The Pharmaceutical Journal
Vol 270 No 7232 p69
18 January 2003

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Delivery strategy for diabetes points way for pharmacists to extend services

Pharmacists could become more involved in providing extended services to patients with diabetes as a result of the second part of the National Service Framework for Diabetes.

The NSF delivery strategy was published last week by the Department of Health. It is designed to help the National Health Service develop a service based on the 12 standards of care set out in the first part of the NSF which was launched just over a year ago (PJ, 22/29 December 2001, p874).

The strategy specifically refers to pharmacists as being a regular point of contact for people with diabetes and says that pharmacists can play a central role in improved medicines management. It adds that diabetes services are "well positioned" to take advantage of extending prescribing to pharmacists.

Dr Gillian Hawksworth, chairman of the Royal Pharmaceutical Society's diabetes task force and Vice-President of the Society, told The Journal that while these could be interpreted as being the only specific references made to pharmacy in the document, the delivery strategy creates opportunities for pharmacists to establish themselves within the health care team. As no additional funding is being provided it will be up to pharmacists to seek local funding, perhaps through a local pharmaceutical services scheme.

The delivery strategy relies on primary care trusts (PCTs) making decisions about the best approach to delivering the diabetes standards and discusses steps that PCTs may wish to take over the next 10 years. It also offers a framework to support PCTs in agreeing local priorities so they can begin to deliver the year-on-year improvements necessary to reach the NSF for Diabetes standards. The strategy proposes key elements that PCTs should consider and sets out national objectives against which local NHS performance can be judged.

To ensure all standards are met, the Department expects PCTs to set themselves challenging, measurable targets that will result in realistic service improvements.

The strategy says that PCTs should ensure that systematic treatment regimens for people with diabetes are in place by 2006. At the heart of these will be regular reviews based on a diabetes record and a care plan developed and agreed jointly between the patient and a member of the diabetes team. It adds that structured group education programmes are a good way for PCTs to give patients advice and information about the importance of diet, physical activity and about stopping smoking to help avoid the risk of developing complications of diabetes.

The strategy also refers to the document "Improvement, expansion and reform: the next three years", issued last year, which sets out priorities for the NHS, including specific targets for diabetes for eye screening and practice-based registers.

A range of targets for each intervention in the standards is on the diabetes NSF website and PCTs and diabetes networks should draw upon these and adapt them to agree and monitor local plans in line with local priorities. Implementation of the diabetes NSF will be subject to review by the Commission for Healthcare Audit and Inspection, which is to be established in 2004.

Full details of the NSF for Diabetes delivery strategy can be found here.

News Feature, p75