'Diabetes care depressingly poor, say MPs', is the headline on the BBC News website. This is the damning verdict of a parliamentary report into standards of diabetes care in the NHS. The Public Accounts Committee reported that (in the words of the Daily Mail), "24,000 with diabetes 'are dying needlessly'".
The report was published by the Public Accounts Committee (PAC) – an influential group of MPs who have been given an oversight role to help ensure that taxpayers get value for money.
Based on official figures and spoken and written evidence from independent diabetes experts and officials, the PAC has set out recommendations for improved diabetes care in the NHS.
The report indicates that the NHS spent an estimated £3.9 billion on diabetes services in 2009/10. However, 80% of the costs are estimated to come from the management and treatment of avoidable diabetes-related complications, such as kidney disease and foot ulcers.
The report highlights that the number of people with diagnosed and undiagnosed diabetes is 3.1 million, set to rise to 3.8 million by 2020. This projected increase is likely to have a significant impact on NHS resources, the committee says.
The report accepts that there is consensus about what needs to be done for people with diabetes. However, progress in actually delivering the recommended standards and achieving treatment targets has been 'depressingly poor', it says.
Who produced the report?
The report, 'Department of Health: The management of adult diabetes services in the NHS' has been published by the PAC.
The PAC is made up of MPs appointed by the House of Commons, and is responsible for overseeing government expenditures to ensure transparency, value for money, and accountability in government financial operations.
What are the main findings?
The main findings of the report are:
- an estimated 80% of the costs of diabetes come from the management and treatment of avoidable diabetes-related complications (such as diabetic eye disease and kidney disease)
- the Department of Health estimates that up to 24,000 people with diabetes are dying each year from causes that could be avoided through better management of their condition
- only half of people with diabetes receive all the basic tests to monitor their condition, and failure to carry out these simple checks heightens the risk of developing complications
- less than one in five people with diabetes have achieved the recommended levels for blood glucose, blood pressure and cholesterol
- despite the Department of Health improving information on diabetes, this information is not being used effectively to assess and improve the quality of care
- many people with diabetes develop avoidable complications because they are not effectively supported to manage their condition and do not always receive care from appropriately trained professionals across primary and secondary care
- the projected increase in the diabetic population could have a significant impact on NHS resources
The report states that the reasons these problems have arisen include:
- the fact there is no strong national leadership – each Primary Care Trust is largely 'left to their own devices' when it comes to how they decide to tackle diabetes
- there are no effective accountability arrangements for commissioners (those in charge of allocating funds to particular services)
- there are no appropriate performance incentives (rewards, usually financial, designed to encourage best practice) for the providers of diabetes care
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