Shocking variation in amputation rate across England

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Shocking variation in amputation rate across England

26th November 2010

A Government report out today illustrates the shocking variation in the rate of amputations being carried out across England each week as a result of type 2 diabetes.

The NHS 'Atlas of Variation in Healthcare' - essentially a series of 34 'maps' illustrating rates of healthcare across the country - shows that almost a quarter of people with type 2 diabetes are not getting the foot checks they require, with the rate of major amputations in the South West - at three in 1,000 - almost twice the rate in the South East.

Daniel Lee, Head of Clinical Negligence at Fentons Solicitors LLP, said: "While some geographical differences should be expected, the level of unwarranted variation the Atlas reveals is cause for great concern. Worryingly, it demonstrates diabetes care is still a postcode lottery and the NHS is failing to provide universally high quality care across the country."

Type 2 diabetes results in over 70 amputations each week across England, 80% of which are thought to be potentially preventable. In the UK, 2.35 million people have type 2 diabetes which is caused by the body not properly responding to the insulin it produces.

Along with complications such as heart attacks and strokes, people with diabetes are far more likely to develop foot problems, including ulcers, which can become infected and lead to gangrene. If the infection becomes too severe, foot or leg amputations below the knee may become the treatment of last resort.

Good diabetes care relies on a team of specialist healthcare professionals to provide nine key care processes recommended in diabetes management, including frequent eye and foot checks as well as the monitoring of glycaemic, blood-pressure and cholesterol levels.

"Given that the majority of amputations can be prevented, the existing situation in regard to foot care and amputations is shocking," said Daniel, a partner with the firm. "Diabetes is the single most common cause of lower-limb amputation in the UK. Foot checks are incredibly important as any injuries or ulcers that are detected need to be assessed as a matter of priority. The longer they are left untreated, the greater the risk of deterioration and the subsequent need for amputation."

The Atlas shows that only 50.8% of people with type 2 diabetes, and 32.2% of those with type 1 diabetes had received all nine key care processes. Most people with diabetes see their healthcare team only once a year. It is this annual review that is so crucial for analysing signs of complications and can often be the only chance for people to discuss their ongoing treatment and management.

"It is appalling that less than half of people with diabetes have received all nine recommended health checks," said Daniel. "It is vital we identify and address areas in which poorer care has become a sad reality. The devastating impact on some of the 2.3 million people in England with diabetes must not be dependent on geography.

"People throughout the country have a right to access high quality care, patient education and effective diabetes management," added Daniel. "By making this information available, variations in levels of diabetes care can be remedied to better meet the requirements of those who need it most."

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