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.
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.
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.
With the HSE Cyber breach still preventing answers to Parliamentary Questions from public representatives and the Dail going into summer recess, we have postponed our “call to action” where we will be asking members of the diabetes community to contact their local representatives on the issue(s) most relevant to them until late August/early September as the Dail resumes.
However, Diabetes Ireland contacted all TDs and Senators on Wednesday 14 July on behalf of our community asking them to make representations on all these issues on our behalf. Some of our active volunteers groups also followed up locally with their own local representatives. In late August/early September, we will need your help to highlight these issues once again in advance of the upcoming budget.
Please note there are many other important issues we plan to highlight and advocate for implementation and we will be working with all stakeholders to do this in a strategic way going forward.