Health and Social Care Committee

Inquiry into the implementation of the National Service Framework for diabetes in Wales and its future direction

DB 13 Patients Association

Diabetes in Wales

Diabetes is becoming an increasingly pressing problem not just in Wales but across the UK. With £14 billion spent every year on treating and dealing with the by-products of the condition, this is a major area of concern.

Increasing levels of obesity in the UK are creating an explosion in the number of cases of Type 2 diabates diagnosed every year. Dr Nadim Haboubi, Chair of the National Obesity Forum for Wales has said that the obesity crisis in Wales is almost as bad as the USA. In England we are increasingly seeing the bariatric (weight loss) surgery being placed on Procedures of Limited Clinical Value (PLCV) where PCTs refuse to fund the procedure. This is despite its proven clinical outcomes for reducing obesity.

Patients and carers need to be made more aware of the health risks associated with obesity, such as diabetes. This must be done proactively, with health bodies reaching out to often hard to reach groups such as faith groups and BME groups. 

For example, in Newham PCT which has one of the highest recent immigrant populations in the UK, there were concerns that there were large levels of undetected diabetes in the South Asian community. The PCT set up testing booths in local areas such as shopping centres and advised people who tested positive for diabetes to seek help from their GP. There was no increase in the rates of GP consultation for diabetes, nor was there and increase in diabetes incidence. The PCT then took a different approach engaging with local community and faith groups to improve health literacy and engage with patients in a manner that was understandable. Since this work was undertaken, diabetes 2 rates have dropped by 18% across Newham PCT.

A one size fits all approach will not necessarily be appropriate as different communities and different areas will have difference needs and issues. For example, one area may have very high obesity rates while another may have higher than average underage drinking rates. Any changes to the NSF should be geared to ensure that there are local solutions to local problems.

There is clear evidence that effective and strong patients and public involvement in this area can help to improve public health outcomes.

Aside from work to improve public health which will ultimately help to reduce rates of development of diabetes, changes may need to be made to ensure the ongoing care of those who have already developed the condition.

Thousands of patients across the country suffer from long term and chronic conditions which affect every moment of their lives. We believe that the NHS needs to be able to provide better care and as importantly improved continuity of care for patients.

There is also the issue of continuity of care. When patients are being moved between care settings, we have heard that oftentimes their medical records and information about their ongoing care are not properly passed on. There must be effective systems in place to ensure that when patients are moving between care settings, the information about their care follows them and that all professional involved in their care are fully prepared to treat their condition holistically.

Finally, it is important to remember that patients are not only the long term condition they suffer from. They will suffer from the same seasonal and chance diseases as everyone else. If a patient with a long term condition develops a cold or another ailment unlinked to their condition, they should be able to access effective healthcare services without their long term condition getting in the way.

The National Service Framework for diabetes has been in place for 10 years now, yet there has been little improvement. Indeed, in its 2012 State of the Nation report, Diabetes UK called for the standards to be implemented in England which is extraordinary for a 10 year old report which was meant to lay out the future of diabetes care. Wales must ensure that it also implements all the recommendations of the National Service Framework for diabetes.