Diabetes is a leading cause of premature mortality, doubling an individual's risk of cardiovascular disease. With over 22,000 additional deaths each year, it costs over £10 billion every year to manage. It is right, therefore, that diabetes features prominently in the NHS Long Term Plan (LTP).
While type 1 diabetes cannot be prevented and is not linked to lifestyle, type 2 diabetes is largely preventable through lifestyle changes. That is why I am delighted that prevention is at the heart of the NHS Long Term Plan. One of the key commitments in the LTP is to double, to 200,000 people per year by 2024, the scale of the NHS Diabetes Prevention Programme which supports those identified as high risk of type 2 diabetes to reduce their risk.
To date NHS England has invested approximately £120 million of transformation funding into local services to target variation and improve performance in the treatment and care of people living with diabetes since 2017/18. This is focused on improving attendance at structured education to increase understanding, improving achievement of NICE targets and reducing variation across the country, reducing amputations through improved provision of multidisciplinary footcare teams, improving timelines of referrals from primary care for patients with diabetic food disease, and reducing lengths of stay for diabetic inpatients through specialist nursing services.
I absolutely agree that technology could, and should, provide vital support to people managing diabetes and I know that new treatments and technologies are being created all the time. I welcome the DHSC Research and Development Budget for 2021 of £1.3 billion, which underlines the commitment to ensure that the best possible treatments and technologies are available through the NHS at the earliest opportunity.
In addition, medical research has shown that some people with type 2 diabetes can achieve remission through adoption of low-calorie diets: this is a non-invasive treatment allowing people with type 2 diabetes to tackle their diabetes as part of leading healthier lives. NHS England launched the low-calorie diet (LCD) pilot programme in September 2020, following a commitment in the NHS Long Term Plan. While I understand that there are no immediate plans to increase research funding into this subject, NHS England is now testing different service delivery models for up to 5,000 people across 10 integrated care systems to understand how these services can best be delivered at scale by the National Health Service.
Clinical Commissioning Groups (CCG) are responsible for commissioning diabetes services for their local populations and are best placed as clinically-led organisations that have both the local knowledge and accountability, to make commissioning decisions in the best interests of their patients. This includes prescribing technologies for people living with diabetes, for example glucose monitoring devices. Commissioning decisions for the adoption of technology products in diabetes are always guided by clinical and cost-effective assessments, delivered by NICE and other regulatory bodies.
Nevertheless, I know that diabetes has emerged as a significant risk factor for patients with coronavirus, and that the NHS is strongly encouraging patients with diabetes to manage their condition using a dedicated helpline and online tools throughout the outbreak. These tools form part of the diabetes prevention programme but are more useful than ever while people with diabetes are at greater risk of infection. I agree that it is important that people with diabetes can access the routine care and support that they need, which is why I welcome the Government’s commitment to tackling the elective backlog through the biggest catch-up programme in the NHS’s history. £2 billion will be spent this year, double the previous commitment, with an additional £8 billion to be spent in the following three years. This welcome funding could deliver the equivalent of around 9 million more checks, scans and procedures and will mean NHS England can aim to deliver around 30 per cent more elective activity by 2024-25 than before the pandemic.
Finally, I understand that managing diabetes can be difficult and isolating at times, and I know that Diabetes UK worked with NHS England to produce “The Future of Diabetes” report. It emerged from this that there are a number of ways the NHS can make it easier to live with diabetes, one of which is providing more support for emotional and physical health. As a result, the NHS Diabetes Programme team is working with the NHS mental health team to explore best practice in mental health support for those with diabetes to ensure uniform access to appropriate support services across England.
I hope this reassures you about the commitment to tackling diabetes as well as supporting those living with it to lead healthier lives.