Refer more diabetes patients to structured education, GPs told

GPs should refer more diabetes patients to structured education so they can better self-manage their condition, experts have advised.

Diabetes: GPs urged to encourage self care (Photo: Jason Heath Lancy)
Diabetes: GPs urged to encourage self care (Photo: Jason Heath Lancy)

But senior GPs have warned that increasing support for patients to self-care would require a huge amount of training for general practice.

Diabetes specialists at the first all party parliamentary group (APPG) meeting for diabetes this week discussed how people with the condition could be better supported to understand and self-manage their condition.

Experts highlighted how GPs could do more to refer patients to education services.

But Dr David Payton, RCGP clinical lead for commissioning, warned that this would require a ‘huge amount of training for an entire profession’, which might not be feasible.

Self-management forms up to 95% of diabetes care. Speakers at the APPG for diabetes said ‘too few’ patients were being given the skills they need to effectively manage their condition, which was effectively ‘dooming’ patients.

They said a nationally-standardised structured education system was ‘crucial’ to improving diabetes care, with different options for people with different needs, taking into account their type of diabetes, age and time since diagnosis.

Patients referred to structured education

Although referral is incentivised in the QOF, the National Diabetes Audit 2011/12, released last year, revealed just 5% of diabetes patients were referred to a structured education programme, of which only 1% took up the programme.

Dr Trudi Deakin, CE and founder of X-PERT Health – a programme that delivers structured education – said there was a ‘lack of awareness’ of the benefits of structured education in general practice and primary care, which has led to a lack of referrals to the service.

She said: ‘They're seen as an optional extra, rather than an integral part of diabetes treatment and management. When people are offered it and it’s introduced in a positive light, they do tend to take it up.’

But Dr Payton said focusing on structured education for diabetes was ignoring the fact that most affected patients are likely to have co-morbidities.

He said: ‘About 10% of my patients have diabetes, as I work in a very high BME community. The evidence we've got is that, of the people with diabetes, less than 15% have only got diabetes. So in other words, over 85% of those people I look after have at least one other long-term condition.

‘And I think to just look at education for diabetes is ignoring the importance of this. We've got to think about it in the context of a multi-morbidity agenda, not just a disease-specific agenda because otherwise we’ll sort something out for the 15% and leave out the other 85% of the population.’

Re-brand structured education

The experts also said the label ‘education’ acted as a barrier, serving to dissuade patients from the programme, making it seem ‘optional’ or ‘like going back to school’.

They suggested it required a re-branding in the minds of patients and primary care professionals, marketed instead as ‘essential training’ which forms part of the normal, ongoing treatment for diabetes.

Around 3.2 million people in the UK have diabetes, and this figure is expected to rise by 5% each year.

The meeting kicked off the APPG for diabetes’ year-long investigation into the state of diabetes education.

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