File on 4 Feb 21/26

[viviennem]

BBC Radio 4's programme File on 4 are investigating NHS diabetes care on Tuesday 21 February at 8.00pm, repeated on Sunday 26 February at 5.00pm (usually). Why does it cost so much, and why is it responsible for 24,000 deaths per year.

If you go on to the File on 4 web page on http://www.bbc.co.uk you can find a Contact Us bit which has an email form.

I've already emailed to say I'm looking forward to the programme, what I think about NHS care for Type 2s, and told them to look at this forum (if they haven't already done so).

Should be worth a listen!

Viv 8)

edited twice - can't spell today!

 

[catherinecherub]

Here are the details of the programme.
http://www.bbc.co.uk/programmes/b01c7pr5

 

[viviennem]

Thanks, Catherine.

Viv 8)

 

[al_leister]

Further Info

As a daily listener to radio 4 there are often programmes advertised for times when I know I will not be in the house or car to allow me to listen.
I now record the programme and listen when it suits me.
This might be stating the obvious, or it’s just how my brain works or doesn’t, but you can record the programmes on TV. I always associated the TV with video and not audio. Just go to the radio 4 channel, like you would BBC1 for east eastenders, and select record.
You will need to have virgin or sky + box.
For the record, I phoned virgin over a year ago and got a V+ box free, no monthly charge and I do not have any packages like movies or sport etc.

 

[didie]

It'll also be available on iPlayer after it is broadcast.

This link takes to the You and Yours iPlayer site.




http://www.bbc.co.uk/iplayer/episode/b0 ... _websites/

 

[catherinecherub]

Worth reading this from DUK, they are heavily involved with getting better care for all diabetics and this particular programme.

"The Government say the right things but the fact is we are treading water when it comes to delivering quality healthcare for diabetics"
http://www.diabetes.org.uk/About_us/New ... -diabetes/
There is this from the BBC website ahead of the programme. They are asking that maybe the public will be as outraged as they are for limbless servicemen???? Nobody seems to know the toll that diabetes takes on people who are not getting the best care.
More than 1.3 million with diabetes not offered vital tests.

http://www.bbc.co.uk/news/health-17014480

 

[Unbeliever]

I have heard Baroness young say this before. U nforunately governments find it difficult to take he longer view. As in test strip provision.
In the short term all these tests are bound to cost more -not for tesing in itself but for all the follow up and treatment .

My concern is always with the interpretaation of the results and he competence of the interpreters. At present many of us feel that we are subjected to a superfluity of tests merely to tick boxes and which offer us no supprt or reassurance,

Diabetes care is being downgraded. When I last saw her speaking on this subject she did not reassure me in the least.
I felt she was advocating more of the same. Its a good soundbite I suppose..

 

[catherinecherub]

You could always leave your comments on the BBC page that I put in my post.
If we can't be bothered or think that nobody listens, how will we know if we don't take every opportunity available to us?

 

[al_leister]

Copy and paste the link at the end of list.

TYPE 2 DIABETES
National clinical guideline


Metformin 53
9.3 Insulin secretagogues 65
9.4 Acarbose 79
9.5 Oral glucose control therapies; from evidence to recommendations 85
10 Oral glucose control therapies (2): other oral agents and exenatide
10.1 Clinical introduction 89
10.2 Thiazolidinediones (glitazones) 89
10.3 Gliptins (GLP-1 enhancers): dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors) 114
10.4 Exenatide: GLP-1 mimetics 114
10.5 Oral glucose control therapies (2): other oral agents and exenatide; 120
from evidence to recommendations
11 Glucose control: insulin therapy
11.1 Oral agent combination therapy with insulin 125
11.2 Insulin therapy 130
11.3 Insulin detemir 146
11.4 Insulin delivery devices 146
12 Blood pressure therapy
12.1 Clinical introduction 151
12.2 Blood pressure lowering – targets and intervention levels 151
12.3 Blood pressure lowering medications 157
13 Cardiovascular risk estimation 181
14 Management of blood lipid levels
14.1 Overall clinical introduction 191
14.2 Targets and intervention levels 191
14.3 Statins and ezetimibe 193
14.4 Fibrates 198
14.5 Nicotinic acid and derivatives 205
14.6 Omega 3 fish oils 209
15 Antithrombotic therapy
15.1 Antiplatelet therapy 215
16 Kidney damage
16.1 Diabetes kidney disease management 223
17 Eye damage 233
18 Nerve damage
18.1 Diabetic neuropathic pain management 235
18.2 Autonomic neuropathy 246
18.3 Gastroparesis 247
18.4 Erectile dysfunction 250
18.5 Other aspects of autonomic neuropathy 255
19 Areas for future research



http://www.nice.org.uk/nicemedia/live/1 ... /40803.pdf

 

[noblehead]

More than 1.3 million with diabetes not offered vital tests.

http://www.bbc.co.uk/news/health-17014480

Absolutely shocking!!!!


I'll listen to File on 4 tonight.

 

[Unbeliever]

You could always leave your comments on the BBC page that I put in my post.
If we can't be bothered or think that nobody listens, how will we know if we don't take every opportunity available to us?

Quite agree catherine. I always try to do so.

 

[Unbeliever]

This programme has jus finished. Interesting within its limitations. Maybe not enough inoput from patients . Nothing of course, about test strips although, of course they had to poiint out that money spent now on diabees care would save billions in the future. I was not at all convinced that this is likely to happen.

The most shocking thing to me was the revelation that GOs can meet their targets on diabetes - and claim heir funding by doing so little. To me thiat makes it even more frusraying and infuriating to see them avoiding their responsibilities towards diabetics. We are , in effect, a nice little earner for them not a drain on their resources and a nuisance.
How anyone could deny {as someone did} that GPs avoid making referrals to consulants because of cost....Not any Gp , not ever , never?

I hope all the right people were listening. A good ime for follow up comments folks?

I

 

[viviennem]

I would have liked to hear more about educating patients in their own care, and more about which PCTs are at the bottom of the list! It was not a great deal of time to spend on diabetes in all its ramifications. We need to lobby hard to get another programme, from the patients' point of view.

The Minister was Paul Berstow (Birstow?) who was the one I lobbied about the PCTs who are forbidding strips for Type 2s. I'll have another go at him again, and I suggest as many people as possible do that too - contact details can be found on www.parliament.uk. I got a few names to look up and pester, too - very useful!

The point about needing to test only 50% of patients to get the money was scary to say the least, though I do know some people who simply can't be bothered to go - and I hope the story of the guy who got gangrene and had his toes amputated wakes people up - diabetics and HCPs alike.

As usual I am fortunate - there is never any problem with me being referred to a specialist if I ask, and sometimes even if I don't :lol: . Mind you, if they get £2000 per annum for testing me, I reckon I deserve my test strips!

Viv 8)

 

[Unbeliever]

yes I thought a follow up would be good oo. Very happy to lobby for it , Just think none of the ten GPs in my Pracice will even speak o a patient about diabetes. !

Plenty of material around for another programme. Paul seemed to be all at sea!Perhaps he hought you would be confronting him in person Vi!
Still , not he usual amount of rubbish by any means Think the producers may well be open to suggestins for a follow up .

Thanks for the heads-up .

 

[IanD]

Just "listened again."
The programme was concerned with the lack of primary care & reluctance to refer patients to hospital, with a consequent deterioration, even death, because symptoms were not recognised, regular tests were not done, & simple ignorance of the health professionals. One very significant reason for such failure was cost - referral & tests cost the primary care practice money - now. Neglect moves the cost to the patient & secondary care possibly many years ahead.

It's a horrifying story - & that's before they get on to the serious misinformation on diet, & restriction of test strips. Save money now, & let the patient pay in future health problems, & the NHS pay for treatment.

I have overcome the onset of serious health problems* by diet alone. I have "advised" DUK & the Hounslow daibetes support group, but my suggestion of a presentation to the support group has not been taken up. I'll try again after this programme.

My Dr & the Hounslow dietician do listen to me, but the Dr has not referred any patients to me, nor convened a local discussion. The dietician has modified her advice, & has called me to a follow up X-PERT course as one who has successful controlled the condition & can help others. She gives out my notes & recipes.

*Potentially crippling neuropathy, early stage retina damage, & extreme tiredness. For a time I had to give up tennis & table tennis, could not do many of the gentle exercises at the gym group at Ealing hospital, run for heart patients. (I'm there with my wife.)

 

[noblehead]

My Dr & the Hounslow dietician do listen to me, but the Dr has not referred any patients to me

I don't suppose they would want to risk their jobs Ian unless your a registered practitioner.

 

[IanD]

My Dr & the Hounslow dietician do listen to me, but the Dr has not referred any patients to me

I don't suppose they would want to risk their jobs Ian unless your a registered practitioner.

Maybe not, but there is a patient support group, & I am at liberty to express my views there. Patients are advised to attend that group - & the committee are not HPs either. (I was invited onto the committee, accepted, but the committee has not met in 8 months.) I did report on the X-PERT follow-up course, where I was free to advise other patients.

I am concerned, though, that AFAICS no-one has come onto this forum despite my recommendations - including the sympathetic dietitian.

This forum exists to advise patients, many of whom come here because they aren't getting adequate advice from the HPs.

The HPs would of course be welcome - & advised - to chair such a meeting.

 

[catherinecherub]

The programme was commissioned in the light of the statistics published for 2009 - 2010 by the National Diabetes Audit. Executive Summary.

http://www.ic.nhs.uk/webfiles/Services/ ... 9_2010.pdf

It is a long document but if anyone has the time they will see how care is performed throughout PCT's in the UK.
If you go to the part where there has been an audit of patients receiving all necessary checks, you will see that some PCT's perform badly.
Mid Essex is the worst offender followed by Swindon, Medway, Stoke on Trent and Berkshire West. It is far from a north south divide. You may think well I had good care from my team in Swindon but that will be anecdotal, it is the overall performance for patients in Swindon.

 

[noblehead]

Maybe not, but there is a patient support group, & I am at liberty to express my views there. Patients are advised to attend that group - & the committee are not HPs either. (I was invited onto the committee, accepted, but the committee has not met in 8 months.) I did report on the X-PERT follow-up course, where I was free to advise other patients.

This forum exists to advise patients, many of whom come here because they aren't getting adequate advice from the HPs.

The HPs would of course be welcome - & advised - to chair such a meeting.

Yes Ian but at a support group we are all free to express our views without it be the spoken word, same as here on the forum, a gp directing a patient to you on how best to control their diabetes could leave them upon to negligence should any harm come from that advice.

You have to remember we are all experts in managing our own diabetes but not necessarily everyone else's, only HCP can access patients medical reports when accessing a patients needs and this needs to be taken into considration.

 

[catherinecherub]

+1 Nigel, we can only manage out own diabetes. Our method does not always work for everyone else and anyone who thinks they have found the secret as how to manage everybody else here is sadly mistaken. Age, physiology, gender, activity levels, pre-existing conditions, food preferences, to name a few of the differences between us.