The new NHS and diabetes care

The National Health Service (NHS) is under unprecedented pressures created by the increasing healthcare demands of a rapidly ageing population and the unsustainable cost of providing care in the traditional hospital-centred model. These pressures manifest themselves financially, but also in adverse clinical outcomes and patient experiences. Transformative changes are required, not only for system survival but, also, to create a system fit for purpose in the rapidly changing socio-political environment. The responsibility for re-engineering NHS services is placed on 211 Clinical Commissioning Groups using competitive tendering as the lever for change. The presumption is that competition will drive increased quality and reduced cost by promoting efficiency and innovation. High value has been placed on patient-centred integrated care and partnership working. The issues in diabetes care mirror the broader NHS. This review describes key features for an alternative model of care for diabetes, which takes advantage of the current priorities and initiatives in the new NHS. “Innovative” changes are rarely without problems and challenges and these “Wicked Issues” are identified and potential solutions discussed. The time is right to consider transformative changes that can improve patient care and develop, improve and protect the specialty of diabetes.