Inpatient diabetes – £600 million excess outlay could be reduced with specialist care

Inpatient diabetes – £600 million excess outlay could be reduced with specialist care
 
NHS Diabetes is today calling for more investment in specialist diabetes care to reduce the estimated £600 million excess spend on treating diabetes in hospitals identified in a new report.
 
People with diabetes are more likely to be admitted to hospital and have longer stays than people of the same age without the condition.
 
The research, titled ‘Inpatient Care for People with Diabetes – The Economic Case for Change’, found that the NHS in England spends more than £2.3 billion a year[1] on inpatient care for people with diabetes. That’s 11% of NHS inpatient care expenditure.
 
About £600 million of this outlay is estimated to be excess expenditure on diabetes – that is, over and above the sum spent on a population of the same age and gender without the condition. Inpatient care for someone with diabetes costs the NHS 35% more a year than care for someone of the same age without diabetes.
 
In spite of these high levels of expenditure, the report presents evidence that diabetes inpatient care is poor in many areas. Specialist diabetes inpatient teams can improve outcomes for patients and generate savings that substantially outweigh the cost of such teams.
 
The findings have led NHS Diabetes Director Anna Morton to call for more investment in specialist diabetes teams. She said: “There is cause for concern about the quality of inpatient care and people with diabetes frequently experience avoidable complications while in hospital.
 
“If people with diabetes are admitted to hospital, care from diabetes specialist nurses reduces problems and shortens lengths of stay. Unnecessary hospital admissions and lengths of stay do not only increase costs, more importantly they cause great distress for patients.”
 
Care Services Minister Paul Burstow MP said: "Every week, 73 people lose a leg or part of a leg to amputation as a result of complications from poor diabetes care. There is a powerful human case for delivering better diabetes care. With today's report we have the economic case too. Good care can save 8 out of 10 people from the trauma of losing a limb, and save the NHS money.

"The report provides yet further evidence of the contribution diabetes specialist nurses can make. By getting things right first time, such as good foot care and medicine management, it is possible to improve quality for the patient, shortening the length of stay and saving money too."
 
The cost savings and improvements to care highlighted in the report are based on local examples. Derriford Hospital, in Plymouth, made annual net savings which are estimated at £207,000 following the introduction of a specialist nurse team. The hospital reduced emergency admission bed days for people with diabetes by around 1,129 days a year and elective admission bed days by around 762 days a year.
 
Other improvements which came on the back of introducing specialist care, included:

• A 2001 randomised controlled trial at the University Hospital of Wales found that median length of stay for patients who received standard care plus care and advice from a Diabetes Specialist Nurse (DSN) was 3 days shorter than for those who received standard care only.
• A study at New Cross Hospital, Wolverhampton, in 2006 showed the number of inpatients with diabetes fell by 35% after the introduction of an outreach team.
• In 2010 Portsmouth Hospitals NHS Trust reported that the percentage of patients with good glucose control rose from 42% to 70% after the introduction of a specialist diabetes service. Mean length of stay fell from 14.9 to 13.8 days. Readmission rates fell in all parts of the hospital covered by the team.
• A multidisciplinary team at Sheffield Teaching Hospitals NHS Trust reduced harm events by 26.2%.

For more information on the work of NHS Diabetes and supporting resources, visit our website at www.diabetes.nhs.uk.
To read the full report follow this link below..
 
http://www.diabetes.org.uk/upload/News/Inpatient%20Care%20for%20People%20with%20Diabetes%20%20The%20Economic%20Case%20for%20Change%20Nov%202011.pdf
 

[1] The £2.3 billion figure covers the costs of treating people with diabetes in hospitals irrespective of the condition which they were admitted for.