Diabetes specialist nurse funding vital to neighbourhood health service, says charity

Local systems have been urged to prioritise investment in diabetes specialist nurses as part of the government’s shift towards a neighbourhood health service.

Diabetes UK suggested the Additional Roles Reimbursement Scheme (ARRS) – used by primary care networks (PCNs) to employ staff to work across GP practices – could be used to support the development of more diabetes specialist nurses, pharmacists, dieticians and other health professionals with specialist expertise in diabetes.

The charity’s call for investment into a specialist diabetes healthcare workforce comes as part of a new report, which sets out how a neighbourhood health service could improve diabetes care across England.

As part of its 10-year plan for the health service, the government has committed to creating a neighbourhood health service that focuses on prevention and provides more care outside of hospitals and closer to home.

Diabetes UK said the move could help to provide more preventative care for people at risk of type 2 diabetes – noting that one in five adults now live with prediabetes or diabetes.

According to the charity, the cost of diabetes complications makes up 60% of the total cost to the NHS, but it stressed that ‘with the right care, treatment and support, many diabetes complications can be prevented’.

In its new ‘Delivering diabetes care in a neighbourhood health service‘ report – which draws on healthcare professionals working to improve diabetes care – Diabetes UK set out six key priorities, including investment in the healthcare workforce, the need to embed diabetes clinical leadership and financial incentives, and a focus on moving to digital healthcare.

Crucially, it urged local systems to: ‘Develop a range of roles within neighbourhood health teams that can provide diabetes care and treatment, including diabetes specialist nurses, healthcare assistants, mental health practitioners, dietitians, pharmacists, technologists, admin support and other health care professionals with specialist expertise.

‘This might be done through the Additional Role Reimbursement Scheme (ARRS).’

It also stressed the need to: ‘Embed training opportunities into the system to support upskilling and career progression for community and primary care professionals.’

The report highlighted the work done led by primary care diabetes specialist nurse who worked 24 hours a week in delivering diabetes education, guidance, support and some ‘hands-on clinics’ across the PCN – funded by ‘Covid-Recovery’ monies.

The team ‘particularly provided support for underserved communities, people newly diagnosed, women of childbearing potential and complex cases not able to be managed in routine general practice care’.

Two-year data showed that ‘202 referrals to secondary care were prevented, there was effective optimisation of glycaemia and cardio-metabolic risk factors and care processes uptake especially for the under 50 years cohort, improved greatly’, said the report.

However, funding constraints meant the project came to an end.

‘When the initial funding completed, the [diabetes specialist nurse] DSN who had led on this innovative work was not able to be funded by the Additional Role Reimbursement Scheme (ARRS) and the service ended,’ the report said.

The report’s six key recommendations included:

Embed diabetes clinical leadership to drive innovation.
Invest in financial incentives which support diabetes care and reduce inequalities in health.
Ensure neighbourhood health teams provide optimum routine diabetes care.
Invest in a healthcare professional workforce with the expertise to both prevent and treat diabetes, obesity, and multimorbidity.
Assign clear accountability for recording data and delivering improvements and integrate data across community, primary, and secondary care providers.
Underpin neighbourhood health by moving to digital healthcare.

Diabetes UK said it had been in talks with decision makers at both a national and local level about what a neighbourhood health service might look like.

Colette Marshall, chief executive of Diabetes UK, said: ‘Lasting change starts in our communities; in the environments we live in and in the care we receive.

‘Our vision is one in which diabetes prevention, treatment and care are thriving, and people are living longer, healthier lives. Delivering these outcomes will put us firmly on track towards a health system that’s fit for the future.’

In September, the government confirmed that general practice nurses (GPNs) and community nurses would help make up ‘neighbourhood health teams’ across 43 services in England.

It was revealed this month that a record number of people with type 2 diabetes enrolled in the NHS’s ‘soups and shakes’ diet programme in 2024-25, with over 13,000 participants joining the initiative aimed at supporting weight loss and potential remission.

In August, new draft NICE guidelines proposed patients be given earlier access to newer type 2 diabetes treatments to help reduce health inequalities and provide better outcomes.