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Doing more with less?

I wonder if any of you have read the damning report from The National Audit Office on the state of Diabetes Care within the NHS. I was reading one of my other nursing journals and my attention was drawn to this article, and I'd like to challenge you to read the executive summary of this report, which can be found at

Reading this report has stirred me up. The report makes out that care is variable and that many areas of the country do not deliver the nine processes of care that were set by the NHS in 2001.

What it does not appear to consider are the patients who persistently refuse to attend screening appointments such as retinal screening, or annual diabetic reviews.

How many patients in your practices never respond to invitations for appointments, how many are reluctant to make any lifestyle changes when this is discussed at any review appointments?

Why is it we are supposed to be able to do more and more with less and less? How can we control patients' habits when we are also supposed to give them freedom to choose what they do or don't do? Do you, like me, think that the NHS needs to invest more financially in diabetes services?

There needs to be better provision of training for healthcare professionals, including those of us who are practice nurses, to remain competent to provide the care necessary, so that in the long term our patients with diabetes have better control in all three areas of blood glucose, blood pressure and cholesterol levels.

Also, if Structured Education is key to improved control, we need the finances to run these sessions; if bariatric surgery will reduce the burden of diabetes care, let's make it available to those who need it, instead of constantly being told to try and make short-term savings.

We need to pool our resources and work more closely with secondary care. They should not view us a threat - our roles are so different and we should be working to support one another, to provide more seamless care.

It would make such a difference if there could be a greater meeting of minds, more effective networking amongst us, so that we learn from our mistakes and inadequacies and are constantly working to improve our standards of care.

After all, diabetes is an ever-growing condition and reducing our resources will not assist in an effective addressing of the problem.

Let's encourage each other, and pass on to others, methods and systems that work well to improve the lot of those with Diabetes.