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Patients need more help to self-manage diabetes, says CQC

The work of nurses has been highlighted in a major diabetes review that warns the NHS must do more to help patients self-manage their condition.

The work of nurses has been highlighted in a major diabetes review that warns the NHS must do more to help patients self-manage their condition.

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NICE recommends people with diabetes are educated in managing the condition. Picture: iStock

The review by the Care Quality Commission (CQC) on diabetes care in England states the challenge of caring for 3.5 million people with diabetes is ‘enormous’ and that the current model of care provision is unsustainable.

The My Diabetes, My Care review calls for better support for people to mange their conditions to avoid complications, including heart and kidney disease, stroke and amputations.

Structured education

The National Institute for Health and Care Excellence recommends that people with diabetes have structured education that includes advice on how to mange diabetes. 

But the CQC found a number of patients do not attend such courses because they are unaware they exist, or they are discouraged by long waiting times or because the courses are held at inconvenient times.

It also found that patients from black and minority ethnic backgrounds and people with learning disabilities are most at risk of missing out on the programmes, and that those at high risk of developing type 2 diabetes are not always identified and supported to become healthier.

Best practice

The review also highlights best practice in diabetes care, including the work of nurses at The Liverpool Diabetes Partnership.

As part of the service, which was set up in 2014, diabetes nurses provide education and health programmes, and meet with newly-diagnosed patients.

Liverpool Diabetes Partnership community diabetes specialist nurse Gerry Clarke told Nursing Standard: 'We were all working hard before, but in isolated small groups. Now we are one big group with huge opportunities to work closely together, and to share our knowledge and skills.

‘The economic climate in Liverpool had meant the closure of many services, such as healthy eating courses, which we now hope to provide instead.

‘I think the main thing we have given patients is time. Before, they had only 10 minutes with a GP or consultant, but now they get longer, personalised, meetings in a community setting that is familiar and comfortable.’

X-PERT Diabetes

Other areas singled out for praise include Elgar House Surgery – part of the Redditch and Bromsgrove CCG – where an advanced nurse practitioner recently ran a six-week, group-based education programme called X-PERT Diabetes.

The 18 patients who attended each two and a half hour session experienced weight loss and improvements in blood sugar and cholesterol levels.

Diabetes specialist nurses working from a service based at Homerton Hospital in London on behalf of City and Hackney CCG underwent behaviour change training to learn how best to alter patients’ responses to a diabetes diagnosis, and to adapt their lifestyles to manage the condition.


Further information

CQC My diabetes, my care report

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