Diabetes care - Diabetes improvement plan: commitments - 2021 to 2026

Introduction

The 2019 Scottish Diabetes Survey highlights there were over 312,000 people with a diagnosis of diabetes in Scotland at the end of 2019, a crude prevalence of 5.7%.^[1] There were over 19,000 new cases of diabetes diagnosed in 2019.

The prevalence of all types of diabetes continues to increase and depends on a number of factors, including demographic changes (including ageing population), better survival rates from the disease and better detection of type 2 diabetes. While this continues to put pressure on diabetes services, considerable progress in care and clinical outcomes has been made in the last decade. This reflects the strength of the healthcare community supporting people with diabetes in Scotland, the active engagement with people living with diabetes, the support of the Scottish Government and the third sector.

In 2020, COVID-19 caused an unprecedented disruption to all NHS services including diabetes services. Many out-patient diabetes services were suspended to allow resources to focus on acute unscheduled care and as services resume, they are no longer being delivered by traditional models of care. Care has evolved to ensure it aligns with COVID-19 secure measures, with a significant proportion of diabetes care now being delivered through virtual and digital means.

Many aspects of care align readily to virtual care models. However, some, such as group education sessions, robust surveillance processes and initiation of technologies require ongoing development to allow successful delivery of the services to be done virtually. Many digital solutions now exist and these are likely to play an increasing role in diabetes management in the future.

Added to this there is an increasing evidence base which highlights the increased risk of severe COVID-19 for those with comorbidities such as diabetes and obesity, therefore now more than ever it is vital we consider how best to support individuals to optimise their health and wellbeing.

The refresh of the Diabetes Improvement Plan details the significant progress that has been made against the priority areas in the Diabetes Improvement Plan 2014 and sets out new commitments for 2021 – 2026. This report focuses on the commitments that have been made to improve care outcomes and experiences for people living with Diabetes in Scotland and the measures by which we can monitor progress and determine success.

In our commitments from 2021 – 2026, there is an ongoing focus on optimising glycaemic control, preventing and early detection of type 2 diabetes and minimising the risk of complications. Supporting self-management, optimising mental wellbeing and upskilling healthcare professionals remain key to optimising outcomes. The ongoing focus on in-patient care is also important given the adverse outcomes seen in those with diabetes admitted to hospital.

Our commitments from 2021 – 2026 sit alongside a wide range of Scottish Government policy including diet and healthy weight policies, the Mental Health Strategy 2017 -2027, our Technology Enabled Care programme, the Scottish Access Collaboration and the Modernising Patient Pathways Programme. We seek coherence across a range of other policy areas and we will continue to work collaboratively across the Scottish Government to ensure that appropriate links are made and maintained.