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How diabetes care varies across the UK

A new government report highlights the true levels of diabetes care across the UK. The report, The NHS Atlas of Variation in Healthcare, shows how amputation rates vary between different strategic health authorities.
Up to a quarter of diabetics in England are not having foot checks, which is resulting in about 70 amputations a week, the majority of which are preventable.
In areas where there are integrated multidisciplinary specialist diabetes foot teams, rates of amputation fell dramatically. An example is Ipswich where over an 11 year period the rate fell to only a fifth of the rate before the MDT was established.
The Atlas highlighted the number of patients with diabetes that received the recommended nine key care processes, which includes eye and foot checks. Only 50.8 per cent of those with type 2 diabetes and 32.2 per cent of type 1 diabetes received it.
Barbara Young, chief executive of Diabetes UK said on Radio 4’s Today programmen, “We very much want to shine a spotlight on those areas with poorer care but also to inform patients about the level of care they should expect right across the country.”
She also stated later, “Diabetes UK is seriously concerned that less than half of people with diabetes have received all nine health checks . This demonstrates that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery.
“With access to high quality care, patient education and effective diabetes management, there is no reason why people with diabetes should not live long and healthy lives. The devastating impact on some of the 2.3 million people in England with diabetes must not be dependent on geography.
“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.
“The existing situation around foot care and amputations is shocking, given that the majority of amputations can be prevented. Diabetes is the single most common cause of lower-limb amputation in the UK. Foot checks as part of the annual review should be a given and any injuries or ulcers that are detected need to be assessed as soon as possible by an expert team. The longer they are left untreated, the greater the risk of deterioration and loss of the limb.
“Good diabetes care relies on a team of specialist healthcare professionals to provide the care and to empower the people they care for. People across the country should have a right to expect standard levels of good practice to support them with their serious condition.”

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