Check-up from the neck up

After a report from the Public Accounts Committee (reported on the BBC News yesterday), we have again to think about the question of why people with diabetes are not having the checks that they need to identify the well-known complications of diabetes.

According to the report, less than half of people with diabetes get all the nine basic checks that they should.

And it is important.  The Committee have calculated that, if everyone got the right care, 24,000 lives could be saved each year; equivalent to the population of a reasonable sized town.

The problem is that research has proved beyond doubt that the vast majority of the serious complications can be prevented by good management.

So why is the take up so low?

There are only two possible explanations.
1.    Patients are not being advised that they require checks
2.    Patients are not taking up an invitation for a check-up.

The first possibility is unlikely.  Practices claim over 95% of the GMS QOF points available for Cardiovascular Disease and Diabetes.  For Coronary Heart Disease and Hypertension, the figure is 99%.

This leaves the second possibility.  Why do patients with diabetes not attend for their check-ups which, it is known, save lives?  Perhaps they still do not appreciate the vital importance of them.

Patients are quite happy to attend for cervical and breast screening although they are far less likely to take up offers of another life-saving screening test for bowel cancer.  The ten year Numbers Needed to Treat (to prevent one death) for cervical screening is well over 1000!  This compares with treating hypertension in the over-sixties where the ten year figure is 9!

Unfortunately, it is our fault that the message is not getting across.  People as a whole seem to have little understanding of statistics and odds.  How often have you heard statistically impeccable research reported on the radio; with people saying that they don’t believe the figures?

Personally, I think that the “Numbers Needed to Treat” concept is a really good one which we should be using more and more to give realism to sometimes difficult figures.

Find out more on our Diabetes Management course.


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