Long-awaited diabetes NSF launched
pharmafile | October 27, 2003 | News story | |
The long awaited diabetes national service framework has been launched with demanding new targets for the improvement of NHS services.
By 2006, every person with diabetes or at risk of developing the disease will be offered regular check-up and primary care treatment and by 2007, eye screening services for all diabetics will be provided by every PCT.
Local standards will be driven by new diabetes networks, which will include diabetes patients working as champions to develop services and priorities from the patient perspective.
Local and national audits will monitor progress, with strategic oversight for the 10-year plan in the hands of a National Clinical Director for Diabetes.
Deputy Prime Minister John Prescott, who has diabetes, launched the NSF with Health Secretary Alan Milburn.
"The diabetes NSF recognises that people with diabetes often are experts in their own care, I only spend a few hours in contact with healthcare professionals each year. Most of the time I manage my diabetes myself like others,Mr Prescott said. he NSF effectiveness lies in its recognition of this and its commitment to providing patients with the tools they need to manage their own condition."
The NSF has been severely delayed and without explanation from its original launch date of summer 2002.
Diabetes UK Chief Executive Paul Streets nevertheless gave it a cautious welcome, saying: "This is an important step to improving diabetes care but there is still a long way to go. This will be the first real test of the government plans to improve the NHS by shifting power to the local level. Decisions on providing high quality diabetes care are now with PCTs. The government must make sure that the resources PCTs have are adequate to deliver the required care."
The charity said it was, however, concerned about serious omissions from the plan, including:
a failure to immediately address the issue of finding the estimated million people who have diabetes but are unaware of it
a failure to provide ringfenced funding
a lack of performance indicators to monitor success
a failure to deal with current staffing and training failures.
Many of these omissions were in fact intentional, with the Department of Health anxious not to repeat mistakes made with earlier NSFs. Previewing the plan last year, Prof Mike Pringle, Chair of the Implementation Group for the NSF, indicated that NHS clinicians were given greater freedom to deliver improved services.
"NSFs have evolved from a top down ere are the milestones and your targetsto a much more reflective document about the overall targets and how you are going to deliver on that," he said.
He added: "When you look at the entire [Government] philosophy you know the subtext is no more prescriptive, dedicated budgets whether you call them ringfenced or whatever else."
The NHS Alliance has welcomed the decision to avoid further numeric targets, and the document assertion that PCTs must decide how best to deliver the standards.
Dr Ken Aswani, the NHS Alliance lead for diabetes, said PCTs must carefully consider its funding priorities within the diabetes networks, balancing workload, workforce and IT implications.
"Early action is essential,he said. therwise, the conclusion will be that this strategy is too little, too late. PCTs must lead the implementation and make sure that patients get the most effective care in the most appropriate setting."
Prof Carol Black, President of the Royal College of Physicians, welcomed the plans, but said the emphasis on primary care screening meant needs of patients with complex problems, to be referred to consultant specialists, had been neglected.
"With improved detection, and more thorough surveillance, it is likely at least initially that more patients will be referred sooner for specialised advice and care. It will be important to ensure that development of the relevant specialised services keeps pace with these needs."
Prof Black said the college now expected further details setting out their role in the improvement programme.
