Friday, 16 September 2011

Hey! I want to be involved

First published on the Diabetes UK blog

Involving patients in their own care is a major trend running through the NHS. People with diabetes have to be more involved in managing their condition, goes the philosophy, as it will save money, resources and improve the patient’s condition.

The way it saves money is through re-organising care. Doctors are pretty expensive as they are private businesses, small business owners with an ambition to deliver great care and make some serious money. There is nothing wrong with that, but the NHS has to save £20bn in the next few years and so money is tight.

With this in mind some of the bigger businesses involved in providing GPs such as Harmoni and Care UK are looking at how they can replace doctors with well trained nurses for certain areas – no doubt an expansion of specialist diabetic nurses will be encouraged and so will more technical aspects such as how a diabetic clinic might run, teaching us how to use testing strips appropriately so we use less, and weight management. A recent study showed that providing free access to Weight Watchers classes helped reduce obesity.

Two issues spring to mind for me, one is that the introduction of the private sector (Harmoni and Weight Watchers) could be a positive thing for patients. I much prefer to see an expert diabetic nurse than a less well informed GP (although all GPs should be better informed). The second is that when it comes to re-organisation of the health service patients are not being involved.

The 7th annual Primary Care Diabetes Society national conference is now advertising itself to GPs and I got to see the programme. There are no patients as speakers and no patient groups involved in any of the sessions. Do they honestly feel that a patients couldn’t provide some good ideas for sessions such as,’ running a diabetes clinic’ (involving issues such as, clinic times and hand held records/personal plans).

Diabetes is becoming a big industry and the customers – us – are being left out of the design of this market. Rather than us telling them what it is we want and having them meet our needs it is happening the other way around. Private sector companies and the NHS are reducing costs and the patient has to fit into that model. There are many things we can do better than the NHS – such as control our own health data.

If I had all my HbA1c, cholesterol, blood pressure and other such results emailed to me so I could upload them to a secure website that my family could access I would have a huge amount of positive pressure on me to keep my HbA1c at good levels. Too many puddings and I’d be letting my family down. And when I did hit my targets we could celebrate together. But that’s all just too complicated for the NHS. What a shame no one gets to listen to our ideas. What a shame the 7th annual Primary Care Diabetes Society doesn’t have a platform for listening to the people they are treating.