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Are hospitals a safe place for people with diabetes?

Debbie Hicks discusses the reasons why people with diabetes in hospital are vulnerable to complications.

It is estimated that more than one in three inpatients at some NHS hospitals have diabetes (Borland, 2014). The condition is putting an ever-growing strain on the health service and costs continue to rise; yet many hospital staff do not know how to treat it.

In May, the Daily Mail revealed the findings of a Diabetes UK report, which estimates that one out of seven hospital beds is occupied by a person with diabetes (Borland, 2014). The survey of the NHS shows the highest rate of patients with diabetes was at Bishop Auckland Hospital, County Durham, where 35% had diabetes (Borland, 2014), followed by 28% at Hammersmith Hospital in west London and 25% at West Cumberland Hospital in Cumbria. 

It was also reported that 93% of those in hospital have type 2 diabetes (Borland, 2014). We know there is a link between diabetes rates and obesity levels in an area; however, it is important to remember that many with the condition are not obese and that it is also common in the elderly. 

Recently, the former head of the NHS, Sir David Nicholson, admitted he had been diagnosed with type 2 diabetes after living on fry-ups for breakfast, triple-decker sandwiches and eight pints of beer every Friday night. He states that he had lost control of his health and that he believes the condition is completely his fault. You may, or may not, agree with this statement.

Strain on resources
It is estimated that the number of people with diabetes will rise to 5 million by 2025 and current NHS spending on diabetes care is £10 billion a year, and this spending is expected to soar (Diabetes UK, 2013). As the number of people with diabetes increases, the strain on hospital resources means that people with diabetes in hospital are particularly vulnerable to complications, as some NHS staff do not know how to look after them properly, nor do they have the time. NHS figures also show 40% of people with diabetes will experience some kind of medication error.

Simon O’Neill, of Diabetes UK, said: 

“This is becoming a big problem in virtually every hospital and it seems to be getting worse. The level of knowledge about diabetes among general hospital staff isn’t that great. Often, the hospital mucks up their diabetes control and they’re not well enough to leave until the diabetes has been stabilised…We’re also aware of people being allowed to develop foot ulcers in hospital just by not turning them and making sure they’re not spending all day in bed.’

How can general nurses hope to learn more about diabetes care when most of them do not have the time to care for the numbers of patients allocated to them at every shift, nor are they allowed time away from the wards to attend training?

Diabetes education
An excellent diabetes educational resource, which originally was available to all nurses free of charge, was the e-learning modules produced by June James, in collaboration with Virtual College. These modules, covering all aspects of diabetes care, are available online, except now it is up to individual NHS Trusts to purchase this resource. There is a risk that many Trusts will decide not to purchase these modules, at a cost of £5000 per Trust, therefore further restricting access to diabetes education for the nursing workforce. The modules were previously supported by NHS Diabetes, which ceased to function over two years ago.

Why is it that the NHS fails to invest in its workforce by providing appropriate educational resources, but it is happy to waste money investigating errors and compensating those who are involved? Beats logic!

Borland S (2014) Hospitals where one in three patients have got diabetes: Bill for NHS expected to soar to £17bn. Daily Mail. Available at: http://dailym.ai/1pOHlD2 (accessed 03.06.14)
Diabetes UK (2013) State of the Nation 2013. Diabetes UK, London. Available at: http://bit.ly/Kxuohp (accessed 10.06.14)

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