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Weekly diabetes parliamentary round-up

House of Commons Questions

Diabetes – DH – Pauline Latham

Mon, 28 November 2016 | House of Commons – Written Answer

Asked by Pauline Latham (Mid Derbyshire) To ask the Secretary of State for Health, what steps his Department is taking to support clinical commissioning groups that need improvement or have the greatest need for improvement for diabetes care under the Clinical Commissioning Group Improvement and Assessment Framework.

Answered by: Nicola Blackwood Answered on: 28 November 2016

NHS England will work with health communities/clinical commissioning groups (CCGs) in need of improvement against CCG Improvement and Assessment Framework indicators to mutually identify the nature of the change needed and the type of support required to achieve this. A key focus of improvement will be to support CCGs and providers to locally map their services against nationally recognised best practice diabetes pathways and to identify where local pathways need to change in order to improve outcomes. NHS England is developing plans for additional support to be available from 2017/18 onwards:

– The NHS Operational Planning and Contracting Guidance 2017-2019 included an announcement that NHS England intends to launch a major programme of investment in the treatment and care of people with diabetes, for which CCGs will be able to bid for additional funding of approximately £40 million per year, focused on the key areas of diabetes care where improvements in outcomes will be most beneficial.

– A Diabetes CCG Improvement and Assessment Framework Independent Panel has been developed, chaired by the Chief Executive of Diabetes UK and includes panel members with a wide range of other diabetes clinical expertise. This will consider CCG positions in relation to the diabetes Improvement and Assessment Framework indicators and advise on actions to support improvement.

– Sustainability and Transformation Plans (STPs). As part of supporting the development of STPs, a “How to” guide for diabetes has been issued which sets out advice the actions which CCGs can take to support improvements.

– NHS England regional teams: NHS England has funded diabetes programme leads within each of the National Health Service regions to work with CCGs to support improvement.


Diabetes: Chiropody – DH – Lyn Brown

Mon, 28 November 2016 | House of Commons – Written Answer

Asked by Lyn Brown (West Ham) To ask the Secretary of State for Health, what estimate his Department has made of the average number of people with diabetes in England who received a foot risk assessment within 24 hours of admission to hospital in the last 12 months.

Answered by: Nicola Blackwood Answered on: 28 November 2016

This information is not held in the format requested.

However, the National Diabetes Inpatient Audit (NaDIA) (part of the National Diabetes Audit programme) collects information on inpatients with diabetes in England and Wales that had a specific diabetic foot risk examination for ulceration within 24 hours of admission to hospital. The most recent report, published in June 2016, can be found at the following link:

http://content.digital.nhs.uk/catalogue/PUB20206/nati-diab-inp-audi-15-nat-rep.pdf


Diabetes – DH – Pauline Latham

Mon, 28 November 2016 | House of Commons – Written Answer

Asked by Pauline Latham (Mid Derbyshire) To ask the Secretary of State for Health, what steps his Department is taking to hold NHS England to account on the delivery of the diabetes metrics outlined in the Clinical Commissioning Group Improvement and Assessment Framework 2016-17.

Answered by: Nicola Blackwood Answered on: 28 November 2016

The mandate to NHS England requires it to develop the Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) and its supporting indicators in 2016-17, and in subsequent years to improve CCG performance against the indicators by 2020. This includes a specific reference to diabetes. NHS England is being held to account for achieving the deliverables in the 2016-17 mandate through regular assurance and accountability meetings with senior Departmental officials and my Rt. hon. Friend the Secretary of State. NHS England has completed the development of the framework and established baseline data for each group of indicators. In subsequent years, NHS England will be held to account for supporting CCGs to deliver improvements in the CCG IAF indicators.


 

Diabetes – DH – Pauline Latham

Mon, 28 November 2016 | House of Commons – Written Answer

Asked by Pauline Latham (Mid Derbyshire) To ask the Secretary of State for Health, what timetable he has set for publishing the next diabetes-specific ratings as part of the Clinical Commissioning Group Improvement and Assessment Framework; and if he will publish that data on a quarterly basis.

Answered by: Nicola Blackwood Answered on: 28 November 2016

As part of its statutory duty to perform an annual assessment of clinical commissioning groups (CCGs), NHS England will publish its 2016/17 annual assessment of the six clinical priority areas within the CCG Improvement and Assessment Framework in July 2017, which include diabetes. All indicators that are available are updated as frequently as possible; the diabetes indicators are based on annual data.


Pupils: Chronic Illnesses – DfE – Mr Jamie Reed

Tue, 29 November 2016 | House of Commons – Written Answer

Asked by Mr Jamie Reed (Copeland) To ask the Secretary of State for Education, how many schools have been judged by Ofsted to not provide the necessary level of support to children with medical conditions in each of the last five years.

Answered by: Edward Timpson Answered on: 29 November 2016

We do not hold this information. Ofsted inspectors make graded judgements on the effectiveness of leadership and management; the quality of teaching, learning and assessment; pupils’ personal development, behaviour and welfare; and pupils’ outcomes.

In making these judgements, inspectors will evaluate the experience of particular individuals and groups, including those with medical needs, and this will inform the overall judgment of the school. These evaluations may not always be visible in the report, as Ofsted inspectors will be careful not to identify individual pupils.

We know how important it is that children with medical conditions are supported to enjoy a full education. That is why in 2014 we introduced a new duty to require governing bodies to make arrangements to support pupils with medical conditions and have provided statutory guidance outlining schools’ responsibilities in this area.

We continue to work with organisations with experience in supporting children with medical conditions to help raise awareness of the duty.

Article

Levelling Up Diabetes Care

We spend more money on treating complications than fighting to prevent them. Despite good work being done, access to quality diabetes care is still unequal across the UK, which means not everyone is getting the support they need. Addressing this unfairness, we launched on November 23rd our new report on parliament, the result of a year-long investigation on the causes and solutions to this variation.

You can download the report here: Levelling Up: Tackling Variation in Diabetes Care


A revolution in diabetes care

Secretary of State for Health, the Rt Hon Jeremy Hunt MP, spoke at the reception and praised the report. He said the time had come “to see words turned into action” and added that people with diabetes could hold the Government to “our promises about transforming diabetes care”.

He urged the audience of MPs, healthcare professionals and campaigners, including people with diabetes, to use the report, which provides solutions to tackle the current variation in care, as a blueprint to go to their Clinical Commissioning Groups (CCGs) and push for change. He said the £40 million that had been announced by the Government was designed to improve diabetes care, including improving access to structured education.

Rt Hon Keith Vaz MP, Chair of the All Party Parliamentary Group for Diabetes, said: “We are on a cliff edge and things must change. We must revolutionise diabetes care and we need to motivate and put pressure on CCGs.”

“CCGs and other health service providers need to have more staff who can educate patients about diabetes, as well as more diabetes specialists on hand to deliver NICE’s (National Institute for Health and Care Excellence) recommended yearly healthcare checks for people with diabetes. There are simply some providers who are just not delivering, so we hope CCGs will use this extra money to ensure there is better diabetes care in their catchment areas.”


‘We want to see real change and quickly’

Diabetes UK’s Chief Executive, Chris Askew, said: “Too few people with diabetes are being offered an education course and even if they are offered take-up is low. We want to see real change and quickly. Our aim is to see half of all people with diabetes attending a course by 2020. It is no exaggeration to say that these courses could mean the difference between life and death.”

Chief Executive of the Type 1 diabetes charity JDRF, Karen Addington, said: “People with Type 1 diabetes are still routinely receiving poorer care when compared to people with Type 2 diabetes. This must change. Access to technologies such as insulin pumps needs to improve if we are to raise standards of care.”


See some pictures of the event below. If using any, please credit Philippa Gedge Photography.

 

 

 

Article

Weekly diabetes parliamentary round-up

A busy week in Parliament with:

House of Commons Questions

Cardiovascular Disease – DH – Mr Graham Allen

Tue, 22 November 2016 | House of Commons – Written Answer

  1. Asked by Mr Graham Allen (Nottingham North) To ask the Secretary of State for Health, if he will make an assessment of the achievements of the (a) Cardiovascular disease (CVD) outcomes strategy and (b) CVD expert forum since their establishment.
  2. Asked by Mr Graham Allen (Nottingham North) To ask the Secretary of State for Health, pursuant to the Answer of 11 October 2016 to Question 46460, who the members of the Cardiovascular Disease expert forum are; and how regularly that forum meets.
  3. Asked by Mr Graham Allen (Nottingham North) To ask the Secretary of State for Health, pursuant to the Answer of 13 July 2016 to Question 42224, what the remit of the Cardiovascular Disease collaborative group is; and how regularly that group meets.

Answered by: David Mowat Answered on: 22 November 2016

No assessment has been made of the achievements of the Cardiovascular Disease (CVD) Outcomes Strategy or the CVD collaborative group.

The CVD collaborative group is still in the early days of establishment. Its principle purpose is to bring together relevant stakeholders in the field of CVD and to provide a forum where relevant work being undertaken in this area and potential new initiatives can be discussed and responsibilities for action determined. The group’s overarching objective is to improve health outcomes for people with or at risk of CVD, including stroke.

Membership of the group comprises of representatives from NHS England including the relevant National Clinical Directors; Public Health England; Diabetes UK; British Heart Foundation; Heart-UK; British Kidney Health Association; Stroke Association and the Local Government Association.

The group aims to meet three times per year. Continue Reading

Article

Tackling variation in diabetes care

The APPG for Diabetes launches today its latest report titled ‘Levelling Up: Tackling Variation in Diabetes Care’. This report is the result of a year-long inquiry into the causes and solutions to the variation in diabetes care. The report sums up the evidence collected from healthcare professionals, academics, commissioners and people with diabetes, making recommendations for how we can secure a better diabetes care for everyone. The official launch will start at 4pm today with a reception in parliament.

You can download the report here: Levelling Up: Tackling Variation in Diabetes Care


With over 4.5 million people living with diabetes in the UK, the condition is the most serious challenge facing the NHS today. Every week, diabetes leads to over 140 lower limb amputations, 450 heart attacks, 540 strokes and 460 early deaths. At the moment, we are spending more money on hospital stays, kidney complications, and performing amputations instead of helping people to avoid those complications ever occurring. There is a lot of great work going on to help people to manage their diabetes – but far too often, the quality of care someone receives, and consequently the outcomes they achieve, depends on where they live. We must focus our intentions on ensuring that everyone already living with diabetes has the necessary skills and support to manage their condition and reduce the risk of long term complications.

This report is timely as the Government and NHS England announced that all Clinical Commissioning Groups (CCGs) will have the opportunity to bid for additional national funding of approximately £40 million to promote access to evidence based interventions to improve diabetes outcomes. This will be in four key areas:

  • Improving the achievement of the NICE recommended treatment targets whilst driving down variation betweet CCGs;
  • Improving uptake of structured education courses;
  • Improving access to specialist inpatient support;
  • Improving access to a multi-disciplinary foor team for people with diabetic foot disease.

It is vital that this opportunity is grasped and used wisely to transform diabetes services and tackle the variation in diabetes care. The evidence from the report shows how it can be done. The report asks what the areas who are struggling to provide quality diabetes care and support services can learn from the areas which are doing well.

The key message is that good diabetes care is possible, the task is to make it happen everywhere.


Access to key technologies

For people with diabetes, access to the right technology is a matter of safety, control and quality of life. However, self-funding is a worryingly common theme for all people with diabetes, and muddled funding processes make accessing technology difficult even when someone satisfies the NICE criteria for it. The danger facing the NHS is that only the well-off are able to access devices that make living with diabetes easier and contribute to improved health outcomes. The report supports clearer funding pathways for diabetes technology for both patients and healthcare professionals, combined with the necessary training so people can be supported to use the devices successfully.


Support to manage their condition

For people with diabetes, self-management is a large part of their diabetes care. The NHS needs to support a comprehensive and consistent approach that includes: information and one-to-one advice, ongoing informal learning and structured diabetes education courses. CCGs need to plan a radical expansion in diabetes education, with a wider menu of options, and ensure that people with diabetes within a year of diagnosis have attended the courses. Moreover, a national standard of diabetes education for children and young people under the age of 18 is needed, which where appropriate includes training on how to use diabetes technologies such as insulin pumps and CGM.

Finally, there is the need to provide emotional and psychological support to people with diabetes.The anxiety and stress associated with the management of a long-term health condition plus the stigma associated with Type 2 diabetes has harmed people’s motivation to care for themselves.


High quality conversations with the right healthcare professionals

While information should be consistent, treatment plans benefit from being integrated and tailored by specialized professionals to an individual’s needs and lifestyles, allowing the patient to input into the decision-making process. Furthermore, as primary care deals with an ever increasing proportion of diabetes care, training for healthcare professionals should be increased to allow them to have the knowledge and skills to give accurate advice. Health Education England needs to ensure non-diabetes specialists are able to look after people with diabetes well and that there are enough specialists to support the increasing number of people with diabetes.

In terms of integration, local health economies also need to have effective local networks that share data, reduce financial barriers between organisations and undertake a regular quality improvement cycle, including integrated IT systems that allow for a patient’s information to follow them across primary and hospital care.


 

Every two minutes, another person is diagnosed with diabetes. The time to improve diabetes care is now. NHS England needs to work collaboratively with local health economies to support the effective use of transformation funds to address the recommendations in the report, supporting and monitoring delivery to enable high quality care. Furthermore, the Department of Health needs to ensure that the Mandate to NHS England recognises the importance of reducing the variation in diabetes care, by including a specific measurable on reducing variation in the number of people reaching the three treatment targets.

Variation is not a signal of despair – but of hope. It shows that good care can be achieved. Our task is to make it happen everywhere to tackle the diabetes crisis.

Download the report here: Levelling Up: Tackling Variation in Diabetes Care

Article

Diabetes in Parliament: 11th – 28th November

House of Commons Questions

Vaz, K – DH – Diabetes prevention

Tue, 15 November 2016 | House of Commons – Oral Question

Keith Vaz (Leicester East) (Lab)

Yesterday, on World Diabetes Day, the Prime Minister opened the new headquarters of Diabetes UK and said that the number of cases of diabetes increased by 75% in the last decade. The Minister and I attended the launch of the Food Foundation’s declaration on how to tackle obesity. Which of the 10 measures put forward by the foundation has she decided to accept?

Nicola Blackwood

The right hon. Gentleman is absolutely right to raise this issue, and we are considering the contributions from the Food Foundation, which are very important. He is right about the role that obesity plays in triggering diabetes. That is why we are focusing on preventing type 2 diabetes through the world’s first national diabetes prevention programme, which aims to deliver at-scale, evidence-based behavioural change to support people to reduce their risk of developing type 2 diabetes.


Sharma, V – DH – Diabetes

Tue, 15 November 2016 | House of Commons – Oral Question

Mr Virendra Sharma (Ealing, Southall) (Lab)

T2. Diabetes is a big problem in my constituency, and the number of unnecessary lower limb amputations due to diabetes is on the rise. Will the Minister ask clinical commissioning groups to provide fully staffed community podiatry foot protection services to avoid amputations, keep people in work and make huge cost savings? [907149]

Nicola Blackwood

The hon. Gentleman is absolutely right that diabetes is a major health risk in the UK. That is why we have rolled out the first ever NHS diabetes prevention programme this year on 27 sites, covering nearly half of England and referring nearly 10,000 people. Next year, the second wave of the programme will reach a further 25% of the English population. The aim is for the NDPP to be rolled out across the whole of England by 2020 to support 100,000 people at risk of diabetes each year.


Diabetes – DH – Keith Vaz

Mon, 14 November 2016 | House of Commons – Written Answer

Asked by Keith Vaz (Leicester East) To ask the Secretary of State for Health, how many incidences of hypoglycaemia were recorded in (a) England and (b) each clinical commissioning group in 2015.

Answered by:
Nicola Blackwood
Answered on: 14 November 2016

The attached table gives a count of finished admission episodes with a primary diagnosis of hypoglycaemia for England and each clinical commissioning group of treatment for 2015/16.

However, only the most severe cases will be hospitalised and therefore this is not a count of the number of incidents in England, but the number of hospitalisations.

PQ52284 table(Excel SpreadSheet, 25.45 KB)


Newlands, G – DH – Childhood Obesity Strategy

Tue, 15 November 2016 | House of Commons – Oral Question

Gavin Newlands

A few weeks ago, I hosted a Westminster forum on the implementation of the strategy, at which there was much consternation about why another important recommendation—the creation of a 9 pm watershed to reduce children’s exposure to junk food advertising—was cut. Does the Minister not realise the seriousness of the obesity crisis, and can she explain why that important measure was dumped?

Nicola Blackwood

Current restrictions on the advertising of less healthy food and drink in the UK are among the toughest in the world, so I am pleased to reassure the hon. Gentleman and his constituents on that fact.


Law, C – DH – Television advertising and childhood obesity

Tue, 15 November 2016 | House of Commons – Oral Question

Chris Law (Dundee West) (SNP)

T5. Both Public Health England and Food Standards Scotland support restricted advertising of junk food to children, yet this was entirely omitted from the Government’s completely underwhelming obesity strategy. Given that we clearly cannot rely on the UK Government to take this forward, will the Secretary of State support the devolution of broadcasting powers to allow the Scottish Government to tackle the obesity crisis and its devastating impact on society? [907153]

Nicola Blackwood

The obesity plan is one of the most ambitious in the world. It will reduce obesity by a fifth by cutting the amount of sugar in our food, helping all children to engage in an hour of physical activity a day, and making it easier for families to make healthy choices. We already have some of the toughest advertising rules in the world, and we have consulted Scotland closely on these arrangements.


Donaldson, S. B – DH – Childhood Obesity Strategy

Tue, 15 November 2016 | House of Commons – Oral Question

Stuart Blair Donaldson (West Aberdeenshire and Kincardine) (SNP)

Climbing obesity rates are expected to lead to increases in type 2 diabetes, cardiovascular disease and the need for joint replacements, which will put even greater pressure on the NHS. Given such threats to health, does the Secretary of State really think that now is the time for timidity and sucking up to business?

Nicola Blackwood

As I have made absolutely clear today, I am determined not to allow the House to get lost in a debate about what the plan could or should have been. Our children deserve more from us. We should not politicise this debate; we should get on with delivering the plan that we have before becoming involved in a lengthier conversation about what a long-term obesity programme should be.


Hodgson, S – DH – Obesity

Tue, 15 November 2016 | House of Commons – Oral Question

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

Another target that “Dispatches” uncovered was to be scrapped was the target to halve childhood obesity by 2026. This was compounded by recent national childhood measurement data showing that obesity is on the rise and that obesity rates are more than double in deprived areas compared with more affluent ones. Instead of squandering this opportunity, the Government should be pushing ahead with a comprehensive and preventive strategy. Can the Minister explain, therefore, why this significant target was dropped from the Government’s plans to tackle childhood obesity?

Nicola Blackwood

The hon. Lady is right to say that the childhood obesity strategy is one of our key priorities for tackling health inequalities in the UK. Obesity prevalence for children living in the most deprived areas is double that for those living in the least deprived areas, and the gap continues to widen. That is exactly why we will press ahead with the plan, but, as she has said, this is just the beginning of the conversation and we will continue to fight obesity as a government priority. Continue Reading

Article

Lend your support for World Diabetes Day

World Diabetes Day is a day when millions of people around the world come together to raise awareness of diabetes. This year we’re talking about the complications diabetes can lead to and how to avoid them.

In the UK, diabetes leads to 65 early deaths every single day. Diabetes can cause blindness and it’s the leading cause to kidney disease. Each day, there’re over 200 cases of heart failure, over 75 strokes and more than 20 amputations caused by diabetes. The right diabetes care is crucial to help avoid developing complications now and in the future.

In honour of World Diabetes Day, we are asking MPs to pledge to improve care for everyone living with diabetes, in order to prevent these complications from ever taking place. 1011_appg_wdd-twitter-image

We are encouraging MPs to tweet this infographic to demonstrate their support for all people living with the condition. If your MP has twitter, you should be able to find their twitter handle by following this link.

Together, we can can do more to cut the financial and human costs of diabetes.

Know more of how you can know diabetes and fight diabetes.

Article

Weekly diabetes parliamentary round-up

House of Commons Questions

Cholesterol: Drugs – DH – Mr Virendra Sharma

Wed, 2 November 2016 | House of Commons – Written Answer

Asked by Mr Virendra Sharma (Ealing, Southall) To ask the Secretary of State for Health, what assessment his Department has made of the innovative potential of PCSK9 inhibitor medicines for the treatment of high levels of cholesterol.

Asked by Mr Virendra Sharma (Ealing, Southall) To ask the Secretary of State for Health, what assessment he has made of the adequacy of funding for people with high cholesterol to access PCSK9 inhibitors for the treatment of that condition.

Answered by: Nicola Blackwood Answered on: 02 November 2016

The National Institute for Health and Care Excellence (NICE) has appraised the PCSK9 inhibitors alirocumab (Praluent) and evolocumab (Repatha) for treating primary hypercholesterolaemia and mixed dyslipidaemia. In June 2016, NICE issued final technology appraisal guidance recommending both treatments, subject to certain criteria. Further information is available at:

www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal–nutritional-and-metabolic-conditions/lipid-disorders

NHS Commissioners are legally required to fund drugs and treatments recommended in NICE technology appraisal guidance within three months of its final guidance being issued.


Diabetes: Hartlepool – DH – Mr Iain Wright

Tue, 1 November 2016 | House of Commons – Written Answer

Asked by Mr Iain Wright (Hartlepool) To ask the Secretary of State for Health, what assessment he has made of the level of Type (a) 1 and (b) 2 diabetes among the population of Hartlepool constituency; and what steps he is taking to (i) manage and (ii) reduce such conditions.

Answered by: Nicola Blackwood Answered on: 01 November 2016

Diagnosed diabetes prevalence in England is taken from the Quality and Outcomes Framework (QOF) and represents all patients aged 17 and over who have been diagnosed with diabetes and included on general practice (GP) registers. Data are available by GP practices, clinical commissioning group (CCG) and for England.

Table: Estimated number of people with diabetes in Hartlepool
2014-15 Number Prevalence
Hartlepool 4,838 6.3%
Source: Quality and Outcomes Framework 2014-15. NHS Digital is the trading name of the Health and Social Care Information Centre. All rights reserved.
Notes:
  1. Diagnosed diabetes prevalence is not available by parliamentary constituency and has been estimated by aggregating GP practice level data where the postcode of the main practice falls within the local authority boundary.
  2. The data are not split by type 1 or type 2 diabetes but it is estimated that approximately 90% of all diabetes is type 2 (source: National Diabetes Audit).

This Government is working hard to improve outcomes and quality of life for those already living with diabetes and those who will develop it in the coming years.

Preventing type 2 diabetes is a key priority. Delivery of a national diabetes prevention programme is a manifesto commitment and alongside this the mandate to the National Health Service includes goals on diabetes prevention. Healthier You: the NHS Diabetes Prevention Programme (NDPP) is the first type 2 diabetes prevention programme of its kind to be delivered at scale, nationwide. By 2020, the NDPP will be made available to up to 100,000 people at risk of diabetes each year across England. Those referred will get tailored, personalised help to reduce their risk including education on healthy eating and lifestyle and bespoke physical exercise programmes.

One of our key goals in the mandate to the NHS is a measurable reduction in variation in the management and care of people with the condition within the lifetime of this Parliament. Funding has been secured through the spending review to help achieve this and NHS England is developing a programme to ensure that those CCGs which need extra investment in this area, accompanied by sound plans for delivery, receive it.

In addition, the Clinical Commissioning Group Improvement and Assessment Framework will play a key role in delivering this as it contains two recognised evidence based measures of whether patients with diabetes are being supported to successfully manage their condition (achievement of the National Institute for Health and Care Excellence treatment targets and participation in structured education programmes). Continue Reading