NAO highlights stalled progress on diabetes care

21 Oct 15

Progress in improving NHS diabetes care in England has stalled, a National Audit Office review has found.

The NAO said that, while the additional risk of death has reduced since its last review of adult diabetes services in 2012, 22,000 deaths per year could still potentially be avoided and elsewhere improvements have been lost.

In 2013/14, an estimated 3.2 million people over the age of 16 had diabetes and 200,000 people are newly diagnosed every year. In 2010/11 the disease cost the NHS approximately £5.6bn, 69% of which was due to complications such as amputation, blindness, kidney failure and stroke.

NAO head Amyas Morse said that, with the improvements identified in the watchdog’s last report stalling, the uplift in long-term outcomes for patients was likely to stall as well.

Meg Hillier, chair of the Public Accounts Committee, said it was disappointing that so little progress has been made in helping people who suffer from diabetes.

“Not enough has been done to increase the proportion of patients who receive the recommended checks and achieve the recommended treatment standards,” she said.

“A staggering 135 people every week in England now have an amputation as a result of diabetes, yet less than three in five patients are monitored for the tell-tale signs that can help detect and manage the risk of developing diabetic complications.”

Since the NAO last reported on diabetes, the relative risk for people with diabetes developing complications has not changed or reduced for most complications. However, because the number of patients with diabetes is increasing this means the amount of patients developing complications is in fact rising.

While the number of patients receiving key care processes, such as blood, cholesterol and eye screening tests, has stagnated, the number of newly diagnosed patients being taught how to manage their condition themselves and prevent complications has fallen.

Hillier noted that only 16% of those diagnosed with diabetes were offered education about their condition and fewer than 4% take up the offer.

Responding to the report, Professor Jonathan Valabhji, national clinical director for obesity and diabetes at NHS England, said: “Performance of the NHS in England on diabetes remains strong.

“People with diabetes are less likely than a few years ago to either die or develop heart failure. We are also seeing trends for lower rates of angina, heart attack, stroke, major amputation and kidney failure. This is with a backdrop of more and more people developing Type 2 diabetes every year and constraints on funding.”

Diabetes is anticipated to affect almost 9% of the population, with the number of people with the condition expected to rise to 4.2m people by 2030.

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