Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 26 November (HL3958), what plans they have to ensure that podiatric services are available to diabetics who need them; and what criteria they are recommending that Clinical Commissioning Groups use to differentiate between those diabetics who will continue to require podiatric services and those who will not.
Answered by Lord Prior of Brampton
Podiatry services are commissioned locally by clinical commissioning groups working with local partners and based on the need of the local population, resources available and evidence based practice. Treatment decisions should always be made by doctors based on a patient’s individual clinical needs.
Preventing diabetes and promoting the best possible care for people with diabetes is a key priority for this Government and is part of the 2016/17 Mandate to NHS England. Building on the NHS Diabetes Prevention Programme, the Department of Health and NHS England are exploring options for ensuring a sustained focus on improving the management and care of people with diabetes.
The new National Diabetes Foot Care Audit, a module of the National Diabetes Audit, aims to establish the extent to which national guidelines on the management of diabetic foot disease are being met. The audit will provide local teams with the evidence needed to tackle any identified differences in practice which will lead to an overall improvement in management and outcomes for patients. Local and national level results will be available in March 2016. However, we do know that there has been an increase in the proportion of Trusts with multidisciplinary diabetic foot care teams, from around 60% in 2011 to over 70% in 2013.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they are changing the availability of podiatric services to diabetics, and if so, based on what criteria.
Answered by Lord Prior of Brampton
Podiatry services are commissioned locally by clinical commissioning groups working with local partners and based on the need of the local population, resources available and evidence based practice. These commissioning decisions are informed by the Joint Strategic Needs Assessment and the local Health and Wellbeing Strategy. Clinical networks provide opportunity to adopt and disseminate best practice.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what estimate they have made of the cost over a five-year period of providing group-based education courses for all people living with diabetes.
Answered by Lord Prior of Brampton
The National Institute for Health and Care Excellence Quality Standard for diabetes, attached, sets out that people with diabetes should receive a structured educational programme. NHS England is statutorily required to have regard to this.
There are a number of national and locally developed patient education programmes available including Dose Adjustment For Normal Eating (DAFNE) for Type 1 diabetes, and Diabetes Education and Self-management for Ongoing and Newly Diagnosed (DESMOND) for Type 2 diabetes.
While there is still much room for improvement, the proportion of people with diabetes being offered structured education is improving. 16% of people newly diagnosed with diabetes were offered structured education in 2012/13 compared to 8.4% of those diagnosed in 2009. In the same period the number of people newly diagnosed with diabetes offered or attending structured education rose from 11% to 18.4%.
No estimate has been made of the cost over a five-year period of providing group based education courses for all people living with diabetes.
The Department is developing plans to improve outcomes for those with diabetes. This will be announced in due course.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to increase the number of people living with diabetes who receive structured education courses to help them self-manage their diabetes, in the light of recommendations by NICE.
Answered by Lord Prior of Brampton
The National Institute for Health and Care Excellence Quality Standard for diabetes, attached, sets out that people with diabetes should receive a structured educational programme. NHS England is statutorily required to have regard to this.
There are a number of national and locally developed patient education programmes available including Dose Adjustment For Normal Eating (DAFNE) for Type 1 diabetes, and Diabetes Education and Self-management for Ongoing and Newly Diagnosed (DESMOND) for Type 2 diabetes.
While there is still much room for improvement, the proportion of people with diabetes being offered structured education is improving. 16% of people newly diagnosed with diabetes were offered structured education in 2012/13 compared to 8.4% of those diagnosed in 2009. In the same period the number of people newly diagnosed with diabetes offered or attending structured education rose from 11% to 18.4%.
No estimate has been made of the cost over a five-year period of providing group based education courses for all people living with diabetes.
The Department is developing plans to improve outcomes for those with diabetes. This will be announced in due course.
Asked by: Lord Harrison (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what progress has been made in reducing the national diabetes-related amputation rate since their commitment to halve the rate two years ago.
Answered by Earl Howe - Shadow Deputy Leader of the House of Lords
NHS England and clinical commissioning groups have responsibility for determining the overall approach to improving clinical outcomes from healthcare services for people with diabetes. Nevertheless, there are various actions at a national level which will help to ensure that all patients with diabetes receive good quality care, including foot care, to help improve outcomes and minimise amputation rates.
The new National Diabetes Foot Care Audit, a module of the National Diabetes Audit, aims to establish the extent to which national guidelines on the management of diabetic foot disease are being met. The audit will provide local teams with the evidence needed to tackle any identified differences in practice which will lead to an overall improvement in management and outcomes for patients. Local and national level results will be available in March 2016. However, we do know that there has been an increase in the proportion of trusts with multidisciplinary diabetic footcare teams, from around 60% in 2011 to over 70% in 2013.
As part of its focus on the Cardiovascular Disease Outcomes Strategy, NHS Improving Quality is working with the National Clinical Director for Diabetes to identify potential areas of service improvement such as diabetic foot disease. A number of Cardiovascular Strategic Clinical Networks are focussing on this to ensure that appropriate clinical pathways are in place which will deliver improved clinical outcomes for people with diabetes, including minimising amputation rates.
Within NHS England, the National Clinical Director for Rehabilitation and Recovering in the Community and the Chief Allied Health Professions Officer are leading work to improve rehabilitation services, including collection and dissemination of good practice. This will help to improve outcomes, such as improving/maintaining foot health, by putting the patient at the centre of their care, and a focus on their goals.