Is your G.P. doing enough for your diabetes?

Doctor waiting for a patientData from the National Diabetes Audit 2011/12, released last year, showed only 5% of diabetes patients were referred to a structured education programme during that 12-month period, and of those, just 1% took up the programme.”

But Dr David Payton, RCGP clinical lead for commissioning, warned that increasing self-care support for diabetes patients would require a ‘huge amount of training’ for general practice, which might not be feasible…

These excerpts, from a report I read recently, prompted me to wonder why there is such apparent apathy in meeting recommendations by the National Institute for Clinical Excellence (NICE) that EVERY newly diagnosed diabetic should be given access to structured education? Why would doing so need a massive amount of “unfeasible” training in general practice? 

Could there be another underlying reason? 

Could it be that G.P. targets for diabetes care are simply too lax?

You see, your G.P. practice has to meet specific targets, called QOF, in order to achieve its government subsidy.  Many practices are achieving these easily because they are simply too easy to achieve.

HbA1c is the measure used to reflect average blood glucose levels over a period of weeks.  For non-diabetics that measure is between 20 and 41 mmol/mol.  Get to 42 and you might be described as “prediabetic”.  At 48 a diabetic is thought to be in “good control”.  Above 59, a diabetic is at serious risk of severe complications from the disease.

G.P.s receive their maximum financial incentive when you reach 59.  They have no further incentive through QOF.  There is no financial benefit through QOF for your G.P. to help you reach “good control”.  

In my world that is not OK.  It’s simply not OK!

But this might tell us why doing more is “unfeasible“?  “Unfeasible” for your G.P.’s budget plan maybe.  But an absolute necessity in terms of your health!

health choicesThe big question this week is this:

“If you are simply not going to be given this opportunity within the NHS – what are you going to do for yourself?”


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