Call to Action: Extend the Type 2 Cycle of Care to all People

Diabetes Ireland has launched its 2022 Pre-budget submission and is proposing 8 immediate actions for implementation which will improve the quality of life for over 225,000 people living with diabetes and reduce the long term costs of preventable diabetes complications. The submission is focused on a range of deliverable actions that are person-centred, cost effective and builds on existing HSE commitments to tackle chronic conditions including diabetes.

 

One of these Actions is to Extend the Type 2 Cycle of Care to all People

Extend the Type 2 Cycle of Care Programme

Extend the current Type 2 Diabetes Cycle of Care initiative deliverable at community level to all people with uncomplicated Type 2 diabetes

 

Diabetes Ireland is calling for the Type 2 Diabetes Cycle of Care initiative be extended to all people with Type 2 diabetes. Currently about 35 – 40,000 people of working age and those who are retired and under 70 are locked out of this scheme. The roll out of the Cycle of Care to all people with Type 2 diabetes would remove the financial barriers that currently exist to managing uncomplicated diabetes in the community, reduce pressure on hospitals by reducing the numbers attending hospital and potentially reducing the number of complications arising from lack of regular care due to financial constraint.

 

Benefit to people with uncomplicated Type Two diabetes

The Type 2 Diabetes Cycle of Care initiative was introduced in 2016 so that General Practitioners could deliver diabetes care to people with uncomplicated Type 2 diabetes holding a medical card or GP visit card in the community with support from community-based diabetes nurse specialists, dietitians, and podiatrists, and who are guaranteed two visits a year for review of their condition at no cost.

 

However nearly one-third of people with Type 2 diabetes aged ≥50 years who appear to fit the HSE criteria for uncomplicated diabetes for are not eligible for the Cycle of Care (recent study, University College, Cork). These patients can be appropriately managed in the primary care setting rather than the more expensive hospital setting where they are not prioritised or seen as regularly as by their GP. Extending this scheme has the potential to offer equality of care for people with uncomplicated Type 2 diabetes through more frequent support and monitoring from their GP in a location convenient to their home and has the potential to improve their quality of life by reducing financial stress.

 

Integrated diabetes care such as this scheme has been shown to reduce preventable hospitalisations for diabetes-related complications. Structured approaches to diabetes care have demonstrated improvements in glycaemic management and cardiovascular risk factors but it can only be clinically effective, and therefore cost effective, if it is provided in the most appropriate setting for all people with diabetes.

 

Financial benefits

Up to 2019 this scheme had cost €34 million but, at its inception, it was estimated that it can save at least 25,000 hospital bed days per year and reduce the number of people with diabetes who develop diabetes related complications which are expensive to treat. (model-of-integrated-care-type-2-diabetes-2018.pdf (hse.ie) Extending care to the whole community of people with uncomplicated Type 2 diabetes would increase bed day and other savings within the hospital system.

 

The roll out of the Cycle of Care to all people with Type 2 diabetes would remove the financial barriers that currently exist to managing uncomplicated diabetes at the right time and in the right place. There is an opportunity through the Enhanced Community Care Programme to achieve this by extending the Cycle of Care to all people with Type 2 diabetes and Diabetes Ireland supports this proposal unreservedly.

 

Diabetes Ireland contacted all TDs and Senators on Wednesday 14 July on behalf of our community asking them to make representations on this and the other issues contained in our Pre-budget submission. Some of our active volunteers’ groups also followed up locally with their own local representatives. We are now asking you to Act. We need your help to highlight this issue once again in advance of the upcoming budget.

Call for Action: What Can I do?  

  1. Copy the template below into an email and if you wish add your personal story and reasons why this problem matters to you.
  2. Find your local TD’s (constituency) https://www.oireachtas.ie/
  3. Send your email to your local politicians.

Email/Letter Template 

Dear (INSERT NAME OF TD)

I am a constituent and regular voter in your area.

I/family member have lived with type 2 diabetes for [INSERT YOUR DIABETES DURATION] years.

(You can write here your personal story and the reason why you would like to highlight this particular issue to a politician; if you pay privately for your GP care, please mention it here).

             

The Type 2 Diabetes Cycle of Care Programme was introduced in 2016 so that General Practitioners could deliver diabetes care to people with uncomplicated Type 2 diabetes holding a medical card or GP visit card in the community with support from community-based diabetes nurse specialists, dietitians, and podiatrists with a guaranteed two visits a year for review of their condition at no cost. I was very happy to see the Type 2 Diabetes Cycle of Care programme launched, but like me/my family member, many people are not able to access the scheme which is unfair.

I feel disappointed, as integrated diabetes care such as this programme has been shown to reduce preventable hospitalisations for diabetes-related complications. Structured approaches to diabetes care have demonstrated improvements in glycaemic management and cardiovascular risk factors but it can only be clinically effective, and therefore cost effective, if it is provided in the most appropriate setting for all people with diabetes, so why it is not available to me?

As this topic is very close to my heart, I am writing to you to ask for your support by asking the Minister for Health to extend the Type 2 diabetes Cycle of Care Programme for all people diagnosed with type 2 diabetes so we can all access free diabetes care through their general practitioner services and maintain good health.

Parliamentary Questions to ask the Minister for Health:

  1. To ask the Minister for Health the cost of the Type 2 Diabetes Cycle of Care programme since its inception; how many people currently avail of the programme; how many GPs provide the programme; has the programme been evaluated; has an audit of the programme been completed and if he will make a statement on the matter.
  1. To ask the Minister for Health if he will extend the Type 2 Diabetes Cycle of Care programme to all people with Type 2 diabetes; does he think it is equitable that people with Type 2 diabetes without a GMS or GP Visit Card but who otherwise meet the HSE criteria for uncomplicated Type 2 diabetes to be managed in primary care are excluded from the programme and if he will make a statement on the matter.

For more detailed information about this issue, please see here: https://www.diabetes.ie/advocacy-call-to-action/extend-the-type-2-cycle-of-care-to-all-people/

Thank you for your time in considering my request.

I hope to hear from you in due course.

 

Yours sincerely,

Your Name, Address, Email

 

To read the full Pre Budget Submission, click here.

Please note there are many other important issues we plan to highlight and advocate for going forward. implementation and we will be working with all stakeholders to do this in a strategic way.

Our advocacy work is important in giving our diabetes community a voice to be heard, become a member today, click here.

To read the next call to action for the inclusion of Women with Gestational Diabetes to the LTI Scheme, click here.