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Battle for paediatric diabetes funding despite new tariff

Many paediatric diabetes units in England are struggling to secure the extra funding made available in April by the new Best Practice Tariff, despite meeting its mandatory standards, warns NHS Diabetes.

In a letter to paediatric diabetes service providers, NHS Diabetes Director Anna Morton has asked for a formal progress update on the new Tariff. The letter comes as many paediatric diabetes teams report commissioning groups are looking for loopholes not to have to pay the Tariff while others claim they do not have the necessary funding available.

Dr Fiona Campbell, Paediatric Network Clinical Lead and Consultant Paediatrician at Leeds Children’s Hospital and Editor-in-chief of Diabetes Care for Children & Young People, said: “It seems providers are either unaware the standards are mandatory, are finding reasons – just or unjust – not to pay, or think it unlikely units will face closure or merger if the benchmarks are not met by next year.

“Some local CCGs tell me there are other clinical areas with Best Practice Tariff that are not paid even if criteria are met – this is especially the case if Trusts are on block contracts, which a vast majority are. This is extremely disappointing considering units are working hard to achieve the criteria under the current budget constraints,” she added.

Ms Morton said: “We will continue to work with commissioners to ensure standards are met by April 2013 and that those paediatric teams working at the required standards receive the funding they are due. This Tariff represents a significant increase in funding for the service to this particularly vulnerable group and it’s likely many organisations will require some upfront investment to provide sufficient staffing capacity and skill mix.”

The Best Practice Tariff for Paediatric Diabetes sets out 13 areas of care that must be met for teams to qualify for greater financing. Local services unable to achieve these standards will be supported to improve but face having their funding withdrawn if still unable to reach the required level by April 2013.

NHS Diabetes is calling on all healthcare professionals involved in the support and care of children and young people with diabetes to join its paediatric diabetes network to ensure sharing of good practice, up-to-date guidance and education tools.

Gavin Terry, Diabetes UK Policy Manager, said: “It is very disappointing that many paediatric diabetes units are struggling to secure the extra funding. The Best Practice Tariff for paediatric diabetes, and the opportunities it presents for the improvement in care in this highly specialised area, will have a huge benefit for children living with diabetes. Providing high quality care is crucial to manage children’s diabetes well and reduce the risk of developing complications now and later in life.”

For an overview of the Tariff, see Tabitha Randell’s article, Developing a best practice tariff in paediatric diabetes: Can we improve services and outcomes for children and young people with diabetes in England?.

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