The structure of the NHS Commissioning Board is an “act of total folly”, a leading charity chief has told HSJ.

Diabetes UK chief executive Baroness Young told HSJ that the shape of the organisation means that no single individual is responsible for improving care for diabetes patients

This is because the board will be structured around five outcome “domains”. Although one of these is “long term conditions”, Baroness Young said the others, including reducing mortality rates and patient experience, were applicable to some aspects of diabetes care.

She said: “The NHS Commissioning Board structure is an act of total folly. The condition is not being given any visibility in the new commissioning arrangement.”

And, Baroness Young said, there was a lack of certainty over how services for the rarer type one diabetes would be commissioned. It is understood that specialised services will be commissioned by the board, but this is not yet confirmed, and she said she is anxious for clarity on how it will work in practice.

Baroness Young, formerly a Labour peer, said: “If you wanted to construct a service that’s impenetrable, impossible for the patient to understand, you couldn’t do much better. I do commend [health secretary] Andrew Lansley for this.”

The charity is keen to provide advice for improving local diabetes services to clinical commissioning groups and commissioning support organisations. However, although Diabetes UK has not ruled out setting up a paid-for commissioning support service, Baroness Young said: “That’s not a priority. We don’t see the reforms as an opportunity to get our snouts in the trough”.