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GPs 'will struggle on diabetes targets'

GPs face an uphill struggle to meet targets for diabetes in the new contract and the national service framework as a study shows many practices are not conducting basic monitoring.

Less than half of diabetes patients have had their cholesterol measured in the last year and 25 per cent have not had their blood pressure checked.

Some 60 per cent have

not had their HbA1c levels measured.

The research, carried out by the charity Healthy Heart UK, surveyed 3,741 patients with diabetes from 24 practices across England.

The patients had no history of coronary events or stroke.

The results also showed that of the patients who had had their cholesterol and blood pressure measured, half had uncontrolled hyperlipidaemia and two-thirds had uncontrolled systolic hypertension.

Eve Knight, chair of Healthy Heart UK, said: 'The results shocked me. If that's what we're doing with our high-risk patients then what are we doing with the rest of them?

'One patient had a cholesterol of over 30. There were very few people who had cholesterol under the 5mmol/l target.'

Dr Gillian Braunold, a member of the diabetes national service framework implementation group and a GPC member, said the new contract was a great lever to improve diabetes care.

The quality and outcomes framework has dedicated 99 points out of 1,000 to

diabetes.

Targets GPs will have to meet include setting up

practice-based registers, check- ing smoking status and lowering HbA1c levels to 7.4 or

less.

Dr Braunold, a GP in north London, said some of the quality indicators for diabetes overlapped with those for coronary heart disease and so practices could combine clinics and resources.

She added: 'There is nothing like incentives to get things done.

'What is in the contract is evidence-based practice. So, as long as the resources are there and GPs don't skew consultations around data collection, there is hope.'

Dr Eugene Hughes, a GP on the Isle of Wight and a member of Primary Care Diabetes Europe, said: 'The combination of the national service framework and the new contract put the management of diabetes firmly in the hands of primary care.'

He added: 'GPs will grab the opportunity and run with it. At the moment chronic

disease management pay is

demeaning.'

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