MORE than 200 diabetes specialist nurse positions remain unfilled – twice the figure reported in 2009, says Diabetes UK.

Barbara Young, the charity’s chief executive, described the shortfall as “a false economy which harms patient care and will increase costs to the NHS.

“We are very concerned that at a time when numbers of people with diabetes are increasing, there is a decrease in frontline diabetes specialist nurses.

“This will mean longer waiting times for specialist support, more unnecessary amputations, more people losing their sight and far poorer health outcomes. This is simply not acceptable.

“DSNs are crucial in supporting independence and in helping people self manage their diabetes more effectively.

She added: “They play a vital role in preventing expensive complications, in supporting people with complex needs and, critically, in providing primary care teams with specialist expertise that reduces emergency hospital care.

“Diabetes costs the NHS £9bn a year and that can only increase as a result of these short-sighted and harmful actions.”

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “It really is worrying that despite repeated warnings, NHS Trusts are still making short-sighted decisions which risk leaving patients high and dry.

“Our own survey showed that more than one in ten specialist nurses may already be at risk of redundancy – something which we know would have a serious impact on patient care.

“Not only does this put patients at risk of needless complications, but by doing so it wastes money. The smart solution for Trusts would be to keep investing in specialist services which can keep patients as well as possible and above all, out of hospital.”

June James, audit author and a diabetes consultant nurse, said: “There is a mass of evidence proving the clinical effectiveness of DSNs and their ability to reduce medication errors, the numbers of people needing admission to hospital, and length of hospital stays.

“Reductions in DSN staffing levels will continue to compromise the quality of care received by people with diabetes, complicated by associated health problems such as heart and kidney disease, or during pregnancy.

“Worryingly, even when DSNs are in post, they are being asked to cover shortfalls elsewhere.

“At a recent national meeting of around 100 hospital DSNs, I asked how many of those in attendance were being asked to work on general wards to help with staff shortages there, and nearly everyone put their hand up.”

The National Diabetes Inpatient Audit found people with diabetes account for 15 per cent of inpatients.

According to a previous survey by Diabetes UK, the average diabetes patient reported a twofold increase in their ability to manage their condition before and after seeing a specialist nurse.

Another study at Liverpool’s Aintree Hospital showed how an entirely nurse-led diabetes clinic can increase ‘good’ cholesterol levels as well as significantly reduce high blood pressure levels, a strong risk factor for heart disease – which accounts for around half of all deaths among people with diabetes.

Research presented at the Diabetes UK Annual Professional Conference in March 2011 shows the effectiveness and cost savings of Diabetes Specialist Nursing input.

An ongoing project run by Portsmouth Hospitals NHS Trust, enables a Diabetes Specialist Team, including Diabetic Specialist Nurses and a consultant, to provide proactive and reactive treatment to inpatients with diabetes.

Data extrapolated from this project shows a reduced hospital stay of 1.4 days and the researchers calculated that in their 1,000-bed hospital, this equated to a potential cost saving of between £1.5 and £4.4 million a year, with staffing cost for this project to be around £170,000.

Poorly controlled diabetes can lead to short-term complications of low blood glucose (hypoglycaemia) and high blood glucose (hyperglycaemia), which, in extreme cases, can require urgent hospital treatment. Changing blood glucose levels over the long term can increase the risk of blindness, kidney failure, stroke, heart disease and amputation.

Diabetes UK is calling on commissioners and NHS Trusts to stop cutting or freezing DSN posts to support short sighted cost saving initiatives.

The charity has written to Secretary of State for Health Andrew Lansley urging that the Department of Health questions Trusts who cut posts to ensure people with diabetes receive the highest quality care they deserve in the most cost effective way.


Diabetes factfile:

Diabetes UK is the leading charity for over 3.5 million people in the UK with diabetes.

In 2011, Diabetes UK aims to spend over £6 million on diabetes research to investigate the causes and prevention of diabetes, to improve care and treatment of diabetes and ultimately to work towards a cure.

In the UK, there are currently 2.8 million people diagnosed with diabetes and it is estimated that 850,000 people have Type 2 diabetes but do not know it.

Type 1 diabetes develops when insulin-producing cells in the pancreas are destroyed. This type of diabetes usually appears before the age of 40 and accounts for around 10 per cent of all people with diabetes.

Type 1 diabetes cannot be prevented, it is not known why it develops and it is not connected with being overweight.

People with Type 1 diabetes have to take insulin either via a pump or by injections several times a day to stay alive.

Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly.

Insulin acts as a key unlocking the cells, so if there is not enough insulin, or it is not working properly, the cells are only partially unlocked (or not at all) and glucose builds up in the blood.

Type 2 diabetes usually affects people over 40 (over 25 in people from South Asian and Black backgrounds) and can be treated with a healthy diet and increased physical activity but medication and/or insulin is often required.

In around 80 per cent of cases the condition is linked with being overweight and can go undetected for up to ten years.

One person is diagnosed with diabetes every three minutes in the UK.