GPs face crackdown on adherence to NICE guidelines under new targets for diabetes

[Northerner]

GPs will be expected to double the percentage of adults with type 2 diabetes who achieve NICE-recommended blood glucose, blood pressure and cholesterol levels in five years, under new targets set by the Government.

The Government said more should be done by GPs to make sure that risk factors were controlled in diabetes and set a target for 40% of patients with diabetes to be within NICE-recommended levels, which is double the current rate of 19.8% by 2018.

It also recommends a dramatic increase in the proportion of patients with diabetes being given nine basic care processes annually - such as foot checks and microalbuminuria tests - from 50% to 80% by 2018, possibly by bundling the QOF indicators together.

Pulse last year that ministers had written to NICE to ask it to explore the practicality of raising QOF thresholds and creating a ?composite? indicator in QOF for diabetes worth over ?5,000.

The targets were revealed in a response from the Treasury to a report published by the House of Commons Public Accounts Committee that was very critical of GP the management of diabetes last year.

http://www.pulsetoday.co.uk/clinica...ernment-targets-for-diabetes/20002195.article

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[DeusXM]

Sorry - does that mean more than 80% of T2s aren't meeting the basic guidelines?

What on EARTH are these doctors doing?

 

[LeeLee]

Wouldn't surprise me... almost everything I know about D has be learned from this forum, which I stumbled across by fortunate accident 6 months ago. Before that I was as ignorant as the rest of the poor sods who are diagnosed, told what to aim for and then not told how to do it! With many on annual tellings off only, how do they know what they're doing wrong? Education, education, education should be the mantra... but that takes time and money.

 

[HelenM]

That 19.8% is actually for T1 and T2 combined:

19.8 per cent of patients had Hb1Ac, cholesterol and
blood pressure within the target ranges above.

The figures are worse for type I than Type 2
Percentage of patients in England achieving all targets*
Type 1 all ages 11.6%
Type 2 all ages 20.4%

The figures for those who get all the care processes is also lower in T1 than T2
T1 38.5%
T2 56.4%
https://catalogue.ic.nhs.uk/publica...-11/nati-diab-audi-10-11-care-proc-rep-V4.pdf

 

[trophywench]

Well you can find out by using the Diabetes Watch Tool on the DUK website.

http://www.diabetes.org.uk/About_us/Our_Views/Diabetes-Watch/Diabetes-Watch-online-tool/

There was something a while ago published where you could drill down to actually find your exact surgery, but I can't recall offhand where it was. I'll look for that now.

Haven't found it, it was when the National Diabetes Audit was released last year; there were links in a newspaper article that you could open (and I'm pretty sure Northerner posted the newspaper article in the 'news' section) and then you could drill right down and find out how many diabetics were registered to each practice and the results in each category - SHEDLOADS of info. Very frustrating not being able to find out where it lives now .....

Anyone?

 

[DeusXM]

http://www.ic.nhs.uk/diabetesinpatientaudit

Looks like a new version's out next Thursday - how timely!

The figures are worse for type I than Type 2
Percentage of patients in England achieving all targets*
Type 1 all ages 11.6%
Type 2 all ages 20.4%

Wow.

When 9 out of 10 people fail to meet the targets, isn't it time to admit that maybe the advice or care being given isn't fit for purpose?

I mean, imagine if 9 out of every 10 people having an operation died? It'd be a massive scandal. Good to see someone's at least trying to push GPs to do more work - but is there going to be any attempt to figure out better ways of managing the condition? The current advice is either not being given to patients or it's not very good advice - it's not clear which at the moment.

 

[trophywench]

It was interesting Deus being at the researcher end of a study to discover why so many people don't go to their retinopathy appointments.

Most of those who failed to attend also failed to accede to being interviewed by the researcher but of those that were intervewed, about 90% thought when they went for their eyeSIGHT test at the optician, because he shone a light in their eyes - then there was no need for anything else and THEY THOUGHT THEY WERE SAVING THE NHS MONEY.

So perhaps some of the doctors/opticians need educating, that they MUST reiterate the necessity at every opportunity amongst non-attendees?

But those people are a very small percentage of non-attendees, the vast majority of whom quite a lot of the time, don't turn up for anything despite having booked it themselves .....

A lot of people don't know if the appt offered is inconvenient for whatever reason, by phoning the service they may be able to arrange summat better for them. My docs just offer a block and you are allocated the next available appt, when they get to your name no matter how inconvenient it is. Whereas when I had to change mine this year (due in Feb but it would have been in May cos they are running 3 months late due to a mobile machine being out of commission last year but we are on hols then) so I rang the Service itself and I could go whenever I chose almost to Rugby hospital where they are based! Job done - in Feb !

But they apparently don't even KNOW this can be done at my GP surgery ....... just get Noooooo - we can't alter it ....

You cannot FORCE patients to do what THEY do not personally wish to do.