NHS could save £727MILLION if type 2 diabetes patients hit targets

NHS could save £727MILLION over the next decade if all over-20s with type 2 diabetes kept their blood sugar, blood pressure and cholesterol in check

  • Fewer than two in five patients meet targets to control their disease
  • If the main targets were met, it would save £1,037 per patient over 10 years 
  • The costs would mainly be saved on complications such as heart attacks 
  • It would also add an extra 1.5 years to a patient’s life, research found 

The NHS could save £727million over the next decade if type 2 diabetes patients met three key treatment targets.

Analysts say the money would mainly be saved by preventing complications caused by the condition, such as heart attacks.

Fewer than two in five patients in England and Wales keep their blood glucose, blood pressure and cholesterol levels in check. 

But the cash-strapped health service could save the equivalent of £1,000 per patient over a decade, if they were able to hit all three targets. 

Many type 2 patients find it difficult to stick to strategies to manage the condition, and the reasons are multifaceted. 

Experts say patients often avoid pills because the side effects are too strong, or they can’t afford a healthy lifestyle – such as a gym membership.  

GPs said they are too busy to give more help, and branded the findings ‘pointless’ because the study does not take into account the workforce crisis.

The NHS could save £727million over the next decade if type 2 diabetes patients met treatment targets to control their disease

Figures show there are four million people living with diabetes in the UK, and 90 per cent of those have type 2.

However, experts expect the figure to increase in the coming years amid spiralling levels of obesity.

This would add more pressure and financial strain on the NHS, which already spends 10 per cent of its budget on the type 2 diabetes. 

Approximately £10billion is spent by NHS England every year on treating diabetes in all its forms, including complications.   

Researchers at Nuffield Department of Population Health and University of Oxford looked at type 2 diabetes patients in England and Wales over the age of 20. 

WHAT ARE THE THREE TREATMENT TARGETS? 

The targets are the same for every patient with type 2 diabetes, and healthcare professionals are encouraged to help all people with type 1 and type 2 diabetes to get as close to each of the targets as possible.

The three treatment targets are fixed targets that indicate that a person’s diabetes management is good.  

Meeting these targets reduces their risk of complications in the long term.

The specific targets are: 

  • Blood glucose level/HbA1c of 58.0 mmol/mol
  • Blood pressure level of less than 140/80
  • Cholesterol level below 5 mmol/l

People with diabetes can be helped to meet more targets through various treatments, including diet and lifestyle changes or medication.

If a person has prolonged periods of time with higher than normal glucose levels, high blood pressure or high cholesterol, it can eventually cause problems.

In the year 2016-2017, all three treatment targets were met by 19 per cent of patients with type 1 diabetes and 41 per cent of patients with type 2 diabetes in England and Wales. 

They used computer software to anaylse data from the patients to predict how the condition would develop, their cost on the NHS over a lifetime and their life expectancy.

The study found meeting the three treatment targets lowered a patient’s risk of complications, such as vision loss, stroke, nerve damage and amputations.

This would yield an additional 1.5 years of healthy life per patient, according to the paper published in Diabetes, Obesity and Metabolism.

For example, the risk of having a heart attack within 10 years was 5.6 per cent if one target was met, and was 1.8 per cent if all three treatment targets were met. The trends were similar for other life-changing complications like stroke, blindness and amputation.

The team, led by researcher Mi Jun Keng, calculate the NHS could save £1,037 per patient over 10 years, if they met all the targets. 

They also claimed the health service could save £940 per patient if they hit two targets, and £859 if they managed just one.

The three main targets are set by officials at The National Institute for Health and Care Excellence (NICE).

All healthcare professionals are encouraged to help people meet these targets, for example, reaching a blood glucose level of 58.0 mmol/mol. 

The researchers admitted the savings do not factor in the potential costs – such as improved care – involved in increasing the number of patients reaching targets.

Dr Hajira Dambha-Miller, a GP and researcher at the Department of Public Health and Primary Care, University of Cambridge, slammed the study. 

Discussing the report, she told MailOnline: ‘As a GP it’s very frustrating when we see studies that do not consider the wider healthcare context.

‘Anyone can say let’s just get the GPs to do better cholesterol, sugar and blood pressure control. But without an explanation for how to achieve this, it’s pointless.

‘It doesn’t take into consideration the limited resources available to GPs and patients; the cost, time and effort it would take to make these savings.

‘GPs have 100million consultations a year – one in four of which is a patient with diabetes – we are already doing the best that we can to meet existing targets.’

She added: ‘We need more support and a better understanding of how to achieve taking into account what patients want.’

Professor Borislava Mihaylova, the senior author of the paper, said at the worst GP practises, around a quarter of patients meet the targets.

At the highest, just half of patients keep their blood glucose, blood pressure and cholesterol levels in check.

He said: ‘Our study shows that if the 10 per cent lowest performing GP were to reach the target levels achieved by the top 10 per cent performing GP, they would realise an average gain of 30 years of life for every 100 patients or 3.6 months per patient.

‘These benefits would more than double if they could get all their patients to meet all three treatment targets.’ 

Nikki Joule, policy manager at Diabetes UK, who supported the research, said: ‘It’s vital that all people with diabetes are given the support they need to meet as many of their treatment targets as possible. 

‘This will help people with diabetes live longer, healthier lives and could also save money for our already stretched NHS.’ 

While this research focuses on three treatment targets, people with diabetes are also entitled to ‘The 15 Healthcare Essentials’.

This is a set of essential health checks they are entitled to for free on the NHS which include blood glucose, blood pressure and cholesterol checks, as well as others like foot and eye screenings. 

Source: Read Full Article