Long-Term conditions (Diabetes) – Value for Money.

Review of a diabetes Locally Enhanced Service which identified the cost-benefit of the LES and worked with GPs to improve this.
. Some GP practices had sent GPs on the Warwick Diabetes Type 2 annual assessment course, and of these a number signed patients up to the LES. We analysed patient attendance at hospital for annual assessments, and compared this with the prevalence of diabetes by GP practice (trained GPs are more likely to diagnose diabetes at an early stage, resulting in earlier treatment, and probably less deterioration, higher likelihood of self management and greater quality of life though the time limits of this study did not permit us to explore this).
Although the difference in attendance was significant, it was not as great as the numbers of patients registered for the LES. We went back to the GPs to discuss this, convinced that patients were attending the GP for annual assessment, then naturally enough also attending the hospital for another annual assessment when the hospital sent an invitation.
GPs were very enthusiastic and helpful. Not only did they accept a lower LES payment (saying that much of the work was already covered in an existing LTC LES), they also agreed to discuss the issue with patients and so cause the behavioural change. Unfortunately I was unable to follow up this change due to NHS reconfiguration.