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Diabetes: policy context

In 2000 the Scottish Executive issued a Health Department Letter, HDL(2000)12, which outlined plans to compile an annual survey of diabetes in Scotland. The HDL included a requirement for NHS Boards to ensure there is a register of patients with diabetes in their health board area. The aim was to improve the availability of data, as many of the complications of diabetes can be prevented or delayed by effective monitoring of diabetic patients.

The Scottish Intercollegiate Guidelines Network (SIGN) published SIGN 55 in 2001. This covers the management of diabetes and its complications in adults and children and supersedes previous SIGN guidelines on diabetes. An update to this guideline is expected in mid 2010. The UK National Institute for Health and Clinical Excellence published a clinical guideline on the management of type 2 diabetes in 2008.

NHS Quality Improvement Scotland published Diabetes Clinical Standards (227KB) PDF Button in 2002. These standards were reviewed during 2003 and a National Overview (504KB) PDF Buttonof findings was published in 2004. A further follow-up report was published in March 2008.

In 2002 the Scottish Executive Health Department published the Scottish Diabetes Framework, which set out a programme of action to improve the quality of services for diabetes in Scotland. The Framework highlighted seven 'first stage priority issues' (information, education and empowerment; heart disease; eye care; strategy, leadership and team working; education and training for professionals; IM&T and diabetes registers; implementation and monitoring). A multi-disciplinary, national advisory group - the Scottish Diabetes Group was established to support and monitor the implementation of the Diabetes Framework. The group is also responsible for the Scottish Diabetes Survey, which has published annual reports since 2001.

The new General Medical Services contract for UK general practices, introduced in 2004, provides a set of quality indicators within a Quality and Outcomes Framework (QOF). The 2009/10 revision of the QOF includes 17 indicators for diabetes care. It provides significant incentives to encourage better care for people with diabetes and also generates useful information about diabetes.

Delivering for Health, published in 2005, set out the Scottish Executive's programme of action for the NHS. It highlights the importance of better management of people with long term conditions (section 2.2) focussing on the example of diabetes.

Plans for a national retinopathy screening programme for diabetic retinopathy (eye disease) were announced in 2003. The programme uses digital retinopathy and covers all patients aged 12 years and over in Scotland.

In June 2006 the Scottish Executive published an updated Action Plan (2MB) PDF Button based on the Scottish Diabetes Framework. This outlines a three year programme of action to improve access to education and information for patients, improve access to specialist foot care services, improve services for people with Type 1 diabetes and help people with diabetes adopt a healthier lifestyle.

In May 2009 the Scottish Government published the Better Diabetes Care consultation which is intended to contribute to the development of a new Diabetes Action Plan.