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Diabetes: Health Services

Volume 479: debated on Monday 1 September 2008

To ask the Secretary of State for Health whether World-Class Commissioning will ensure that commissioners consider the rights and needs of children when developing appropriate diabetes services. (219501)

The intent of the world class commissioning programme is to strengthen commissioners to improve health outcomes across all health needs and conditions in accordance with the needs of local populations. The vision is to achieve better health, better care and better value for all.

For children this means:

clear evidence-based decisions for the commissioning of children’s services;

better targeting of services for children; and

the promotion of partnership working within commissioning.

Commissioners are required to engage with local patients and the public in order to ensure that services are being commissioned and delivered that best meet their needs. World class commissioning will therefore create services that are increasingly patient-led and customised to the needs of different groups and communities, including children.

Commissioners will be held to account on their commissioning performance through an assurance system that is intended to lead them towards world class commissioning of services.

In addition, the Department will be publishing a child health strategy and a joint commissioning framework in the autumn which will specifically support world class commissioning for children and young people.

To ask the Secretary of State for Health what steps his Department is taking to tackle geographical differences in access to insulin pumps for children and young people with diabetes. (219503)

In February 2003, the National Institute for Health and Clinical Excellence (NICE) published guidelines on the provision of insulin pump therapy to all people with type 1 diabetes, including children and young people. This is currently being reviewed, and the revised guidance is expected to be published shortly.

The Department is aware that access to pump therapy in England is variable. In March 2007, it published a joint report with Diabetes UK of the findings of the Insulin Pumps Working Group, a copy of which has been placed in the Library. The Working Group made recommendations about how local services can implement the NICE guidelines and address variation across the country.

To ask the Secretary of State for Health what plans he has to develop guidance for the (a) quality and (b) appropriate timing of hospital meals for people with diabetes; and if he will make a statement. (219611)

There is published guidance on the quality and delivery of hospital food. An appropriate diet, based on acceptable standards, requires good food with the right nutritional content, properly prepared and available when patients need it (and this includes diets for patients with diabetes). The Food Standards Agency has published nutrient and food based guidance for major institutions, including hospitals. Guidance on nutritional information is available for all recipes in the National Dish Selector. To ensure that wholesome, high quality and value-for-money ingredients are used, the Purchasing and Supply Agency have developed specifications for ingredients.

Local national health service trusts are responsible for providing hospital meals at appropriate times. To help trusts devise their policies, including those around meal times, we have produced “Essence of Care” which sets benchmarks for screening and assessment to identify patients’ nutritional needs in health and social care settings, and helps healthcare professionals form appropriate care plans.

To ask the Secretary of State for Health what measures are in place to ensure that people with diabetes receive a comprehensive medical review every 12 months. (219646)

The Quality and Outcomes Framework rewards practices for the number of patients with diabetes who receive key care processes, including measuring blood pressure, HbA1c (blood glucose) and cholesterol.

Guidance on the management of type 2 diabetes from the National Institute of Health and Clinical Excellence recommends that key clinical and lifestyle interventions are carried out on a regular basis.

The Diabetes National Service Framework highlights the importance of people with diabetes having regular checks. This provides the opportunity for the results of key test and measurements to be discussed, and for any complications to be identified as early as possible.