Variation in NHS diabetes care across England 'unacceptable', MPs warn

CCGs failing to meet average levels for diabetes care should be identified and forced to improve, MPs have warned, in a report highlighting 'unacceptable' variation in care across England.

MPs on the House of Commons public accounts committee (PAC) warned that flaws in the DH and NHS England’s current approach to treating diabetes will cause NHS expenditure on diabetes to rise exponentially, and has called for immediate action to improve care.

Current geographical variation in care between CCGs is ‘unacceptable’, the PAC said, and any areas found to be performing poorly compared to average levels should face interventions to help them improve.

In the PAC report published on Friday, MPs said the DH and NHS England had ‘allowed a system to develop’ that has reduced GP practice participation in the National Diabetes Audit, ‘potentially undermining one of the most comprehensive clinical audits in the world’.

GP practice participation stood at 71% in 2012/13, a fall from 88% the year before. The report states it should be mandatory for GP practices to participate in this programme by the end of 2016.

Diabetes care

The PAC urges NHS England to develop proposals within the next 12 months detailing how it will improve financial incentives for primary and secondary care to work together and deliver integrated diabetes care to patients.

Too few patients are engaging in education programmes, it added, directing NHS England to develop ‘a better and more flexible range’ of education support.

Diabetes is estimated to cost the NHS £5.6bn a year, affecting an estimated 3.2m people aged 16 or older in England.

Improvement needed

PAC chairwoman Meg Hillier said: ‘The NHS and DH have been too slow in tackling diabetes, both in prevention and treatment.

‘The number of people with diabetes is increasing, as is the number of patients who develop complications. It is a very serious condition that can have a huge impact on people’s lives. Yet support available to patients and those at risk varies hugely across the country.

‘There’s clear evidence of what works and as a priority action must be taken to ensure best practice in treatment and education is adopted across the board.’

A DH spokeswoman said: ‘The NHS has made big improvements in diabetes care by reducing mortality and complications arising from the disease – but any variation in care as this report highlights is deeply concerning.

‘That’s why we are creating a national diabetes prevention programme, the first of its kind in the world, so that we help people avoid developing this devastating condition in the first place.’

Photo: Ian Bottle

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