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Introduction

We understand commissioning a diabetes service may feel daunting. The nature of the condition means the care areas involved are extremely wide reaching – perhaps more so than for any other long term condition. However, our commissioning resource is here to help you. It describes eight practical steps which will enable you to carry out the key commissioning tasks and deliver high-quality, efficient and cost-effective diabetes services.

Each step is supported with a wealth of information easily accessed on our website – everything you need is in one place. Using our commissioning approach will allow you to deliver these four key outcomes:

A local health needs assessment to help identify gaps in service provision, areas of poor outcome and future needs.
Implement an integrated system-wide diabetes service.
Promote supported self-management and collaborative care planning.
Service improvements in local priority areas identified by the health needs assessment process.

The benefits of effective commissioning

Commissioning good services will help you to reduce complications from diabetes, leading to improved quality of life for your patients and a reduction in unnecessary spend:

£725m a year is spent on diabetes medication – 8.4% of the NHS drugs spend.
An estimated additional £600 million is spent on inpatient care for people with diabetes, compared to those without the condition.

People with diabetes account for 15% to 20% of inpatient bed days.
1 in 3 inpatients with diabetes experience a medication error leading to longer lengths of stay, increasing the cost of care both during the inpatient stay and after discharge.
The cost to the NHS of foot ulcers and amputations in people with diabetes is estimated at £450 to £580 million a year.
Investing in diabetes specialist nurse teams in trusts can save upward of £200,000 a year through reductions in elective and emergency admissions.

The principles of the diabetes commissioning approach is summarised in the document Diabetes Without Walls (PDF 1.9MB) This is supported by a set of commissioning guides, each of which contains a clear intervention map of what services should be provided, outcome-based service specifications, contracting framework, with examples of health economics, protocols, templates, evaluation guidance and case studies.

Using this resource

This commissioning resource should be used alongside the care area to be commissioned. Each care area contains commissioning guides, data and information, policy and guidance, practical examples and other useful resources which will support you to carry out the key commissioning tasks. The commissioning process also promotes quality improvement and this resource is designed to be used to lead a programme of improvement.

Act now!

Commissioning an effective diabetes service is not easy and we understand the temptation to keep to business as usual. However, we’ve shown you the risks to your patients and your budgets of not following a structured commissioning process. We think our model will save you time and money and lead to better care for people with diabetes – the sooner you act, the sooner you will be able to see the benefits.

Remember there is a wealth of information and data here on our website to help you and you can contact us at any stage in the process for advice and support. Also, don’t forget to tell us about your new services once they are up and running – you can get in touch with your regional representative here.