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Association of British Clinical Diabetologists (ABCD) and Diabetes-UK survey of specialist diabetes services in the UK, 2006. 1. The consultant physician perspective

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Abstract Aims 

To identify the views and working practices of consultant diabetologists in the UK in 2006–2007, the current provision of specialist services, and to examine changes since 2000. Methods 

All 592 UK consultant diabetologists were invited to participate in an on-line survey. Quantitative and qualitative analyses of responses were undertaken. A composite ‘well-resourced service score’ was calculated. In addition to an analysis of all respondents, a sub-analysis was undertaken, comparing localities represented both in 2006/2007 and in 2000. Results 

In 2006/2007, a 49% response rate was achieved, representing 50% of acute National Health Service Trusts. Staffing levels had improved, but remained below recommendations made in 2000. Ten percent of specialist services were still provided by single-handed consultants, especially in Northern Ireland (in 50% of responses, P = 0.001 vs. other nations). Antenatal, joint adult–paediatric and ophthalmology sub-specialist diabetes services and availability of biochemical tests had improved since 2000, but access to psychology services had declined. Almost 90% of consultants had no clinical engagement in providing community diabetes services. The ‘well-resourced service score’ had not improved since 2000. There was continued evidence of disparity in resources between the nations (lowest in Wales and Northern Ireland, P = 0.007), between regions in England (lowest in the East Midlands and the Eastern regions, P = 0.028), and in centres with a single-handed consultant service (P = 0.001). Job satisfaction correlated with well-resourced service score (P = 0.001). The main concerns and threats to specialist services were deficiencies in psychology access, inadequate staffing, lack of progress in commissioning, and the detrimental impact of central policy on specialist services. Conclusions 

There are continued disparities in specialist service provision. Without effective commissioning and adequate specialist team staffing, integrated diabetes care will remain unattainable in many regions, regardless of reconfigurations and alternative service models.

Diabet. Med. 25, 643–650 (2008)
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Keywords: National Service Framework; commissioning; consultant diabetologists; diabetes; specialist services

Document Type: Special Article

Affiliations: 1: Information Analyst, Diabetes UK, London, 2: Consultant Physician, Hull Royal Infirmary, Hull, 3: Consultant Physician, Pinderfields General Hospital, Wakefield, 4: Head of Health Care Policy, Diabetes UK, London, 5: Professor of Clinical Epidemiology, Swansea University, Swansea, 6: Senior Diabetes Specialist Nurse, Peterborough Primary Care Trust, Peterborough and 7: Reader in Endocrinology and Metabolism, University of Southampton and Chair of Professional Advisory Council, Diabetes UK, Southampton, UK

Publication date: June 1, 2008

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