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National service frameworks (NSF) are long-term strategies for improving specific areas of care. They set national standards, identify key interventions, and put in place agreed time scales for implementation.

The NSF for diabetes, published in 2003 along with a 10-year delivery strategy, set out 12 national standards covering all aspects of diabetes care and prevention.¹ The Department of Health (DH) produced a report in August 2008 summarising progress made over the first 5 years of implementation of this NSF.² According to this interim report, diabetes care in the NHS is improving:

• the report recognises the role that primary care is playing in improved management of this condition, and the importance of the quality and outcomes framework (QOF). Since the introduction of the QOF, there has been a year-on-year increase in patients with diabetes undergoing essential tests and measurements and, more importantly, an improvement in the results
• progress has also been made in the identification of those at risk of developing diabetes, with 600,000 people having been diagnosed with diabetes in the past 5 years, equivalent to 2000 a week—these patients can now be provided with support and advice to help prevent them from developing the condition.

As the number of people in England who have diabetes continues to rise, the report emphasises that prevention is of particular importance. The link between obesity and diabetes is highlighted as a specific concern. The obesity strategy Healthy weight, healthy lives—published earlier this year by the DH—will help people make lifestyle changes to reduce diabetes risk.³

In this month’s issue of Guidelines in Practice, Dr Matthew Capehorn reviews currently available advice on assessment and management of obesity, and highlights the importance of sharing best practice to develop local, regional, and national strategies to deal with the epidemic.

Throughout the interim report from the DH, examples of best practice are included to demonstrate how the NSF for diabetes has been implemented locally. In November 2008, Guidelines in Practice will feature an article on the set up and delivery of one of these successful initiatives—it will highlight how one PCT has used diabetes nurse practitioners to deliver at-home annual reviews, resulting in improved patient care.

References

1. Department of Health. National service framework for diabetes. London, DH: 2003.
2. Department of Health. Five years on—delivering the diabetes national service framework. London, DH: 2008.
3. Department of Health. Health weight, healthy lives—a cross-government strategy for England. London, DH: 2008.G

Julia Morris, Editor
julia.morris@mgp.ltd.uk

Would you like to share your successful local initiatives with Guidelines in Practice readers?
Write to:	Julia Morris Guidelines in Practice The Chapel Park View Road Berkhamstead Herts HP4 3EY
Email:	gip@mgp.ltd.uk