This week the APPG for Diabetes chaired a roundtable discussion with over a dozen GPs and consultants from across the country to gain their views of some of the key challenges faced in diabetes care.
The meeting began with Professor Jonathan Valabhji, NHS England’s National Clinical Director for Obesity and Diabetes, providing an overview of the Government’s strategy on diabetes.
In terms of prevention, NHS England is working to roll out the NHS Diabetes Prevention Programme, which aims to identify individuals at high risk of developing Type 2 diabetes and refer them into evidence-based behavioural intervention to help them reduce their risk. The Government will also be launching its planned Childhood Obesity Strategy in the new year, which is anticipated to address some of the wider population wide risk factors for obesity and help create an environment that enables people to make healthier choices.
In terms of care, four areas have been identified for improvement, which include:
- Reducing variation in care: people living with Type 1 diabetes, people of working age and people living in certain parts of the country are receiving considerably worse routine care than other people with diabetes.
- Improving access to structured education: there is good evidence that shows individuals are able to better look after their condition and reduce their risk for complications after attending a structured education course, but access to these types of diabetes self-management courses remains low.
- Improving foot care: there are more than 135 diabetes-related amputations occurring every week, but improved foot care can drastically reduce someone’s chance of having an amputation.
- Improving inpatient care: many people with diabetes in hospital are often admitted for reasons other than their diabetes, but while in hospital their diabetes control worsens and they stay in hospital for longer.
The meeting was then opened to discussion. Individuals in the room agreed that access to structured education to make sure people with diabetes get the skills and the confidence they need to look after their condition is woefully poor. More GPs are beginning to refer people with diabetes on to courses, but the question is whether this actually translates into more people attending.
Variation in care across the country and across GP surgeries was a common theme. Lord Rennard challenged the room for ways of tackling this variation and how to deal with practices that don’t provide good enough care. The group identified a need for better clinical leadership and more integrated IT systems. There was also concern that the number of GP surgeries participating in the National Diabetes Audit is dropping, meaning we do not have a full picture about what’s happening nationally in diabetes care and treatment.
George Howarth MP raised the issue about a continuing failure to make clear the difference between Type 1 and Type 2 diabetes. He also said we need to be clearer about what we mean when we talk about integrated services. There is a particular issue among young people with Type 1 diabetes and eating disorders, and there needs to be better integration between diabetologists and psychological services.
Keith Vaz MP thanked the room for their contributions and thanked Professor Valabhji for continuing to raise these issues with the Government.