Essex: Diabetes report reveals post-code lottery of care
DIABETES treatment is a postcode lottery with one of Essex’s health areas being cited as one of the nation’s worst areas in a report by the National Audit Office (NAO), it emerged last night.
Published today, the NAO survey highlights a massive variation in care quality from region to region.
In some regions, only 6% of sufferers received the recommended levels of care compared to 69% in the highest-achieving primary care trusts (PCTs).
Not a single PCT delivered the nine basic care processes which reduce the risk of diabetes-related complications such as blindness, amputation or kidney disease.
The report highlighted Mid Essex PCT as one of the worst performers with less than 9% of patients getting the nine basic tests recommended by the Department of Health (DH).
Mid Essex last night hit back saying the figures used by the NAO - which relate to 2009-2010 - are out of date, did not factor in the PCT’s use of a different test to the one audited and did not reflect the care now being given to people with diabetes.
According to the NAO, the DH was not holding poorly performing PCTs to account.
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The authors say: “The Department holds information to assess performance but there is a lack of accountability for PCTs who fail to ensure that the recommended standards of care are met.”
The report says: “People with diabetes require regular review of clinical indicators of disease progression.
Amyas Morse, head of the NAO, said: “The DH has failed to deliver diabetes care to the standard it set out as long ago as 2001.
“This has resulted in people with diabetes developing avoidable complications, in a high number of preventable deaths and in increased costs for the NHS.
“The expected 23% increase by 2020 in the number of people in England with diabetes will have a major impact on NHS recourses unless the efficiency and effectiveness of existing services are substantially improved.”
A spokeswoman for Mid Essex PCT said: “We have looked closely at this audit and it does not present a true picture of diabetic care in our area in 2012.
“The National Diabetes Audit (NDA) is based on 2009/10 data. It shows that NHS Mid Essex is in the mid range for seven out of the nine care processes that have been measured but there are two care processes that have significantly reduced our overall score.
“One relates to a routine blood test for creatinine that GPs order for diabetic patients. We believe that diabetic patients in mid Essex are receiving this test routinely as our Quality and Outcome Framework Figures (QOF) from our GP practices indicate this. It seems that this information was not captured by the NDA system in 09/10.
“The second relates to protein testing. The test used in mid Essex was different to the one in the national audit but was equally as effective so people with diabetes in mid Essex were not disadvantaged. We now commission the protein test that the NDA measures.
“Since 2009/10 progress has been made in a number of the care process areas. We are also making a number of improvements to diabetic care that are not measured by this audit including developing more integrated commissioning for diabetic patients so that local access to services improves and care is more ‘joined up’.
“A handbook for diabetic patients, to enable them to record and plan their care more effectively has been developed and piloted. We will be distributing this to all GP practices in mid Essex by August 2012.”