes to play its part in achieving the standard of diabetes care which is essential.
Further information in brief:
· 2,000 people per week were diagnosed with diabetes last year (2006)
· Most newly diagnosed middle-aged diabetes patients have a 40% chance of having a heart attack or stroke, and a 10% of dying within 10 years - worse than many cancers ("Working together for better diabetes care" - Dr Sue Roberts, National Director for Diabetes)
· Access to structured diabetes education is limited and it is heavily over-subscribed. The Healthcare Commission recently found that only 11% of people with diabetes in England have been on an education course
· Frequent, disruptive changes to the NHS have led to inequalities in access and quality
· Treating diabetes complications costs the NHS around £2.5 billion per year. This could be greatly reduced by improved treatment, which has been shown to reduce complications by up to 50%
· Cost to employers through working days lost due to diabetes could rise by as much as £250 million per year by 2026
Spokespeople available for interview include:
Professor David Matthews, Chair of MODEL group
Dr Clare Davison, MODEL group member and GP in East London
The full report can be downloaded from the website of the National Diabetes Support Team at http://www.diabetes.nhs.uk/reading-room/other-resources or obtained from the MODEL secretariat (firstname.lastname@example.org).
For more information or to request interviews please contact Paul Naish on 020 7292 3674 or 07967 602371.