Diabetes UK funded surveys of the structural provision of primary care diabetes services in the UK.
OBJECTIVE
To describe diabetes service provision in primary care in the UK.


METHODS
Postal questionnaires were sent to all UK primary care organizations (PCOs), and to a sample of general practices in England and all practices in Wales and Scotland. The data collection period ended on 30 April 2001.


RESULTS
Seventy-nine per cent of the PCOs and 40% of the practices provided usable information. There is evidence that respondents were not significantly biased in relation to their interest in diabetes care. Diabetes was included as a Health Improvement Programme (or equivalent) priority by 62% of PCOs and had been identified as a clinical governance priority by 27%. Sixty-five per cent had information about the ethnic composition of their general population, 57% had an estimate of the number of people with diabetes. Sixty-nine per cent had a local diabetes register but this was said to cover the entire local population in only 64% of these. At least one audit of diabetes care had been carried out (in the previous 5 years) in 75% and, in 76%, clinical guidelines on diabetes care were made available to practices. In the practices, 80% had a designated lead person for diabetes. Seventy-three per cent had at least one general practitioner with a special interest and 87% at least one nurse. Seventy-two per cent of practices ran specific diabetes clinics and 51% had a screening policy. Eighty-six per cent considered that they had adequate systems in place for the delivery of diabetes care. However, only 6% were able to offer a dedicated diabetes telephone help or advice line and only 9% an evening out of hours clinic. Regular practice meetings were held to discuss diabetes in 35%, whereas 39% had a formal shared care protocol. Fourteen per cent held regular joint meetings with the hospital-based team and in 38% there was membership of Diabetes UK for at least one partner or the practice itself. A third (34%) of responding practices were unsure whether a Local Diabetes Services Advisory Group or equivalent existed in their area. Geographical differences in service provision were identified with, for example, practices in London having fewer components in place that were specifically related to the provision of diabetes care. Single-handed practices, wherever they were situated, had in place fewer staff and facilities specifically for diabetes care.
Nuffield Institute of Health, University of Leeds, Leeds, UK. d.r.r.williams@leeds.ac.uk
D R R
DR
Williams
H S
HS
Baxter
C M
CM
Airey
S
S
Ali
B
B
Turner
D003920:Diabetes Mellitus / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology