Postcode Lottery: NHS Failures Lead To Deaths Of 24,000 Diabetics Each Year

Treatment for diabetic patients is a postcode lottery with a massive variation in quality of care from one region to another, a report has revealed.

In some regions, only 6% of sufferers received the recommended levels of care compared to 69% in the highest-achieving primary care trusts (PCTs), a National Audit Office (NAO) report found.

Across England only half of people with diabetes received the recommended standards of care in 2009 to 2010. And not a single PCT delivered the nine basic care processes that reduce the risk of diabetes-related complications such as blindness, amputation or kidney disease.

The report also claims the NHS does not "clearly understand" the costs of diabetes at a local level and is therefore finding it difficult to deliver diabetes services in the most effective way.

The review into the management of adult diabetes services in the NHS in England states that up to 24,000 people die each year from avoidable causes relating to diabetes.

It said that there is poor performance in expected levels of care, low achievement of treatment standards and high numbers of avoidable deaths.

It concludes that the NHS diabetes services in England are not delivering value for money.

Darren Gough Talks About "Preventable Problem" Of Diabetes

While the DH estimates it spent £1.3 billion on diabetes services in 2009 to 2010, the NAO claimed the figure was a "substantial underestimate" and was more likely to be in the region of £3.9 billion.

The authors of the report recommend that services for the growing number of people suffering from the disease are "adequate" to help minimise additional costs that are generated by diabetes-related complications.

Barbara Young, chief executive of Diabetes UK, said the results are a "national disgrace".

She said: "The fact that the Government's own value-for-money watchdog has found that poor diabetes healthcare is resulting in avoidable complications and a high number of preventable deaths is a damning indictment of the current approach to the condition.

"By using the money we already spend on diabetes more wisely, we could stop 24,000 people dying unnecessarily every year.

"It has been clear for the last 10 years what needs to happen to fix the problem, but the plan the Government published on this has never been implemented.

"Action is needed now and escalating diabetes costs threaten to wreck the NHS budget so this is an issue that affects all of us, not just people with diabetes."

The worst offenders were Mid Essex and Swindon PCTs where less than 9% of patients were given the nine basic tests recommended by the Department of Health (DH).

The report said that the DH is not holding poorly performing PCTs to account.

The authors say: "The Department holds information to assess performance but there is a lack of accountability for PCTs who fail to ensure that the recommended standards of care are met."

Amyas Morse, head of the NAO, said: "The DH has failed to deliver diabetes care to the standard it set out as long ago as 2001.

"This has resulted in people with diabetes developing avoidable complications, in a high number of preventable deaths and in increased costs for the NHS.

"The expected 23% increase by 2020 in the number of people in England with diabetes will have a major impact on NHS recourses unless the efficiency and effectiveness of existing services are substantially improved."

Care Services Minister Paul Burstow said: "There is no excuse for delivering anything but the best diabetes care.
"Nice (National Institute for Health and Clinical Excellence) guidance and Quality Standards set out what good care looks like. By exposing poor practice and shining a light on best practice, we are determined to drive up standards for everyone.

"We are already working on a new outcomes strategy covering long-term health conditions and are committed to publishing a companion document on diabetes later this year."

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HackedOff

4 Fans

07:10 AM on 05/24/2012

I am in the dark with Elek, just what are these nine basic things????? Please post here as I live in the Swindon area and am worried that I have not been getting all the treatment that is available.

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elek

138 Fans

05:58 AM on 05/24/2012

please does anyone on here know what the 9 basic things actualy are ? thank you

thedrainpig

25 Fans

09:26 PM on 05/23/2012

Love how ignorant the public are when it comes to Diabetes. I was diagnosed as Type 2 when I was in my mid-20s, despite never having been overweight and being a sportsman. After years of complaints, once my family's history, of both Type 1 and 2 Diabetes was taken into consideration, I was correctly re-classified as a Type 1. Many comments here,equally as ignorantly, blame all Type 2 Diabetics for being responsible for having this condition. Not true! Family history is a very important thing to be considered.
Before anyone accuses me of making excuses for Diabetics, I'm not, many have brought upon them selves. However, there are many other things to be considered before making sweeping statments blaming Diabetics for their lot in life. Mis-diagnosis is one of them, doctors following trends are another, as are the regular witch hunts carried out by the red top papers in this country. Finally, the biggest problem in the jigsaw is, the NHS itself. It has never met the targets it, or the Govt of whatever colour has, set itself for the health of anyone, let alone its targets, as mentioned above, for Diabetics that were set out in 2001.
It is exactly why the NHS needs to be reformed and modernised, so that it is fit for purpose.
That is not a political comment, just the thoughts of someone who has suffered from this condition, and the NHS's inability to deliver effectve support, for almost 26 years!

edmurfin

Old man, on Bonus Time:-)

131 Fans

08:41 PM on 05/23/2012

It is not just diabetes which is dealt with at different NHS hospitals at different levels of care competence. Don't dare have a stroke in Stockport, for example - you or your parent will end up on a PEG device and die from dehydration and malnutrition - and you'll get no help to recover, even if the all -important swallow reflex returns. (Check out Professor Ray Tallis, a pioneer on the value of encouraging the swallow reflex in stroke patients as well as care of the elderly in general). If you have a complex meds regime, make sure the nurses dealing with it can read English, lest life saving drugs are not given at prescribed times. My website devoted to such problems is down now but I have so many sad tales from unhappy relatives about poor care of the elderly. At 75 and with medical conditions that will in due course require hospitalisation I am, frankly, very nervous of what might happen when I am eventually admitted.

Southern law girl

Researching my viewpoint....

160 Fans

09:11 PM on 05/23/2012

edmurfin, what you speak of seems to be everyone's fear these days. I don't know Stockport, but it is about the same in most places now. (please see my comment posted at 20.56 approx.).

A while ago a good friend of mine had to have surgery for bowel cancer, during his time at the post operative care unit, there were so many things going wrong that along with another mutual friend, we actually stayed on the ward, in shifts, until we were thrown out. At the time of being thrown out, we read the riot act to the staff, who at times became bolshy, but we dealt with it. I went to the Head of Nursing at that hospital, threatened to report her to the Nursing and Midwifery Council, and assured her I would push the issue if that particular problem wasn't sorted out. The issues were sorted out eventually, but eventually is not good enough!

I think the thing to remember is that anyone can report a nurse to the NMC, but a hospital is a different matter, you have to get the Press on board, create mayhem in the Press, it's called name and shame. Never embroider on the facts, keep straight to the point, and keep a journal, record what happens, if you cannot, get family or friends to do it for you, then they will think twice.

Part II to follow -

09:17 PM on 05/23/2012

Part II

Another thing to do is a living will. In other words, something recorded in writing as to your wishes, how you wish to be treated in your lifetime, any medical treatment 'as such', how it's to be carried out in hospital, ie resuscitation, nutrition, religious beliefs (if you have specific requirements that is), nourishment and so forth. All manner of things can be recorded in writing, in a living will. Some law centres provide help to do this, I believe CAB do this too. Anyway, I wish you all the very best!

11:06 PM on 05/23/2012

Thank you, SouthernLawgirl. You have a clear grasp of the difficulties, and you offer valuable advice:-) I did keep a journal of my mother's trials during her last nine months at Stockport. It was my intention to create a great fuss afterwards, exposing the clinical deficiencies. However, the lawyer I consulted to help me was reluctant to proceed because my interest was not about compensation - of which, no doubt, he would earn a portion - but in getting the Hospital Authority into a courtroom where they would be obliged to justify their conduct. That almost never happens, it seems, as NHS Trusts prefer to settle out of court. I may still write about the experience of my ma and of others who wrote to me in years afterwards. Or will try to when health permits. You may care to Google the Graham Pink saga, where you will see how that Trust spent 100s of 1000s of public money trying to defend themselves against Mr Pink's accusations. It was a disgraceful episode and a warning of just how the system works - or rather, does not work for the benefit of patients, especially the elderly. Again, thank you for your commonsense words. They are much appreciated :-)

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Caustic Pencil

08:39 PM on 05/23/2012

The fact is that everyone dies eventually. NHS failures do not lead to the deaths of diabetics. They may or may not result in diabetics dying younger than could have been the case. The health of a diabetic is largely in his or her control. It could of course be said that supermarkets cause people to die prematurely by promoting unhealthy food. No doubt there are failures in the NHS but lets not exaggerate the significance of these. It is hard on diabetics to blame them for their illness. In some jobs it is very difficult to get sufficient exercise. THe government could do more by providing better sports facilities

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Nicky Skerritt

1 Fans

11:09 PM on 05/23/2012

KQXVHAO - get yer facts right!!!! my dad has type 2 diabeties he walked everywhere an had 2 meals a day never been a greedy eater u ignorant person unfortunatly his dad died an his mum got throat cancer it was trauma that bought his diabeties on try reading few books before u bring your ignorant self on this site!!!!

Beth Reiter

0 Fans

02:04 AM on 05/24/2012

will walking to work make my immune system stop attacking my pancreatic islet cells?
Moron.

PGU

22 Fans

06:12 PM on 05/23/2012

About 800,000 deaths occur annually in this country. Diabetes is not one of the leading causes of death, so 3% of total mortality from medically neglected diabetes sounds suspiciously high.
This report just pulls the figure out of nowhere (at least as you present it) and such should never be believed. And it is diabetes related. The implicit assumption behind all x-related mortalities (e.g. alcohol and smoking) appears to be that man is naturally immortal, combined with that persistent logical error: post hoc; propter hoc.

Clarks0n

24 Fans

05:46 PM on 05/23/2012

Its ironic they call the deaths 'totally avoidable' and blame the NHS when type 2 diabetes is totally avoidable in the first place and the blame should lie with the patients.

aliscot

8 Fans

06:01 PM on 05/23/2012

The report is about quality of care not the cause of diabetes. I presume that you mean that diabetes 2 is caused by obesity. It can be in some cases but not all, and such generalisations are just nonsense.

06:17 PM on 05/23/2012

Type 2 diabetes is not caused by obesity, but diet and lack of exercise is the sole cause in the vast majority of cases, and to eat a diet so poor it gives you diabetes it is hard not to become obese.

dirtyboy

35 Fans

06:49 PM on 05/23/2012

HTF is type 2 totally avoidable.

majdf18148

I have nothing to declare but my curiosity

248 Fans

08:30 PM on 05/23/2012

See above.

severus193to211

62 Fans

04:38 PM on 05/23/2012

Diabetes is more prevalent among African-Caribbeans and, to a lesser extent, Africans directly from Africa. Hence, like sickle cell anaemia which is almost exclusively an African illness, the UK has deliberately placed these two illnesses as low priority or even as not requiring any funding, research or treatment. The UK sees it as just Black people’s illness, which can be ignored.

That is why in January 2011 “two ambulance workers refused to take a dying student to hospital” while she suffered from a sickle cell crisis. Sadly, Sarah Mulega aged 21 consequently died.

The problem with allocating health care resources on racial lines in the case of diabetes is that it is now fast becoming a white person’s illness as well. This is because of changing lifestyles and the increasing consumption of takeaway fast foods and supermarket prepared food designed to cause diabetes. The salt contents increase by the month in serials and precooked foods. Each new batch has more salt than the previous delivery.

West Indians are the descendants of slaves who were fed a diet of excessive salt (e.g. salted fish which is in effect poisonous), lard and the fatty bits from cattle; and whose genes they have inherited.

Today, people in the UK of ALL ethnicity are voluntarily eating food with similar contents. Hence, we expect a rapid increase in diabetes in UK among ALL ethnicity.

05:45 PM on 05/23/2012

Why should money be expressively spent on non-natives to the country? Especially when they make up a supposed 4% of the population. Perhaps their own native countries should look after them.

Also, salt has no bearing on diabetes it is purely an insulin response disorder.

talha54

06:08 PM on 05/23/2012

What an idiotic response. I suppose you are one of those who claims he has no problem with those who adopt the british way of life aswell(oh the irony). Also diabeties is most prevalent amongst south asians so that needs correcting. Instead of complaining about spending of non natives, ask yourself what have you done to contribute to the health of this country? Ever been to a care home, see what colour the people are who will be willing to wipe your backside.

09:48 PM on 05/23/2012

Clarks0n, you have posted a number of infantile comments. Are you just taking the piece?

eric14

1215 Fans

08:59 PM on 05/23/2012

West Indians are the descendants of slaves who were fed a diet of excessive salt (e.g. salted fish which is in effect poisonous), lard and the fatty bits from cattle; and whose genes they have inherited.
-------------------------
The above is based upon false science.
See:
http://en.wikipedia.org/wiki/Lamarckism

10:27 PM on 05/23/2012

What a warped comment from you.
You are contradicting yourself by referring to the principle of inheritance of acquired traits on the one hand but rejecting my suggestion that the ancestors of African Caribbeans passed on characteristics that they acquired during their lifetime to their offspring. Inheritance of acquired traits is a reality; that’s how we evolved and continue to evolve.

It is inevetable that future generations of UK residents of ALL ethnicity will inherit the diabetes traits acquired because of present day lifestyles with fast foods and supermarket salty, transfat foods.

02:06 AM on 05/24/2012

LAMARK LIVES ON!!!

cellorman

41 Fans

03:39 PM on 05/23/2012

does CORPORATE MANSLAUGHTER come to mind!!!!

allanenergy

56 Fans

04:30 PM on 05/23/2012

His reforms are not about heath they are about handing as much as he can get away with to the private sector.

04:32 PM on 05/23/2012

Sorry i should have put health not heath

bulldog77

73 Fans

03:15 PM on 05/23/2012

I'm confident that diabetes is the only area within the healthcare system that, literally, suffers because of the system.......my fear is that diabetics are simply becoming too expensive to treat!

06:02 PM on 05/23/2012

and your solutions is........ ?

11:54 PM on 05/23/2012

As a diabetic I expressed a legitimate concern for all diabetics whatever the cause of their condition.You appear to be of the opinion that I should, by default therefore, somehow have a solution to the problem facing us all, well I don't, I wish I did.
If I had a "solution" I would clearly not have found it necessary to express my fear, I would have simply handed over the answer would I not?
Your question is therefore, manifestly, an inane one.

bolden

19 Fans

02:36 PM on 05/23/2012

my husbands a diabetic and it runs in families my husband was nine stone then 20 years agio i married him 9 stone now he is blind through diabetes and on renal dialysis his uncles had the disease all skinny and his aunt, he has been treated well and not so well many times hes been in hospital

HUFFPOST SUPER USER

paulie boy

Justice for all..not the few

52 Fans

Sir Steve Redgrave is not fat and he is diabetic, I am a martial arts black belt all muscle and no fat, I am diabetic.. It has nothing to do with obesity. I feel sorry for people like your husband, my mother was diabetic, she had renal dialysis and she also went blind, my mother did not go in hospital more than twice in 93 years..She always worked and paid into the tax and National Insurance, so I think she never exploited the system..

10:35 PM on 05/23/2012

i agree with you totally on the issue i think your amazing to carry on my husband worked for 31 years and they did not want him at work they retired him on full pension at 48.

doggyboy

02:28 PM on 05/23/2012

been a diabetic for 37 years-u can rely on no one but yourself for help so perhaps education is better than medication for many suffers!

nottonguetied

02:19 PM on 05/23/2012

state drug (vaccine) abuse has so much to answer for and those involved in the adminstration of same (abuse) as well as coverup.

clanbear

5 Fans

02:04 PM on 05/23/2012

good news for CamOrOn then,save a few quid

Derek25

7 Fans

02:13 PM on 05/23/2012

No, it costs the NHS more the only profit is from the Pharmaceutics used to treat the complications so only the drugs industry could profit. Bad news for Cameron (Ithink).