A new report has called for an alternative approach in the way diabetes is considered and handled in the UK, not only for the benefit of patients, but also to give the best fighting chance of tackling the growing burden of the condition to both the National Health Service and the economy.
The report, by new diabetes expert group MODEL, suggests that recent NHS reforms have been “dominated by addressing acute conditions, rather than the growing epidemic of chronic disease,” and says “society must invest properly in keeping people with diabetes well and preventing the costly complications associated with the disease.”
“We've seen many policy initiatives but they're not translating quickly enough into the significant improvements on the ground that patients need,” commented MODEL founder Professor David Matthews. “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,” he added.
A spokesperson for the group told PharmaTimes UK News that, “while there have been improvements thanks to the Quality and Outcomes Framework, what diabetes needs now is a holistic approach to help meet the urgent challenges ahead.”
Spiralling prevalence and cost
The number of patients with diabetes is set to rocket by 200,000 up to 2.5 million in the next three years in England alone, largely because of the ageing population and rising levels of obesity. Already, treating the illness and its complications in England and Wales carries a hefty bill of around £3.5 billion per year, or £111 per second, according to the Department of Health, at a time when the NHS is struggling to stand up under the strain of considerable financial pressure.
In an attempt to help decelerate the looming crisis, back in 2001 the National Service Framework for Diabetes came up with 12 standards of care to be reached by 2013, such as the provision of adequate support to patients to help them reach optimal blood sugar levels. But, as MODEL points out, the Healthcare Commission recently revealed that, in 2005/6, just 61.8% of patients attained their target level.
Another care standard concerns better education of patients to help them self-manage their disease but, as the spokesman explained to PharmaTimes UK News, “this just isn’t happening.” Indeed, figures by the Healthcare Commission reveal that just 11% of diabetes patients in England have been on an educational course about their disease.
MODEL firmly believes that achieving these goals by 2013, which, it stresses, is “the minimum that patients should expect,” will not be possible “without renewed energy, attention and investment.”
Innovative approaches “vital”
The group’s findings were presented in Parliament hot on the heels of a report by Dr Sue Roberts, the National Clinical Director for Diabetes, which stressed that the NHS “must deliver joined-up diabetes care and improve patient knowledge in order to continue progressing.”
According to Dr Roberts, innovative ways of delivering services in community settings is “vital” for the NHS to continue providing “first-rate services to the growing number of people with diabetes.” For example, she suggests moving annual assessments with long waiting lists out of hospitals and into GP surgeries, which could lead to “more comprehensive check-ups, less duplication of tests and a more convenient service.”
“I would urge the NHS to think radically about new approaches to care - not just tweaking existing systems - to ensure that NHS services now and in the future are able to cope with increased demand,” she concludes.