Thousands dying needlessly each year, says Diabetes UK

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A study by the National Audit Office (NAO) has revealed that an NHS 'postcode lottery' for diabetes sufferers is leading to some 24,000 unnecessary deaths every year.

Diabetic

A leading diabetics' charity believes the NAO report reflects a national shortfall in care for the condition, with "colossal" sums of money wasted.

"By using the money we already spend on diabetes more wisely, we could stop 24,000 people dying unnecessarily every year," said Diabetes UK's chief executive Barbara Young.

The NAO report noted significant regional shifts in the quality of treatment for diabetic patients, with just 6% of sufferers receiving the guideline standards of care in some areas, compared to 69% in the top primary care trusts (PCTs).

The auditors also observed a lack of accountability for PCTs which do not ensure that recommended standards of care are met, despite the Department of Health (DoH) holding data for assessing performance.

Across England from 2009 to 2010, the recommended levels of care reached only about 50% of diabetes patients. Meanwhile, no PCT was able to provide the 9 checks set out by the DoH essential to countering severe diabetes-related problems.

The lowest-rating PCTs were Mid Essex and Swindon, where fewer than 9% of patients received the tests.

The NAO also said that because the health service does not "clearly understand" local costs of diabetes, it encounters problems in providing effective services.

The government has acknowledged that there is "no excuse" for the NHS delivering anything but the best diabetes treatment.

"NICE [National Institute for Health and Clinical Excellence] guidance and quality standards set out what good care looks like," said the care services Minister Paul Burstow. "By exposing poor practise and shining a light on best practise, we are determined to drive up standards for everyone.

"We are already working on a new outcomes strategy covering long-term health conditions and are committed to publishing a companion document on diabetes later this year."

Despite the ministerial assurances, specialists in health law warn that the rising number of people with diabetes-related illness suggests that a "state of crisis" is engulfing NHS diabetes treatment.

Neil Fearn, head of clinical negligence at Simpson Millar LLP, said it is worrying that barely half the country's diabetic sufferers enjoy the level of care recommended by NICE.

"People with diabetes are at much higher risk of amputation, blindness, kidney failure and stroke," said Neil. "It is absolutely vital that the care they receive matches the seriousness of these health threats."

The NAO report concluded that regular reviews of clinical indicators of disease progression are essential. "Without regular monitoring and treatment, this damage can lead to complications such as blindness, amputation and kidney disease."

Barbara Young agreed that action is needed urgently. "Escalating diabetes costs threaten to wreck the NHS budget so this is an issue that affects all of us, not just people with diabetes."

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