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Health boards missing chances to improve diabetes care to save money and lives

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Health boards are failing to learn from clear evidence that interventions to improve diabetes care can save the NHS money as well as give people with diabetes longer and healthier lives, according to a new Diabetes UK report1 which highlights a series of measures that improve care and reduce costs.
NHS Wales spends £500m per year on diabetes care2 and the new report shows that this money is too often being used ineffectively, with the vast majority spent on treating complications that could often have been prevented if the person had received good healthcare in the first place.
In a period of tight financial restraints in the NHS, the report, based on conclusive research based evidence, outlines a range of practical measures that health boards can adopt that have been shown to improve the quality of care for people with diabetes and reduce costs. Many of these measures appear in health board diabetes plans but are poorly delivered in practice.

Examples include:
People with diabetes are at risk of developing serious problems with their feet that lead to amputation if not managed properly. The NHS in Wales is estimated to spend £30 million on foot care for people with diabetes3. The report demonstrates that multidisciplinary foot care teams in hospitals have reduced amputations by over half and can save over four times their cost but only half of hospitals in Wales have multidisciplinary foot care teams in place for people with diabetes4
Education can help people with diabetes effectively manage the condition and so reduce their risk of costly and debilitating complications. The Welsh Government’s Together for Health: A Diabetes Delivery Plan places education and self-management at the centre of its strategy but there is much work to do. In some health boards no education is provided and across Wales less than 1 in 3 people with newly diagnosed diabetes can currently access education5. This is despite the fact that the new report demonstrates evidence that education for people with diabetes can reduce complications and save the NHS money.

With the number of people with diabetes in Wales projected to rise from 173,000 to 288,000 by 20256, Diabetes UK says that the NHS needs to get better at learning from evidence-based demonstrations of good diabetes care and is calling on health boards to implement the measures highlighted in the report.
The charity says it is aware that it can be difficult to invest in one part of the health service if the resulting savings are in another part. But, some of the interventions highlighted in the report have been shown to make savings quickly and health boards need to be more flexible and accept the need for more pooling of budgets across primary, community and secondary care.
Dai Williams, Director of Diabetes UK Cymru, said: “The NHS is spending an eye-watering amount on diabetes but the money isn’t being used effectively, which is running up a huge bill for the future.
“This report shows how dealing with problems early, such as by improved provision of education and better foot care, costs could be greatly reduced and more people would live longer and healthier lives. With such strong evidence, it is bewildering that health boards have clear plans to deliver these services and then fail to actually make them happen in practice. “With the NHS operating in a period of flat budgets and with the number of people with diabetes rapidly increasing, it is really important that health boards see the bigger picture. One of the benefits of a national system for health ought to be fast and universal adoption of good practice.
“Put simply, if a service is shown to improve the care provided to people with diabetes and save money why on earth should it not be delivered universally and as quickly as possible”.

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