The provision of care and support to help diabetes patients successfully self-manage their condition is not always flexible and responsive enough to meet individual needs, according to regulators.
The Care Quality Commission has published a review – titled My diabetes, my care – that explores the quality of care for people with both type 1 and type 2 diabetes in England.
“I encourage providers and commissioners to use the findings of this review”
CQC talked to patients aged between 18 and 65 about their experiences as well as with commissioners, providers and staff about how community diabetes care was delivered.
The review found that patients at high risk of developing type 2 diabetes were not always identified and supported to become healthier.
In addition, some patients felt they were not receiving enough emotional support – the provision of which could contribute to more effective self-management and increase engagement with services.
However, the CQC said it also saw many good examples, including commissioners and providers proactively engaging with patients and communities, and innovations to increase self-management.
“This review emphasises the importance of people having much better access to diabetes education”
It highlighted that the Silver Star charity in Slough and South Reading ran mobile units that travelled around workplaces and community hubs to discuss the risk of diabetes and offer lifestyle advice.
As a result, Slough Clinical Commissioning Group said it was able to identify 1,500 people deemed at high risk of diabetes and invite them to join an intervention programme.
The review also highlighted that people attended structured education courses felt it had improved their ability and confidence to manage their diabetes.
But the CQC said it was evident that the courses were not able to meet everyone’s needs, especially those from black and minority ethnic or with a learning disability.
There were exceptions, however. The review commended City and Hackney CCG, which trained local people to act as “lay educators” and provide culturally relevant information, support and training.
Other key findings from the review included that most people the CQC spoke to had the regular checks recommended by the National Institute for Health and Care Excellence.
Generally, patients reported they were able to discuss their care with primary care staff and they felt they received good explanations about their care, said the regulator.
However, patients showed a lack of awareness and understanding of their test results. Few people had a hand-held care plan that they could take with them as they moved across services.
In addition, knowledge of diabetes was often lacking within some staff groups, particularly in adult social care, and in some areas diabetes training for care workers was absent.
CQC chief executive David Behan called for self-management to be made “a real priority” for both the benefit of patients with diabetes and the “future sustainability of the NHS”.
“Our review highlights some great examples of community diabetes care,” he said. “But it also shows that more work is needed to ensure that everyone who lives with diabetes can access the right level of personalised care and support.
“We have seen the positive health and financial outcomes that can be achieved when people are empowered to take control and successfully supported to self-manage – and I encourage providers and commissioners to use the findings of this review to learn from what is working well,” he added.
Chris Askew, chief executive of the charity Diabetes UK, said: “We welcome the CQC’s review, which highlights just how crucial it is for people with diabetes to get good support to help them better self-manage this very serious condition.
“This review emphasises the importance of people having much better access to diabetes education, something Diabetes UK believes is vital, and it also makes it clear that emotional support needs to be available for people from the point of diagnosis to give them control of their lives,” he said.