24,000 with diabetes ‘are dying needlessly’: Fewer than half of patients get vital checks, say MPs
By Jenny Hope
PUBLISHED: 19:01 EST, 5 November 2012 | UPDATED: 19:01 EST, 5 November 2012
Up to 24,000 patients with diabetes are dying needlessly each year despite the NHS spending £3.9billion on their care, warn MPs.
A report from an influential Commons committee says that there is an ‘unacceptable postcode lottery’ of care, with massive variations across the country.
Fewer than half of diabetes patients are given nine basic checks by their GP which can reduce the risk of complications such as blindness, amputation or kidney disease.
Risk: New figures show that less than half of diabetes patients receive the correct checks by their GP
The Public Accounts Committee warns: ‘Most alarmingly, the Department estimates 24,000 people with diabetes die prematurely each year because their diabetes has not been managed effectively.’
Unless care improves significantly, the NHS will incur ever-rising costs and avoidable deaths will continue, it says.
The number of those with diabetes, mostly type 2, is expected to rise from 3.1million to 3.8 million by 2020.
PAC chairman Margaret Hodge said fewer than one in five diabetes sufferers has the recommended levels of blood glucose, blood pressure and cholesterol.
She criticised the lack of mandatory targets to deliver diabetes care, as there are for cancer, stroke and heart disease.
Across England fewer than half of diabetes patients received the nine recommended checks between 2009 and 2010.
In some primary care trusts, standards actually worsened with fewer than one in ten patients getting proper checks.
Rising problem: The number diabetes patients is expected to rise by 700,000 in eight years
The PAC report says GP practices are being paid for individually monitoring diabetic patients rather than providing the vital nine-point check-up – and this should be changed.
The Department of Health is reviewing annual incentive payments, which could result in practices getting the cash only if they do the full range of checks for at least 75 per cent of patients.
The PAC report comes after the National Audit Office laid bare a decade of failure since minimum standards of care were set in 2001.
Mrs Hodge said progress had been ‘depressingly poor’, with no accountability at local level and no strong leadership.
‘We have seen no evidence that the Department will ensure that these issues are addressed effectively in the new NHS structure.
‘Failure to do so will lead to higher costs to the NHS as well as less than adequate support for people with diabetes.’
Barbara Young, of charity Diabetes UK, said: ‘This sets out how a postcode lottery of care has been allowed to develop that means too many are getting healthcare that’s not good enough.
‘Given the increasingly strong evidence of inadequate care, we cannot understand why the NHS has sleepwalked into this situation.
‘This has led to huge numbers of potentially preventable complications such as amputation, and to many thousands of people dying before their time.’
The Department of Health said: ‘We do not accept the conclusion services are “depressingly poor” as there has been progress. But we know there has been unacceptable variation and we’re determined to put that right.’
THE NINE CRUCIAL CHECKS
All diabetes patients should receive nine crucial tests from their GP at an annual review, including:
– Blood pressure
- Smoking status
- A marker for blood glucose called HbA1c
- Protein in the urine (for kidney damage)
– Creatinine levels in the blood (for kidney damage n cholesterol levels
– Tests to assess whether eyes have been damaged and
– Foot examinations.
If left unchecked, diabetes can lead to blindness, kidney failure and increase a person’s risk of cardiovascular problems such as heart attacks and stroke.