Scottish Diabetes Framework

Scottish Diabetes Framework

Scottish Diabetes Framework: Foreword

Malcolm Chisholm MSP Minister for Health and Community Care

Publication of the full Scottish Diabetes Framework fulfils one of the key commitments in Our National Health, a plan for action a plan for change.

Diabetes services are continually developing to take account of new evidence, new challenges and new opportunities. The Scottish Diabetes Framework reflects and accommodates this reality. It is an enabling and supporting mechanism rather than a definitive statement. It is also more than the sum of its parts - both an umbrella for a range of existing and new initiatives and a unifying programme for the improvement of diabetes services.

The Framework has been developed in an open and inclusive way, with the full involvement of people with diabetes and voluntary organisations representing their interests. The process has at all times sought to be a stimulus to innovation and change rather than an excuse for inaction or a cause of 'planning blight'. It is therefore pleasing to be able to report that as this full Framework document is being published, a number of the ideas circulated during the consultation period or announced in November 2001 are already beginning to take root. That is welcome evidence that the commitment to produce a Diabetes Framework is working with the grain of NHS Scotland.

This Framework is quite deliberately not an exhaustive review of diabetes, nor a prescription to solve all of the problems. Change will be evolutionary and progress will be incremental. This Framework marks the start of what is envisaged as a ten year programme to address the increasing problem of diabetes in Scotland. Although the Framework sketches out what the diabetes service of the future should look like, the Working Group has, rightly, not attempted to map out milestones for the whole decade. Instead, the Framework sets out specific targets for the next 2-3 years, which the Working Group believe are key building blocks for the development of integrated, patient-centred diabetes services. Central to all of this is the development of diabetes Managed Clinical Networks. The Executive welcomes this emphasis, as it believes Managed Clinical Networks are an innovative and appropriate way to provide services for a range of chronic conditions.

The Framework establishes a 'Scottish Diabetes Group' as a national steering group to monitor and support implementation by NHS Boards and makes a commitment to review and reissue the Framework in two years time. This will ensure that Scotland has a strategy for diabetes care that remains relevant and realistic and which can build upon the foundations which this Framework seeks to build. Crucially, the strategy for diabetes in Scotland contains mechanisms to measure and report progress. This is not only nested within the Framework, but builds upon the important complementary work of SIGN, the Clinical Standards Board for Scotland and the Health Technology Board for Scotland's work on a national screening strategy for diabetic retinopathy screening. Thus, the results of the Framework as they are delivered will help to refine the strategy and allow lessons to be learned and good practice to be shared.

If there is one dominant theme throughout this Framework it is the value and importance of collaboration. There must be collaboration between professionals and people with diabetes; between different professionals who make up the diabetes care team; between different organisations involved in the care and treatment of people with diabetes; and between national agencies which need to forge productive links to ensure that intersecting initiatives work together to serve the needs of patients. The basis of good diabetes care is teamwork and it is this that the Scottish Diabetes Framework seeks to promote. I therefore expect that patients with diabetes and health care professionals working together will continue to contribute to shaping high quality diabetes services locally and nationally.

Finally, I should like to record my gratitude to all those who helped to prepare this document. I would also like to pay tribute to the late Professor James Petrie CBE, Chairman of SIGN and the original chairman of the Scottish Diabetes Group. His energetic efforts in the field of clinical guidelines, evidence-based practice and clinical leadership played the key role in preparing the ground for this Framework. The Scottish Executive is committed to building upon this superb platform to develop a world class service for people with diabetes.

Malcolm Chisholm MSP Minister for Health and Community Care