| UK failing to implement diabetes
strategy: charity
By Richard Woodman
LONDON (Agence de Presse Medicale for Reuters Health) - Britain's
plans for tackling its huge diabetes epidemic have so far failed
to make much practical difference to the lives of patients, according
to the charity Diabetes UK.
Its chief executive, Benet Middleton, told APM that standards of
care still varied widely and that research to find out how best
to introduce screening programmes to detect the estimated one million
people who don't yet know they have diabetes had been delayed.
Middleton raised his concerns earlier this week with Rosie Winterton,
the junior health minister with special responsibility for diabetes.
Around 1.5 million Britons have been diagnosed with type 1 or type
2 diabetes, and another one million are thought to have type 2 diabetes
that has not yet been diagnosed. The numbers are expected to double
over the next 10 years at massive cost to the National Health Service.
Realising the problem, the Department of Health announced plans
in 1999 for a "National Service Framework" that would
set standards for preventing, identifying and managing diabetes.
The standards were published in 2002 and a final implementation
document followed in January 2003. This set two key targets: guidance
on screening programmes by 2005; and local registers of diabetic
patients by 2006.
Middleton said that the framework was an important step forward
as it signaled that diabetes was a priority, but the response at
local level was very mixed.
One weakness was that since the framework was announced in 1999
there had been a radical change of healthy policy that had shifted
the balance of power from centrally set health targets to local
control of budgets.
As a result, while some Primary Care Trusts (local health bodies)
took their responsibilities under the framework very seriously,
others were failing to do so.
A survey by the healthcare company Dr Forster last year found that
less than third of health services had a strategy for early detection
of diabetes and almost a quarter were not providing adequate information
for those who are diagnosed.
"One of the things the Department of Health promised is that
within a year people would notice a difference. I am not sure about
that," Middleton said.
He said screening of high-risk groups for type 2 diabetes had still
not been introduced because the government first wanted to find
out the most cost-effective way of screening.
"I think screening should have been introduced when the document
came out in 2003 but we accepted this two-year delay (until the
2005 target date) on the basis that more research was needed on
how to do it effectively.
"But very little research has been commissioned, and what
we don't want is to be in a position in 2005 when they say there
is still inadequate information to introduce a screening programme."
Middleton said plans to set up local patient registers also faced
problems as general practitioners and primary care trusts often
used different computer software. As a result, there was still no
systematic way of planning services and delivering good care.
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