NHS Atlas reveals diabetes "postcode lottery"
Patients with diabetes face a postcode lottery of care, with a 35-fold variation across England in the number of diabetics who are receiving all nine of the NICE key care processes, according to the NHS Atlas of Variation.
The Atlas, a new initiative published today by the Department of Health, maps the variations in health spending and outcomes across England. It comprises of 34 maps indicating high and low spenders among the 152 primary care trusts (PCTs).
It is hoped that commissioners will use the report to consider the opportunities to maximise health outcome and minimise inequalities by addressing unwarranted variation, as well as improving quality for patients and increasing value for the NHS.
NICE recommends in its guidance on type-2 diabetes that all patients with diabetes receive nine crucial tests from their GP at an annual review of their diabetes management. These include measurements of weight, blood pressure, smoking status, a marker for blood glucose called HbA1c, urinary albumin, serum creatinine, cholesterol, and tests to assess whether the eyes and feet have been damaged by diabetes.
Treating these risk factors reduces the development of complications, and the early identification of complications allows patients to receive treatment to slow progression to heart disease, stroke, and blindness.
But the Atlas found considerable variation, 35-fold across the country, among the number of patients who are receiving the NICE key care processes at their annual check-up.
Even when the five PCTs with the highest percentages and the five PCTs with the lowest percentages are excluded, a fivefold variation remains.
Almost a quarter of people with diabetes were found to be missing out on the foot checks they need, and diabetes results in about 70 amputations a week in England, 80 per cent of which are potentially preventable.
Barbara Young, Chief Executive of Diabetes UK, said that the findings demonstrated that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery.
“The devastating impact on some of the 2.3 million people in England with diabetes must not be dependent on geography.
“95 per cent of diabetes management is self-management. Most people with diabetes see their healthcare team only once a year for a few hours. The annual review is vital for picking up any health changes and signs of complications and can often be the only chance for people to discuss their management and treatment with their healthcare professionals. The nine checks are the minimum gold standard of diabetes care.”
25 November 2010
This page was last updated: 25 November 2010