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NHS England commits to health checks in diabetes drive

Clinical Commissioning body to work with Public Health England to improve early diagnosis and treatment of diabetes, report says

NHS England has committed to rolling out NHS health checks and providing incentives for better management of diabetes in a drive to improve early diagnosis and treatment.

The commissioning body would work with Public Health England (PHE) to deliver NHS health checks, according to its Action for Diabetes report, published this week.

Over the next few years it would incentivise the "active management" of risk factors identified during the checks, "wherever they took place", it said. It did not provide details about what the incentives would be.

Health checks were part of "crucial" efforts to enable the early diagnosis of diabetes to save lives and prevent avoidable complications, NHS England said.

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The health checks were part of "crucial" efforts to enable the early diagnosis of diabetes to save lives in type 1 patients and prevent avoidable complications in type 2, it said.

NHS England's commitment to NHS health checks comes despite debate over their benefits. Pharmacists have raised concerns about pharmacy performance and a lack of patient interest and Cochrane review, published in 2012, concluded that the checks did not reduce mortality or morbidity.

NHS health checks in pharmacies were still patchy, Pharmacy Voice chief executive Rob Darracott told C+D this week (January 13). But PHE was increasingly showing interest in pharmacy's value which could "only be a good thing," he said.  

The diabetes report, aimed at clinical commissioning groups (CCGs), called for the development of personalised patient action plans, continuing education for patients, improved obesity management and the safe use of insulin in community settings.

NHS England also said it was considering how pharmacists could provide diabetes services as part of its commissioning strategy for primary care. The Call to Action consultation, launched in December, is calling for pharmacists to share their views on their future strategy for the sector. 

There are 2.7 million people in England who have been diagnosed with diabetes, of whom about 10 per cent have type 1 diabetes, the report highlighted. The disease leads to 22,000 deaths each year and 42.5 million items were prescribed to treat diabetes in 2012/2013, it said.

The Action for Diabetes report came in response to a report by the Public Accounts Committee, published in 2012, which criticised the NHS for its lack of support for adults with diabetes. 

How can you help ensure early diagnosis of diabetes?

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Stephen Eggleston, Community pharmacist

NHS Health checks were opened up to AQP in our area only because GPs were not reaching the targets. I looked in to this in great detail, even going as far as winning a tender but the investment required far outweighed the potential income, given that we could only offer checks to those without pre-existing conditions - in other words, if there is no pre-existing conditions, you are targeting those who have no medication and therefore don't go to a pharmacy. Fair enough - take the service to the public! Unfortunately, the service had to be provided by a pharmacist. So, on top of the heavy initial investment, you then have an additional cost of locum cover. Then you factor in possible room rental costs. No wonder pharmacists are not keen! And if GPs, who have people walk in to see them for all sorts of things, can't get a reasonable uptake, what chance have we? I know this flies in the face of all we say about 6 million visits to a pharmacy every week (or some such figure) but in order to try to lead a horse to water, you've first got to get hold of your horse!

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