Our response to the Government’s 10 Year Health Plan

1: Moving more care from hospitals to communities 

This is an aim everyone wants to see happen in practice. But we often hear from people living with type 1 diabetes that they are struggling to get GP appointments and when they do, the knowledge of T1D just isn’t adequate.  

Primary care needs to be better structured to improve ready access to services, while the quality of training needs to be more consistent so that everyone can trust in their GP services. This means also strengthening the ties between hospital diabetes specialists and primary care provides so that diabetes expertise extends into the community. The Super Six is a good starting point for a genuinely integrated model of care, which is worth revisiting at this time of change. 

As people age, the possibility that some may need home or residential care increases. But as our recent report shows, older people with T1D do not have confidence in the quality of social care, with the concern that the majority of social care staff lack a fundamental understanding of how to support and treat type 1 diabetes. That’s why we are calling for mandatory insulin administration training for all social care staff who are directly involved in older people’s care. 

And finally, the NHS must address continuing health inequalities by taking tailored, community-driven approaches to dismantle the barriers to healthcare and T1D treatments.  Everyone deserves equal access to the tools and care that give them the best chance to live well with type 1 diabetes, no matter where they live. Currently children from the most disadvantaged and minoritsed backgrounds have higher HbAlc levels and have lower use of T1D technologies when compared to white children from more affluent communities. 

2: Making better use of technology 

Type 1 diabetes treatments are powerful examples of how technology can be developed to improve physical health and quality of life.

The strides forward in continuous glucose monitors (CGM), pumps and hybrid closed loops (HCL) are transforming how people can manage T1D, supporting more stable glucose levels and helping to reduce the self-management burden. 

But we need to ensure that everyone has the choice and opportunity for the treatments that are right for them. Currently, only 54% of people over the age of 75 with T1D are using CGM.   

Furthermore, our T1DE parliamentary inquiry heard that some of the unintended consequences of T1D tech can result in some young people feeling under intense psychological pressure from technology-based alarms and the need maintain a ‘perfect’ range as shown by blood glucose trendlines.   

One size does not fit all, and working to find the right treatment solutions takes time and specialist expertise. Continuing focus is required to ensure multi-disciplinary healthcare teams are resourced and trained to support people living with T1D.   

3: Focusing on preventing sickness before people need treatment 

We have the opportunity now to change how people are diagnosed and treated with type 1 diabetes with the potential to eliminate life-threatening diabetic ketoacidosis (DKA), preventing ill health and improving long term health outcomes.  

 It is now possible to identify who will develop type 1 diabetes through a set of simple tests which identify key biomarkers in the blood. However, there’s no national screening programme in place. Now is the moment for the NHS to develop population-based screening and treatment guidance.  

At the same time, we have the first of what will be many T1D immunotherapies currently being assessed for use on the NHS, which can delay the progression of type 1 diabetes. There will soon be more cutting edge treatments that will need to be approved. We can really change the course of type 1 diabetes, to give people greater years of good health to live without the burden of managing insulin administration and long-term effects of T1D.