The diabetes service specification: A practical tool with care planning and shared responsibility at its heart. – By Professor Jonathan Valabhji, National Clinical Director for Obesity and Diabetes at NHS England.


We have been trying to achieve good patient centred, integrated diabetes care for some time. This is because we know that some of the 3.2 million people diagnosed with diabetes can struggle to get care that meets their needs or swift access to specialist care when they need it.

Writing the diabetes service specification was an opportunity to articulate how we can help to ensure that everyone with diabetes gets the care they need. It is a chance to demonstrate how the relationship between primary, community and specialist care providers should look. As well as showing how social and mental health care services must be included in an integrated model of care.

A priority of mine was to make sure the service specification highlights the specific care needs of those with Type 1 diabetes where those differ from those with Type 2.

The other important thing I wanted to get across in the specification is the feeling of shared responsibility and accountability for all providers that are providing care anywhere in the pathway for diabetes. Rather than episodic care where a provider may have responsibility for one consultation, we want to get people to feel a shared responsibility for the clinical outcomes across the patch and crossing institutional boundaries, so everyone is pulling in the same direction to improve patient outcomes.

The diabetes service specification is one of a small number produced by NHS England for CCGs to use if they choose, in areas where NICE has produced quality standards. We worked with NICE to make sure the service specification meets the aspirational NICE quality standard. We also worked with colleagues from across NHS England and with Strategic Clinical Networks to make sure that the service specification focuses on patient centred care. For example, I hope our product facilitates care planning, as this is very much at the heart of the service specification.

We have developed this as a practical tool, and we hope it is one that commissioners will use and find helpful. I have had a chance to engage with many colleagues across the system and I feel that there is a great appetite for this.

The Service Specification is available from the NHS England Commissioning Assembly.

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