People with diabetes not getting the best care due to cost-cutting

Top NHS doctors and nurses have raised concern that people with diabetes are not getting the best care available due to a combination of cost-cutting measures and a perceived lack of local and national leadership.

A Diabetes Snapshot, published by the ABPI Pharmaceutical Diabetes Initiative (PDI), collected research from clinicians, policy makers, and patient representatives, with the results of 50 in-depth interviews revealing a complicated picture of how diabetes care is provided.

The report reinforced that people diagnosed with diabetes in 2015 may not receive the care they need, despite national guidance, innovative treatments and technologies being made available.

ABPI Pharmaceutical Diabetes Initiative commissioned the extensive research project, gathering insights into challenges in current policy and practice, and the future of diabetes care in England

Some GPs claimed they were being prevented from prescribing clinically effective new treatments due to pressure from clinical commissioning groups and local prescribing bodies to prescribe the cheapest available options.

If ignored, type 1 and type 2 diabetes could cost £39.8 billion by 2035, and the report warned that when poorly managed the condition can lead to 24,000 early deaths each year.

Many of the healthcare professionals interviewed said the current system was not working as it should for people with diabetes, and the PDI has called on the Government to ensure that those with the condition get the appropriate treatment at the right time in their patient pathway.

The report also called for more support for GPs in managing the condition, through a clear and integrated community pathway for diabetes care and greater local and national leadership.

Dr David Miller-Jones, Chair of the Primary Care Diabetes Society (PCDS), who contributed to the report, said: “GPs are now carrying more responsibility for managing diabetes than ever before. The PCDS provide education and national leadership, but our aims of supporting GPs should be strengthened by a renewed national NHS policy commitment to tackle diabetes.”

A Diabetes Snapshot comes during the consultation period of a number of type 1 and type 2 clinical NICE guidelines. The recently completed type 2 guideline consultation has proposed changes to the current guidelines of care, which could take diabetes care back by a decade, according to diabetes specialists and healthcare professionals alike.

Leading clinician Professor Anthony Barnett and a collection of diabetes specialists from across the country agreed that while the proposed type 1 guideline were sensible, in contrast some of the recommendations included in the type 2 guideline were “paradoxical in the extreme” and demonstrated a “distinct failure of common sense”.

Suzie Collett, Director of Policy, Communications and External Affairs at MSD and Chair of the ABPI PDI said: “A Diabetes Snapshot indicates GPs are already facing major issues dealing with this condition. This matters because keeping the growing number of people with diabetes well is not just good for them, it also saves costly acute hospital care. The draft guidelines produced by NICE unfortunately outline a short-sighted approach, ignoring and restricting the use of modern therapies, just at the moment where the NHS needs to get on top of diabetes care at every level.”

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