A national service review of diabetes by the Healthcare Commission has revealed that, while most primary care trusts are commissioning services to meet the basic needs of patients with diabetes, the majority are failing to offer the support needed to help them manage their condition.

Out of 152 PCTs reviewed, 73% were considered (being rated as ‘fair’) to meet the basic health requirement of diabetics, while 5% were tagged ‘excellent’, 11% ‘good’, and, worryingly, 12% ‘weak’. These figures show that, while a basic level of care is being achieved by most trusts, there is significant room for improvement.

To attain a ‘fair’ rating, PCTs were found to be giving patients yearly check-ups and tests, such as blood sugar level and blood pressure, and patients reported they knew about their medication and dosing regime. However, the Commission discovered these trusts and those classed as ‘weak’ were not commissioning services that offered enough support to help patients manage there own condition, which not only offers significant benefits to the patient but also NHS too.

Support central to policy

Making support available to people with long-term conditions to care for themselves is central to the Government’s policy for diabetes, and the issue of supported self-care was highlighted in the 2001 Diabetes National Service Framework as a priority area for healthcare professionals.

Effectively managing diabetes through weight management, exercise and health eating plans can help to ward off serious and costly complications associated with the condition, such as heart disease, blindness and kidney failure.

Aside from the obvious distress to the patient associated with such complications, they also have a huge impact on the NHS’ already stretched coffers. According to the Healthcare Commission, £1.3 billion, or around 5% of total NHS expenditure, was used to care for people with diabetes in 2002, but this figure looks set to soar to as much as 10% of total expenditure – around £9 billion – in the current financial year. This means that the NHS’ diabetes bill will hit £25 million a day, illustrating the urgent need to focus on both the prevention of the disease and its associated complications.

Of immediate concern are those trusts that scored ‘weak’ with regard to the provision of care for patients with diabetes, the Health Commission said, adding that it will be working alongside strategic health authorities to help these PCTs create improvement plans, and monitor progress closely.