COMMENTARY

Diabetes and the NHS Long Term Plan

Dr Partha Kar

Disclosures

February 11, 2019

Dr Partha Kar FRCP, is a consultant in diabetes & endocrinology at Portsmouth Hospitals NHS Trust. He's also associate national clinical director, Diabetes, NHS England. Medscape UK asked him for his thoughts on diabetes care and the NHS Long Term Plan.

   

Dr Partha Kar

It has been a few weeks since the much anticipated NHS Long Term Plan was published and I have been reflecting, along with many others, about what it all means for the future of the NHS and particularly diabetes.

Last year brought significant progress to the world of diabetes with some incredible developments for the NHS and for patients with type 1 and type 2 diabetes.

Flash Glucose Monitors 

We reached a major milestone in November when we announced that flash glucose monitors would be available through the NHS for tens of thousands of people with type 1 diabetes.

The wearable sensor, which is the size of a £2 coin and sits on the arm, does away with the need for inconvenient and sometimes painful finger prick blood tests by relaying glucose levels to a smart phone or e-reader.

This was a very welcome step forward, as the aim is to have uniform prescribing across the NHS irrespective of where someone with type 1 diabetes lives, which is great news for NHS patients.

Diabetes Prevention Programme

In November we committed to doubling the size of the NHS Diabetes Prevention Programme to treat 200,000 people every year. The programme, which supports those identified at high-risk of type 2 diabetes to reduce their risk, is the first of its kind in the world. It is in every part of the UK and it has already seen impressive results.

Weight loss in the patients who completed the trial was more than originally predicted and in many areas demand has outstripped supply, so the extra capacity means even more people will now benefit.

We're really looking forward to seeing the results over the next 5 years and to see how far the NHS can go in preventing people from getting type 2 diabetes.

Type 2 Diabetes Remission

In an innovative move, the NHS reacted to recent results from the DiRECT trial. This trial demonstrated encouraging results in putting type 2 diabetes in remission in those recently diagnosed with the condition.

This Diabetes UK funded trial has seen almost half of those who went on a very low calorie diet achieve remission of their type 2 diabetes after 1 year. A quarter of participants achieved a staggering 15 kg or more weight loss, and of these, 86% put their type 2 diabetes into remission.

We're putting effective research into practice with a pilot of 5,000 people to see how it can work for the NHS, in real life settings.

The NHS Long Term Plan confirmed these commitments and brought even more good news.

Diabetes and Pregnancy 

Every pregnant woman with type 1 diabetes will benefit from a continuous glucose monitor, which is a small device that sits under the skin. It measures sugar levels continuously, letting patients see trends in levels and alerts them to highs and low.

There are many advantages for pregnant women, including being able to set an alarm at high and low levels, and generally, not having to do as many, often painful, finger pricks.

We are one of the first countries in the world to do this and the efficient adoption of research into NHS action, is again something to be proud of.

Digital Innovation 

Unsurprisingly, the plan for the future of the NHS is increasingly and rightly focused on the adoption of all things digital. The plan opens a 'digital front door' to the NHS through the introduction of the NHS app.

The diabetes team has been harnessing the power of digital across its areas of work for a number of years. We will continue this work including a new digital offer with the NHS Diabetes Prevention Programme to widen patient choice, in particular for working age populations, and by expanding access to HeLP Diabetes; an online self-management tool for those with type 2 diabetes.

Giving patients the tools to manage their own conditions is a common thread in most of our plans. This empowers patients, allowing them to help themselves as well as help the NHS.

Technology is helpful and increasingly important in the age we're living in but having the right number of staff with the right skills is essential for any part of the plan to be able to work in practice in the NHS.

Hospital Services

Access to diabetes professionals is what we need for the best possible treatment and care, and that's why over the next few years the NHS will be working to ensure that every single hospital has a diabetes nurse in place.

There is also a commitment to ensure that every hospital has a multidisciplinary foot team.

These indispensable features are part of the wider pledge to continue the invaluable transformation fund for the treatment and care of diabetes.

This will help to continue to recruit nurses and podiatrists, and a lot of work is ongoing in the nursing community to make sure we have many more taking up this speciality.

Together with Public Health England and Diabetes UK and local health services across England we've already delivered a wide range of improvements.

The Long Term Plan sets out high level ambitions and now the hard work begins to put them into action so that we can do much more, for the benefit of people at risk of, and living with diabetes. 

Dr Partha Kar has made no relevant disclosures.

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