Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, if he will make it his Department's policy to require all GP practices to refer Type 1 and Type 2 diabetic patients (a) to podiatry services, (b) for blood testing and (c) for eye checks; and if he will make a statement.

Clinical commissioning groups (CCGs) are primarily responsible for commissioning services to meet the requirements of their population including Type 1 and Type 2 diabetes services. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines.

The National Institute for Health and Care Excellence (NICE) has published a wealth of guidance on the management and care of people with diabetes including the recently updated guidelines for the management of Type 2 diabetes in adults which are available at:

https://www.nice.org.uk/guidance/ng28/resources/type-2-diabetes-in-adults-management-1837338615493

It recommends that all people with diabetes should receive an annual health check to monitor and manage their condition, as well as reduce the risk of associated complications, such as heart, kidney and eye disease and amputations. These annual checks, some of which include blood tests, monitor body mass index, blood pressure, blood glucose, cholesterol and signs of early complications (e.g. surveillance for foot, eye and kidney disease). They provide the cornerstone of routine care for people with diabetes and the majority are incentivised through the Quality and Outcomes Framework which is a voluntary annual reward and incentive programme for all general practitioner surgeries in England, detailing practice achievement results.

The foot check enables health care professional to annually assess the risk of diabetic foot disease in people with diabetes. Guidelines help then to decide when to refer cases to a multidisciplinary foot care service or foot protection service (both of which include a podiatrist) for those identified at moderate or high risk. This is outlined in the NICE Guideline on Diabetic foot problems: prevention and management which can be found at:

https://www.nice.org.uk/guidance/ng19

The national diabetic retinopathy screening programme provides an opportunity for all people with Type 1 and Type 2 diabetes to have an annual eye check.