Diabetes Care

Debate between Jane Ellison and Alex Chalk

Thursday 3rd March 2016 Commons Chamber

[Jane Ellison]

I will certainly take that issue away and reflect on it, and we will speak about it again.

For people under 40, only 27% with type 1 diabetes and 41% with type 2 received all care processes, compared with 58% and 65% respectively for those aged between 65 and 79. I have some sense of why that is, but it does highlight the challenge we face. Encouragingly, 77% of those newly diagnosed with type 2 diabetes were offered structured education, but again the percentage was lower for type 1. That is clearly unacceptable, because everyone with diabetes should receive the best possible care regardless of age, postcode or the type they have been diagnosed with. That is why, in our 2016-17 refresh of the mandate to NHS England, we have made tackling variation in the management and care of people with diabetes a key priority over the lifetime of this Parliament.

[Alex Chalk (Cheltenham) (Con)]

Does the Minister agree that we need consistently early diagnosis? Early intervention is particularly important in diabetes care, as it saves the NHS from unnecessary expenditure in the long run, and, just as importantly, saves patients from unnecessary suffering.

[Jane Ellison]

That is absolutely right. I am going to talk about the national diabetes prevention programme, which goes to the heart of the problem. When I spoke to the all-party group, I mentioned the conveyer belt that can start with weight in childhood developing into type 2 and go through to the serious complications that have been alluded to. At all points along that continuum, there are things we can do, and must be doing, to make life better for people with diabetes.

Because of the mandate, diabetes is now right at the heart of NHS England’s agenda. We want it to lead a step change in preventing ill health and supporting people to live healthier lives. Our 2020 goal is for a measurable reduction in variation in the management and care of people with diabetes. However, there is some way to go, so this debate is an opportunity to update the House on some of the areas where we are going to make progress.

We have increased transparency through the creation of the Healthier Lives website, which is a major online tool from Public Health England. I encourage Members who have not looked at it to do so. It highlights variation in the prevalence and treatment of diabetes, allowing clinical commissioning groups and GP practices to compare how well they deliver diabetes care and so drive improvements and iron out variation. I will come on to the support that we are offering them as well.

The CCG outcomes indicator set provides clear comparative information. As was said, it will soon be replaced by the improvement and assessment framework, which will have two diabetes indicators aimed at reducing variation in the achievement of the NICE treatment targets and the referral and take-up of structured education. Consultation on the framework has just closed, and we expect it be published in the summer. It goes to the heart of tackling variation and the cohesive approach that was spoken about.

The NHS Right Care programme is a very practical approach to tackling variation that uses the “Atlas of Variation”. In the case of diabetes, NHS experts help CCGs and other local health system partners to make the step change they need in some areas to improve care, because transparency alone is not enough if we do not offer people support and hands-on advice. In Slough, for example, huge improvements have been made through a clinical mentorship programme that has upskilled healthcare professionals in general practices. That has resulted in an increase in patients who have had their blood glucose, blood pressure and cholesterol controlled. The Right Care programme will be rolled out across CCGs nationally by 2018.

I urge the all-party group on diabetes and the right hon. Member for Leicester East to continue to engage colleagues. It is absolutely right that Ministers are brought to the House and scrutinised about what we can do, but the very nature of our health system and the variation under discussion are also highly susceptible to pressure at local level from well-informed Members and senior councillors. I encourage him to continue to engage Members in asking the right questions at a local level.