The NHS postcode lottery, a term describing the variation in NHS trusts across the country, has extended to diabetes care, with amputation rates 10 times higher in some parts of England than in others.
Researchers compared lower-leg amputation rates for Primary Care Trusts (PCTs) across England over 3 years. Published in the journal Diabetologia, the figures highlight the importance of ensuring the right specialist care for diabetes sufferers, and the absence of this in certain NHS trusts.
Diabetes is a long-term condition caused by too much glucose in the blood. If it is poorly controlled, diabetes can limit the blood supply to the feet and cause a loss of feeling. This can mean foot injuries do not heal well, and the lack of feeling means sufferers may not notice if their foot is sore or injured.
But worryingly, there is a huge variation in the rates of both major and minor amputation for patients with both Type 1 and Type 2 diabetes across the country. For major amputations, rates vary from just over 2 each year for every 10,000 patients to 22.
Compared with the general population, people with diabetes were over 20 times more likely to have an amputation.
NHS Portsmouth has one of the highest rates of major amputations in England.
Study authors say that many hospitals in England do not have the necessary teams trained to deal with diabetes, and a lot of health staff are not trained to recognise the risks of foot disease. Multi-disciplinary teams should include podiatrists, surgeons and specialist nurses to manage every aspect of the condition.
Diabetic amputations are thought to cost the NHS £120m every year. The report author, Marion Kerr, says the savings from specialist foot care teams are six or seven times greater than the costs of setting them up.
In a statement the Health Minister for England, Paul Burstow, accepted that the problem had to be tackled. He said: "Amputation rates in some areas of the country are too high.
“Diabetics need to get their feet checked regularly and should see their local diabetes multi-disciplinary specialist or GP if they have concerns - this will prevent amputations.”
Since diabetes is considered a chronic condition, private medical insurance is unlikely to cover it. For more information, speak to one of our specialist advisors or compare health insurance quotes online now.
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