Lack of dedicated NW podiatrist among Type 2 diabetes failings

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The lack of a specialist podiatrist for people suffering from Type 2 diabetes in the Western Trust should be subject to an urgent Department of Health workforce plan by 2019, the Auditor General, Kieran Donnelly, has recommended.

Mr. Donnelly said the shortfall in provision for local sufferers of a disease that affects almost six per cent of adults in the North, needs to be addressed now.

He issued the warning in his newly-published ‘Type 2 diabetes prevention and care’ audit.

The report points out that as far back as 2003 a joint diabetes taskforce identified “significant staffing shortfalls within key medical disciplines delivering diabetes care”.

This included podiatry, critical in the treatment of Type 2 diabetes due to the potential of foot symptoms being missed, leading, in extreme cases, to amputation.

In 2003 it was estimated 76 podiatrists would be needed to meet demand in the North but only 36 podiatrists were in place, a shortfall of 40.

Mr. Donnelly’s report shows that while there has been considerable investment over the past 15 years workforce planning remains a challenge. It identifies “potentially significant shortfalls in the numbers of dieticians, podiatrists, diabetes specialist nurses, psychologists and consultants providing diabetes care, and highlights the importance of proposals to develop a workforce plan for the area [the North] by 2019”.

Mr. Donnelly said: “Already it is estimated that treating diabetes costs Northern Ireland £400 million annually. This is 10 per cent of the local healthcare budget and forecasts indicate this may rise to 17 per cent of health spending by 2035.

“The projected growth of Type 2 diabetes creates a real risk that the current model of care provision will become unsustainable. A review of diabetes care in 2003 pointed the way towards adopting many areas of best practice.

“Whilst a number of initiatives aimed at enhancing diabetes care were subsequently introduced, I was disappointed to note that there was limited implementation of the 2003 review and that the Department did not introduce a comprehensive strategy until late 2016. This was clearly a missed opportunity to slow the growing prevalence of the disease, and to reduce the numbers of serious complications which can arise, including blindness and lower limb amputations.”

SDLP MLA Mark H. Durkan said revenue generated from the new Soft Drinks Industry Levy, which becomes operative in four weeks, should be used to tackle obesity and Type 2 Diabetes.

He said: “Three in five cases of Type 2 diabetes can be prevented or delayed. In order to tackle the obesity epidemic here we need a joined-up approach working on a cross-departmental basis. It is my opinion that the revenue generated through the new ‘Sugar Tax’, which will come into effect from April this year, should be ring fenced and spent on tackling conditions such as obesity and Type 2 Diabetes.”

Sinn Féin’s Patricia Logue said: “The Diabetes Strategic Framework and the Diabetes Network launched by Michelle O’Neill as Minister for Health in 2016 also puts a focus on the prevention of Type 2 diabetes. Implementation of the Diabetes Strategy is needed if we are to tackle the growing instances of diabetes in the north of Ireland.”