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The Company Chemists’ Association (CCA) has urged the NHS to commission a community pharmacy diabetes screening service, which it says could save the NHS £50m in recurring costs each year.
In a report published on 18 September 2024 — ‘Increasing Access to Diabetes Screening and Prevention Through Community Pharmacy’ — the CCA noted that “an estimated 50% of people with diabetes are undiagnosed”, adding that between 20% and 30% of these “already have serious complications when they are eventually diagnosed”.
“Screening would allow for early diagnosis and treatment,” the report said, highlighting the need to create a national patient pathway for diabetes detection and prevention.
By commissioning this service in a way that “would likely replicate that of the ‘Hypertension case-finding service’”, the CCA said pharmacies across England could screen up to 1.5 million adults annually, identifying 180,000 people with prediabetes and 45,000 people with undiagnosed diabetes.
As well as preventing them from developing serious complications that require specialised care, the CCA suggested that this could prevent almost 7,000 heart attacks and strokes.
The service could also improve patients’ quality of life and prevent nearly 15,000 people developing severe sight loss over the course of their lifetime, the report said.
Figures from the National Institute for Health and Care Excellence (NICE) show that around 4 million people have been diagnosed with with diabetes across the UK.
NHS England has estimated that around 2 million people across England are at high risk of developing the condition, while up to 1 million people may be living with undiagnosed diabetes.
According to NHS England, managing type 2 diabetes mellitus (T2DM) and its complications accounts for 10% of the NHS annual budget, amounting to £15bn.
The CCA report said: “As many as 25 million GP appointments every year are estimated to be dedicated to the management of T2DM.”
It added that patients are facing having to travel long distances or spend an extended period waiting for an appointment, which is creating barriers to access.
“In turn, people are not receiving appropriate and timely treatment,” it said.
Malcolm Harrison, chief executive of the CCA, commented: “With the burden of T2DM set to grow significantly, commissioning pharmacies to deliver a national diabetes screening service makes sense for patients, the NHS and the UK economy.
“A national T2DM screening service could not only free up as many as 25 million GP appointments a year but help reverse the blight of the disease, which continues to disproportionately affect patients in areas of higher deprivation.”
Philip Newland-Jones, consultant pharmacist in diabetes and endocrinology at University Hospital Southampton NHS Foundation Trust, said: “It would be welcome to increase access to diabetes screening through community pharmacies, but we should be cognisant that this will likely continue to miss some harder to reach populations.
“Increasing screening and identifying diabetes at an earlier stage is the first piece of a complex puzzle and does not necessarily lead to reduction in risk of developing complications, or save the NHS money unless patients receive appropriate treatment and support.”
Newland-Jones added that increased funding and support “is required for the entirety of the diabetes pathway focusing initially on further investment in primary care as a whole in order to support and effectively treat those identified with newly-diagnosed diabetes through combinations of medication and lifestyle interventions, which pharmacists are well placed to support in general practice”.
Following its latest review in 2019, the UK National Screening Committee did not recommend a population screening programme for T2DM.
“This is because there is no evidence that screening is more beneficial than not screening; there is no evidence that finding T2DM early by screening results in a greater health benefit than usual health care; [and] more research is needed to review tests and benefits of screening for T2DM,” the committee concluded.
A spokesperson for the Department of Health and Social Care said: “The ‘NHS health check’ programme is England’s flagship cardiovascular disease (CVD) prevention programme, which aims to detect people at risk of heart disease, stroke and kidney disease in those aged between 40-74 [years] — people with risk factors are also offered tests to assess their risk of T2DM.
“To increase both availability and uptake of the ‘NHS health check’, we are developing a new digital ‘NHS health check’ that people can use at home to understand and act on their CVD and diabetes risk.”
