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GPs to deliver diabetes NSF from April via new contract

The Government is expecting GPs to deliver the new diabetes national service framework through the new contract.

Under the framework published last week, GPs in England will be told to start setting up practice-based diabetes registers from April, as well as offering regular check-ups and retinal screening.

By 2006, 80 per cent of patients with diabetes should have been offered retinopathy screening, rising to 100 per cent by 2007.

Registers will have to cover the majority of patients at high risk of heart disease, especially those with hypertension, diabetes and a body mass index greater than 30.

Practices will be audited by PCTs to assess the quality of diabetes care, the framework said.

But GPs said they had been left 'high and dry' because ministers had not ring-fenced any money to implement the NSF and had dumped the delivery strategy in the new

contract.

If the contract gets the go-ahead, GPs will be able to apply for money in advance to deliver higher-quality diabetes care and will be rewarded for achieving targets.

Technically GPs will be able to 'opt out' of diabetes care but not without losing income.

Dr Eugene Hughes, an executive member of Primary Care Diabetes Europe, said money for the diabetes framework should have been ring-fenced to prevent the resource problems seen with other frameworks.

Dr Hughes, a GP on the Isle of Wight, said that the Government had failed to make it clear where extra cash for the framework would come from.

He added: 'GPs have been left high and dry. We tend to do what PCTs tell us and PCTs will have difficulty forming a coherent strategy until the new contract is priced. The NSF is out but we haven't got a contract to implement it with.'

Dr Hamish Meldrum, joint-deputy chair of the GPC, said there was overlap between the standards in the diabetes NSF and the quality markers in the new contract.

The diabetes national service framework was first announced in January 1999 and standards of care were published in December 2001, but the delivery strategy had been delayed since last summer.

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