I’ve heard a lot of talk about the Diabetes NSF. What is it and how will it affect me? Several years ago the Department of Health set up a scheme called the National Service Framework (NSF), which set out standards of care for a number of long-term conditions, such as heart disease and mental health. Diabetes was chosen as an important condition for which clear standards of care were needed. The first section of the Diabetes NSF was published in 2001. This contained the agreed Standards of Care and was followed by the Delivery Strategy, which was published in 2003. This was designed to be implemented over several years with all targets achieved by 2013. The first target to be met was screening for retinopathy by digital photography to be available for all people with diabetes by the end of 2007. The Delivery Strategy is a 40-page document which lacks a summary. However, it contains some worthy aspirations and we hope there will be funding to make these a reality. The key elements proposed in this Delivery Strategy are: setting up a local diabetes network, or similar robust mechanism, which involves identifying local leaders and appointing and resourcing network managers, clinical champions and a person(s) with diabetes to champion the views of local people reviewing the local baseline assessment, establishing and promulgating local implementation arrangements with a trajectory to reach the standards participating in comparative local and national audit undertaking a local workforce skills profile of staff involved in the care of people with diabetes and developing education and training programmes with the local Workforce Development Confederation. It also reflects targets in Improvement, Expansion and Reform: the next three years: ensuring a systematic eye-screening programme to national standards putting in place registers, education and advice, to support systematic treatment regimens. The Delivery Strategy offers a framework for the NHS to build capacity to: put in place building blocks for the NHS to reach the National Service Framework (NSF) standards over the next ten years deliver the national targets. I’ve been told my CP will be paid extra if my HbA1c is less that 7.5%. Can this be true? This may sound a bit surprising, but it is true that the government has recently changed the way GPs are paid by negotiating a new contract based partly on the level of care achieved. For many conditions there is evidence that if certain targets are reached, the outcome for patients is greatly improved. Thus, we know that for people with diabetes the risk of complications is significantly reduced if the HbA1c is less than 7.5%. Similarly, a blood pressure of less than 140/80 and a cholesterol of less than 4 mmol/L will reduce the risk of heart attack and stroke. The government believes that providing GPs with incentives to achieve these targets will drive up standards of care. The early signs are that this strategy has had some success. Buy antidiabetic tabs in Canadian Health&Care Mall pharmacy -www.canadianhealthcaremalll.com. ...read more