Diabetes and the NHS

Treating and managing diabetes takes up a significant and rising share of healthcare costs. Latest figures for England show that diabetes prescriptions cost £725 million a year - 8.4% of the primary healthcare budget of the NHS. The NHS spends around £1m per hour on diabetes care, as diabetes is a complex condition that touches on almost every part of the health service.

Not all of the spending on treatment is down to the cost of prescriptions. Treating diabetes also involves a range of other options such as advising and supporting patients on how to manage their condition and make changes to their lifestyle.

Postcode lottery

Devolution has created four different NHS systems in the UK, and that means people with diabetes can experience different standards of treatment and annual monitoring in what is frequently referred to as a postcode lottery.

"One of the things that was published this year within the National Diabetes Audit results was information and data showing the huge amount of variability in the care that people with diabetes receive, depending on where they live," says Gavin Terry,  policy manager for the charity Diabetes UK.

He adds that in "even the best performing PCT [Primary Care Trust] areas, only up to about 40% to 60% of patients were getting all of the nine key checks that they should receive as part of their annual review".

Those figures covered England and Wales. In Scotland, a survey carried out by the charity in 2010 found that almost a quarter of patients (24.2%) had never seen an NHS dietician, while four out of 10 people complained that they were not given time to talk when they were first diagnosed or sought advice because of a complication.

In Northern Ireland, reliable figures are harder to come by.

Meet your healthcare team

So, what kinds of treatment can a patient expect from the NHS? Once you have been diagnosed with diabetes, you are likely to come into contact with a wide range of specialists. Apart from your GP, these may include a consultant, a diabetes specialist nurse, an eye specialist, a podiatrist (chiropodist) and a dietitian.

Treatment will depend on whether you are diagnosed with Type 1 or Type 2 diabetes. For the 90% of patients with diabetes who have Type 2 diabetes, treatment may revolve around diet and medication. For those with Type 1 diabetes, they will be referred to a diabetes specialist team and receive training and support to use insulin.

You should also bear in mind that you are an important part of your healthcare team because you will be living with the condition 24 hours a day, 365 days a year.

What to expect

National standards were first set out by the Department of Health for diabetes care in 2001. The Diabetes National Service Framework aimed at raising standards and reducing regional variations. In 2011, the National Institute for Health and Clinical Excellence (NICE) brought out a 13-point 'best practise' guide for how adults with diabetes should be treated.