A Medical Device Daily

A report published by the UK Department of Health indicates that diabetes care in the National Health Service (NHS) is improving, with a greater focus on prevention.

The report noted that, in line with the UK government's commitment to providing a health service oriented toward preventive care, the NHS is making progress with several priorities in diabetes care:

• Identifying diabetes earlier in people who were unaware that they had the condition. Around 600,000 people have been diagnosed with diabetes in the last five years, equivalent to 2,000 a week, and are now receiving the treatment they need to manage their condition.

• Identifying people at risk of diabetes and providing treatment and advice to help prevent them from developing the condition. The vascular risk program unveiled in April, Putting Prevention First, is expected to prevent around 4,000 patients from developing diabetes each year. The obesity strategy, Healthy Weight Healthy Lives, is helping people to make lifestyle changes that will reduce their risk of diabetes

• Ensuring that people with diabetes are given tests that help to prevent long-term complications. Increasing numbers of people with diabetes are being routinely monitored by their GP for indicators of complications

The report, "Five Years On," reflects on how the NHS is performing against the standards for diabetes care set out in the National Service Framework (NSF) Delivery Strategy in 2003.

The report also cites areas identified for improvement during the second half of the timeframe set by the NSF.

For example, the report acknowledges that more work must be done to improve outcomes for young people with diabetes and that the Children and Young People Implementation Support Group, set up by the Department of Health, is working to make progress in this area.

The Department of Health also pledges to continue to work with the National Screening Committee and the NHS to offer screening for diabetic retinopathy to all people with diabetes.

Health Minister Ann Keen said, "[This] report shows that the NHS is getting better and better at identifying people with diabetes and at supporting them to manage their condition. The Next Stage Review made prevention a priority for the NHS and this is especially relevant to diabetes, as a disease whose global increase in prevalence is partly a consequence of rising obesity."

She added, "Our vascular risk assessment program, Putting Prevention First, is expected to prevent thousands of people developing diabetes each year and our strategy to tackle the rise in obesity will help many more reduce their risk of the disease."

Dr. Rowan Hillson, national clinical director for diabetes, said, "The NHS has responded impressively to the first five years of the National Service Framework. More and more people with diabetes are getting good routine care, and their outcomes are improving year on year. The next five years will continue to bring challenges for diabetes teams as they work to further improve diabetes services in both primary and secondary care."

Opportunities seen in healthcare IT

New analysis from Frost & Sullivan (London), National Programs Supporting Healthcare IT in Europe, finds that many opportunities are being created for a broad range of healthcare IT solutions.

F&S said the market will expand significantly as national health authorities gear up to take on electronic medical records (EMR), national patient identities and a range of key technology solutions.

"Rising costs have been a prime concern, particularly in the publicly funded healthcare environment," says Frost & Sullivan Research Manager Siddharth Saha. "Governments are keen on improving the quality of care by promoting quality standards, reinforcing the role of GPs, introducing DRG-like systems, improving decision making and ensuring more patient-centric healthcare delivery."

Saha says the public sector plays a dominant role in Europe and has led to centralized approaches towards implementing change in healthcare systems. This change involves key technology solutions such as EMR, patient IDs, e-prescriptions, smart cards and health IT infrastructure being promoted at national, regional and city levels.

The levels at which these programs are implemented are dependent on structural and funding mechanisms.

"The nature of healthcare systems and the mechanism of fund flows are interesting, as they act as indicators of national receptiveness toward large-scale projects and the integration requirements crucial to realize national and regional projects," Saha adds.

The most difficult challenge being faced at present is funding for these projects. Healthcare systems are under-funded, with budgets focused on operational expenses. However, F&S said this is slowly changing, with healthcare budgets increasing year on year, and local authorities being suitably empowered.

"While national programs present an effective way to undertake a systematic overhaul of healthcare systems, the level of cooperation required to realize this is easier said than done," says Saha. "These projects work on strict budgets and timelines, so modules need to be implemented like clockwork to prevent budget overruns. This level of coordination is a tremendous challenge for health authorities to achieve, as it requires unanimous buy-in from all health facilities."