WIREDGOV

The scale of the "postcode lottery" of care that patients can expect across England, and the different amounts of money health authorities spend on health issues, has been highlighted for the first time in an NHS survey published yesterday.

The NHS Atlas of Variation has found that some NHS trusts are failing in key areas including diabetes care, cancer and stroke. The atlas, which consists of 34 maps, shows that people with Type 2 diabetes in the South West of England are twice as likely to have an amputation than those in the South East.

The atlas shows that only 51 per cent of people in England with type 2 diabetes and 32 per cent of those with Type 1 diabetes, had received all the nine key care checks recommended by the National Institute for Health and Clinical Excellence (NICE). These include weight, blood pressure, blood glucose, blood cholesterol, urine and foot checks.

Barbara Young, Chief Executive of Diabetes UK, said: "Diabetes UK is seriously concerned that less than half of people with diabetes have received all nine health checks. This demonstrates that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery.

"Diabetes is a serious condition and can lead to complications such as amputations, kidney failure and heart disease if not managed appropriately. However, with access to high quality care, patient education and effective diabetes management, there is no reason why people with diabetes should not live long and healthy lives. The devastating impact on some of the 2.3 million people in England with diabetes must not be dependent on geography.

"95 per cent of diabetes management is self-management. Most people with diabetes see their healthcare team only once a year for a few hours. The annual review is vital for picking up any health changes and signs of complications and can often be the only chance for people to discuss their management and treatment with their healthcare professionals. The nine checks are the minimum gold standard of diabetes care.

"The existing situation around foot care and amputations is shocking, given that the majority of amputations can be prevented. Diabetes is the single most common cause of lower-limb amputation in the UK. Foot checks as part of the annual review should be a given and any injuries or ulcers that are detected need to be assessed as soon as possible by an expert team. The longer they are left untreated, the greater the risk of deterioration and loss of the limb, which has devastating effects on a person's mobility and mood, reducing independence and causing disfigurement.

"Diabetes is one of the biggest health challenges facing the country today and the number of people with the condition is expected to rise to 5 million by 2025. Good diabetes care relies on a team of specialist healthcare professionals to provide the care and to empower the people they care for.  People across the country should have a right to expect standard levels of good practice to support them with their serious condition."

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