We have looked at the anticipated increase in workload that the NICE
guidelines for Type 2 diabetes are likely to engender. Taking HbA1c as a
surrogate marker of diabetes we identified our diabetic population and then
looked to see how many did not meet the guidelines for measuring HbA1c
(minimum of twice per year), creatinine, cholesterol, triglyceride,
HDL-cholesterol and urine albumin-creatinine ratio (all to be measured
annually at a minimum).
From our population (180,000) we identified 5806 presumed diabetics (3.2%).
40% of these patients had only one HbA1c measured in a one year period so we
are expecting a minimum increase of 2300 requests for HbA1c which represents
approximately 20% of our current workload. Creatinine and lipids (chol &
trig) were measured in nearly all patients (96.7% and 88.8% respectively).
Far more worrying was the projected increase in HDL-cholesterol (5466) and
albumin:creatinine ratio (3979) which represents an increase in our workload
(2001 figures) of 283% and 173% respectively.
We have flagged this up to our Trust and are in negotiation as to how we
cope with/finance this increase in demand. All our figures were based on
2001 workload figures i.e. pre-guidelines and we are already seeing the
increase in requests.
Steve Davis
Royal Glamorgan Hospital.
> -----Original Message-----
> From: Mainwaring-Burton Richard (RGZ)
> [SMTP:[log in to unmask]]
> Sent: Thursday, July 03, 2003 12:15 PM
> To: [log in to unmask]
> Subject: GP contracts
>
> Has anyone acknowledged the laboratory consequences of the financial
> incentive to GPs to screen their patients according to guidelines ? I
> understand that some remuneration will be dependent on keeping track of
> monitoring of HbA1c, lithium, microalb, etc etc .........
>
> Wish we could do the same, but what will be the impact on our budgets ?
>
> with best wishes
>
> Richard
>
> Richard Mainwaring-Burton
> Consultant Biochemist
> Queen Mary's Hospital
> Sidcup, Kent
> DA14 6LT
> 020-8308-3084
>
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