Published: 11/4/2002, Volume II2, No. 5800 Page 8
A number of English patients with diabetes are being denied eye checks to check for retinopathy - a condition which can lead to blindness - even though the national service framework for diabetes standards describe screening as a 'key intervention'.
Meanwhile in Scotland, diabetics have been promised checks every year.
The first part of the diabetes framework, published in England last year, says regular surveillance for diabetic retinopathy 'can reduce the incidence of new visual impairment and blindness in people with diabetes'.
The first of 12 standards set in the framework describes it, along with early laser treatment of sightthreatening retinopathy, as a 'key intervention'. One nurse from a London primary care trust told HSJ that since responsibility for funding the tests had transferred from the health authority to the PCT, patients had reported being turned away by local optometrists.
She said: 'I've got 250 diabetes patients out of 6,000 at the surgery. Only 50 of these are tested at the hospital. My patients went to the optometrist and were told the camera [used for retinopathy tests] will not be coming any more. I only found out via a patient.'
A spokesman for charity Diabetes UK said 'a significant number' of callers to its careline had reported similar problems.
'Some people are being charged£20 to have the test done and do not know any better so they are paying it, and also people are being told the primary care group wasn't paying and are being referred back to their GP practice.'
He blamed 'delay after delay' to the implementation programme for the framework, which has still not been issued, despite publication of the standards last year:
'This is exactly what happens when you have standards but no implementation.'
Diabetes UK head of policy Bridget Turner said: 'It is unacceptable that the NHS is not currently organised or committed enough to ensure people with diabetes receive routine screening to prevent blindness.'
Last week, Scottish diabetics were promised eye checks every year.
The move for a comprehensive screening programme in Scotland follows publication of the first ever health technology assessment by the Health Technology Board for Scotland - the Scottish equivalent of the National Institute for Clinical Excellence.
Ms Turner added: 'We welcome Scotland's commitment to establishing such a programme and hope England, Wales and Northern Ireland will follow soon.'