The diabetes CCG Improvement and Assessment Framework, alongside the transformation funding, means that commissioners are now better equipped to tackle the disease. By Chris Askew
The latest set of diabetes Clinical Commissioning Group Improvement and Assessment Framework data covering the period 2016-2017 shows that the overall performance of CCGs in delivering diabetes care has been steady.
While this might seem like nothing much to write home about, the CCG IAF, along with the NHS England £40 million transformation funding, has the potential to make a real change to diabetes care, and in turn, to greatly improve the lives of the 2.9 million people diagnosed with diabetes in the country.
While there have been some improvements to the delivery of diabetes care in England and Wales over the last four years, the overall outcomes of care are still characterised by significant levels of variation. Data from the 2016-2017 National Diabetes Audit shows that just 18.9 per cent of people with Type 1 diabetes and only 40.8 per cent of people with Type 2 diabetes are achieving the recommended treatment targets for blood glucose, cholesterol and blood pressure.
This is a huge cause for concern because poorly controlled diabetes significantly increases the risk of life threatening and debilitating complications. Diabetes is the leading cause of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.
As well as the human cost, diabetes and its many complications cost the NHS £10bn every year, which represents around 10 per cent of the entire NHS budget. With the numbers of people with diabetes continuing to rise, unless we get better at supporting people with diabetes to live well, these figures threaten to rise to unsustainable levels.
To help CCGs use the diabetes IAF and transformation funding effectively Diabetes UK offers a range of support to CCGs, including boosting attendance of structured education and improving foot care services
Thankfully health leaders now get this, and after some years of neglect there is a greater national focus on improving diabetes care. This is what in part led to the development of the diabetes CCG IAF, which was established in 2015 along with a number of other key services, including mental health, cancer and dementia.
Better access to diabetes education and meeting the key diabetes treatment targets have been set as the indicators for measuring the quality of diabetes care.
Both of these metrics are very important; as noted earlier, a significant number of people with diabetes are not achieving their key treatment targets and evidence shows that giving people the knowledge and skills to manage their diabetes effectively, through a diabetes education course, leads to improvements in their control of the condition, and therefore, reduce their long term risk of complications.
Through an increase in the number of areas that have participated in the National Diabetes Audit we have a better set of data for the 2016-2017 diabetes CCG IAF. This means more local health systems and communities will be able to assess their own progress and identify what they need to do to improve the delivery of diabetes services, drive up standards, and help more people lead a better life with diabetes.
The launch of the diabetes transformation funding in 2016 also means that local areas can now bid for new money to help them target key diabetes services for improvement. It’s vital that the government commits to sustaining transformation funding at current levels of £44m until at least 2021. This would hugely help CCGs to radically improve health outcomes for people with diabetes.
To help CCGs use the diabetes IAF and transformation funding effectively, Diabetes UK offers a range of support to CCGs, including boosting attendance of structured education and improving foot care services.
It goes without saying that improving diabetes care is a complex task, but the diabetes CCG IAF, alongside the transformation funding, means that CCGs are now better equipped to make poor diabetes care a thing of the past.