Diabetes and the quality and outcomes framework: Integrated care is best model for diabetes

doi:10.1136/bmj.331.7528.1340-a

BMJ 2005;331:1340 (3 December), doi:10.1136/bmj.331.7528.1340-a

Letter

Diabetes and the quality and outcomes framework

Integrated care is best model for diabetes

The first 150 words of the full text of this article appear below.

EDITOR—The Association of British Clinical Diabetologists(ABCD) welcomes Kenny's editorial on the impact of the qualityand outcomes framework on diabetes management and supports hisplea for supporting and strengthening secondary (specialist)care diabetes services.¹

The implementation of the updated contract for general medicalservices (GMS2) has resulted in a welcome increase in the monitoringof patients, especially those with type 2 diabetes, who havebeen comparatively neglected in the past. However, the needto improve glycaemic control to meet the target value of 7.5%for HbA_1c has had some unforeseen consequences. In most specialistcentres, referrals of patients treated with tablets for considerationof insulin treatment have increased, and many general practicesdo not feel confident with this. Simultaneously, it is not onlyextremely difficult for secondary care to attract additionalresources, but there is actual "downsizing" of some specialistunits by local primary care trusts, in . . . [Full text of this article]