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Framework for diabetes reined back by CHD costs

The Government deliberately delayed the national service framework for diabetes because of the cost and workload involved in meeting targets in the coronary heart disease NSF, according to a senior GP framework adviser.

Professor Mike Pringle, co-chair of the diabetes NSF implementation group, told delegates at a cardiovascular risk meeting in London earlier this month that he was told to 'slow down' drawing up the framework following a BMJ article highlighting primary care cost and workload pressures over CHD.

The beleaguered diabetes NSF was split into two parts last December, and the Department of Health pledged the second part of the framework ­ the delivery strategy ­ would be published in the summer following the Comprehensive Spending Review in July. Publication of the framework is expected 'soon', according to the department.

Dr Eugene Hughes, an executive member of Primary Care Diabetes Europe and a GP on the Isle of Wight, said delaying the framework on cost grounds was a 'lame


He said: 'The delay in actually publishing it saps morale and stops primary care organisations from planning.'

Dr Neil Munro, a GP in Claygate, Surrey, and an associate specialist in diabetes at the Chelsea and Westminster Hospital in London, said he was not surprised by the latest revelation.

'From what I can gather, the information is there. One is certain the delay is either related to workload and the new contract, or because the cost of the coronary heart disease NSF has been so prohibitive. I'm sufficiently cynical to believe it's mostly economic,' he said.

Speaking at the National Association of Primary Care conference in Manchester last month, Professor Pringle said primary care organisations would have a relatively free role in local implementation of the NSF.

Professor Pringle, professor of general practice at the University of Nottingham, said all practices would have to supply diabetes audit data, not only to their PCT but also to

secondary care organisations.

He added patient services would be developed including 24-hour access through NHS Direct to medical staff with specialist diabetes knowledge.

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