Readers’ letters – 15 November 2013

Championing integrated care pathways

I refer to your piece “Concerns over single specialism ‘integration’ plans”. Diabetes UK has been championing integrated care pathways between primary, community and secondary care for people with diabetes because all too often services which should integrate round the needs of the patient who have this complex and potentially serious condition are fragmented.

Less than half of people with type 2 diabetes get the nine annual simple but essential care processes recommended by NICE.  For type 1 diabetes, the figure is less than one third of people getting these recommended processes.

We recognise, indeed advocate, that this care is best delivered through a Year of Care care planning process, taking account of the all the health needs and circumstances of the individual, which is why we sponsored the original Year of Care pilots.

But until there is some reality to being able to organise complex multi-condition care effectively, let’s start with the simple stuff like getting even one or two conditions right. Otherwise, patients in need of swiftly improved healthcare will simply sink in the grey goo of promises which is all that a multi-condition approach seems likely to deliver in practice for some time.

Getting it right for diabetes can act as an exemplar to show how to put in place the systems, processes and attitudes to deliver on systematic and personalised care for other comorbidities.

Barbara Young, chief executive, Diabetes UK

Innovation fund could have been hugely beneficial

I am writing in response to your article “Innovation fund axed amid confusion over specialised services”. As the chair of the all party parliamentary group for muscular dystrophy − and as someone who has lost many close family members to the condition − this news comes as a devastating blow.

The proposed fund could have been hugely beneficial in the development and commissioning of neuromuscular services, given that a number of exciting proposals were included as part of the initial application. Schemes that could replicate excellent practice in neuromuscular care will now be delayed as a result. Leading neuromuscular clinicians had proposed innovations around specialist physiotherapy; as well an “admissions alert system” that would have looked into ways of alerting a patient’s key worker should they be admitted into hospital.

It is also worth considering the findings of the 2011 audit of unplanned emergency admissions of neuromuscular patients. This proved that better specialist care can help reduce the number of unplanned admissions into hospital for neuromuscular patients; thereby improving quality of life and saving the NHS money.

It seems counterintuitive that an innovation fund that could have helped to support initiatives that would reduce costs and improve patient outcomes has now been scrapped to save money.

Dave Anderson MP, chair, all party parliamentary group for muscular dystrophy