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Foreword

Diabetes is a chronic, progressive disease that affects 1.3 million people in England. There may be as many as another million people who have it but who are not aware they have it and the number of people being diagnosed is increasing every year. Unless diabetes is managed effectively, it can lead to complications that may result in kidney failure, blindness and foot amputation. Diabetes is also a major risk factor for coronary heart disease and stroke.

The cost of diabetes is huge - an estimated 5 per cent1 of all NHS expenditure. But the cost to people's quality of life - and their life expectancy - can be equally heavy. However, with appropriate support, not only in terms of drugs and treatments, but also structured education and advice, people with diabetes can manage their condition so that the effect on their lifestyle is minimised.

Services for people with diabetes have in the past been variable - pockets of excellence are common, but that excellence is not universal. The National Service Framework for Diabetes sets out how, working together, everyone throughout the whole healthcare system can ensure that the best diabetes care and support is available to all no matter who they are or where they live. As Alan Milburn (then Secretary of State for Health) said in his introduction to the National Service Framework for Diabetes Delivery Strategy, 'Our goal is to make the best practice already offered in some places the norm.'

When I was appointed as National Clinical Director for Diabetes, I realised that there was a huge task to be done. In my visits to events organised by the Strategic Health Authorities, involving the whole range of people working in diabetes care, including people with diabetes themselves, I have been encouraged at the progress that has already been made. This report describes that progress, and the next steps. We are not there yet - it is after all a ten-year programme - but I know that with the support of healthcare professionals, organisations such as Diabetes UK and people with diabetes we will see the transformation in diabetes services envisioned by the National Service Framework become a reality.

Sue Roberts
National Clinical Director for Diabetes

• Download Full report: NSF for diabetes: One year on (PDF, 102K)