News

Progress in diabetes care and prevention in UK

5 September 2008

Diabetes care in the NHS is improving and focussing more on prevention, according to a report published by the Department of Health.

The report, Five years on: delivering the diabetes national service framework, reflects on how well the NHS is performing against the standards for diabetes care set out in the National Service Framework (NSF) Delivery Strategy in 2003.

As well as reflecting on progress made in diabetes care, the report sets out areas which must be improved during the second half of the timeframe set by the NSF.

For example, the report acknowledges that more work must be done to improve outcomes for young people with diabetes and that the Children and Young People Implementation Support Group, set up by the Department of Health, is working to make progress in this area.

The Department of Health also pledges to continue to work with the National Screening Committee and the NHS to offer screening for diabetic retinopathy to all people with diabetes.

In line with the Government's commitment to providing a preventative health service, the Department of Health says that the NHS is making particular progress with the following priorities in diabetes care:

• identifying diabetes earlier in people who were unaware that they had the condition: around 600,000 people have been diagnosed with diabetes in the last five years, equivalent to 2,000 a week, and are now receiving the treatment they need to manage their condition.
• identifying people at risk of diabetes and providing treatment and advice to help prevent them from developing the condition: the vascular risk programme announced in April, Putting Prevention First, is expected to prevent around 4,000 patients from developing diabetes each year: the obesity strategy, Healthy Weight Healthy Lives is helping people to make lifestyle changes that will reduce their risk of diabetes.
• ensuring that people with diabetes are given tests that help to prevent long-term complications: increasing numbers of people with diabetes are being routinely monitored by their GP for indicators of complications.

Health Minister, Ann Keen, said: "Today's report shows that the NHS is getting better and better at identifying people with diabetes and at supporting them to manage their condition.

"The Next Stage Review made prevention a priority for the NHS and this is especially relevant to diabetes, as a disease whose global increase in prevalence is partly a consequence of rising obesity.

"Our vascular risk assessment programme, Putting Prevention First is expected to prevent thousands of people developing diabetes each year and our strategy to tackle the rise in obesity will help many more reduce their risk of the disease."

National Clinical Director for Diabetes, Dr Rowan Hillson MBE, said: "The NHS has responded impressively to the first five years of the National Service Framework. More and more people with diabetes are getting good routine care, and their outcomes are improving year on year.

"The next five years will continue to bring challenges for diabetes teams as they work to further improve diabetes services in both primary and secondary care.

"I look forward to working with the National Diabetes Support Team and other key partners such as Diabetes UK to support the NHS in driving further improvements in care for people with diabetes."

Intellect emphasises role of telehealth in diabetes care

Intellect, the trade association for the UK technology sector, has welcomed the new report. Intellect says that in meeting the challenges laid out by the report, it is important to take into account how telehealth (essentially remote patient monitoring) can help support both patients and clinicians.

With the growing problems of an ageing population and a finite amount of resources, telehealth solutions are a vital tool in providing care for diabetes. By performing simple tasks at home, eg measuring their own blood sugar levels, blood pressure or heart rate, patients can take charge of their own care. The information generated is then automatically transmitted to clinicians, which reduces the need for patients to come into health centres or for nurses to pay home visits.

Adrian Flowerday, chair of Intellect’s Telehealth Group and Docobo MD, has over a decade of experience working to help patients and clinicians via telehealth. He highlights below three examples of how telehealth benefits diabetes care: "First, for patients with Type-1 diabetes, telehealth can help clinicians to better understand a patient’s insulin usage and enable appropriate medication titration.

"Second, post diagnosis of type-2 diabetes, two to three months of telehealth can help to educate patients about their condition and any necessary lifestyle changes, monitor potential periods of depression, and can help clinicians to keep their patients’ blood-glucose levels under control. And third, for all diabetes patients, telehealth can serve as a long term reminder system for patients to monitor their blood sugar.”

Telehealth can help patients stay healthy longer, puts patients more in charge of their own care, and supports clinicians in managing their patients more efficiently — all goals of Lord Darzi’s NHS Next Stage Review. The value of telehealth is recognised by the NHS, as is demonstrated by the Whole System Demonstrator programme and NHS Connecting for Health’s wider work on assistive technology.

A broader application of such telehealth programmes would help provide a higher quality of diabetes care, Intellect says.

The report Five years on: delivering the diabetes national service framework and the Diabetes national service framework, can be found at: www.dh.gov.uk/en/Healthcare/NationalServiceFrameworks/
Diabetes/index.htm

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