I was at the RCGP in Euston (London) this morning where I a gave lecture on diabetes (Achieving diabetes management targets in primary care – impact on mortality and hospital admissions) at the RCGP City Health Conference. Diabetes is becoming increasingly common across the world because of lifestyle changes such as more sedentary lifestyles and an increased intake of high-calorie foods (such as refined carbohydrates). Prevention is clearly the best option but once diabetes becomes established, it is important that doctors and patients work towards meeting key management targets for glucose, blood pressure and cholesterol control.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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