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Written on 1st December 2020 by Susan Brown

The GIRFT (or Getting It Right First Time) programme which is working to improve standards of NHS healthcare, reduce avoidable harm and save money for the NHS, recently published its report on diabetes.

The 65 page report was crammed with data, findings and recommendations from GIRFT’s ‘deep dive’ investigation into type 1 diabetes, hospital inpatients with diabetes, and diabetic footcare. The report makes depressing reading, but signals an urgent call to action.

The facts and figures highlight the UK’s diabetes epidemic, the rising human and care cost of avoidable harm, and how far towards reducing it the NHS still has to go.

How many people have diabetes in the UK?

  • An estimated 4.7 million people have diabetes. 
  • 8% of people with diabetes have type 1 diabetes. 
  • 90% of people with diabetes have type 2 diabetes.
  • 2% of people with diabetes have other types of diabetes, including type 3c (pancreatogenic).

Why is diabetes a healthcare concern in the UK?

  • Diabetes is one of the biggest health issues facing the UK. 
  • The number of people diagnosed with diabetes has more than doubled in 20 years, and is still increasing.  
  • Fewer than 30% of people with type 1 diabetes meet the blood glucose level (HbA1c) needed to reduce their risk of complications. 
  • People with type 1 diabetes in the UK have the worst glycaemic (HbA1c blood sugar) outcomes, compared with 12 other countries in Europe and the USA.

What are the complications of diabetes?

  • Complications of diabetes include:
    • amputations from foot problems;
    • kidney failure;
    • sight loss;
    • heart attacks and strokes
    • death. 
  • Every week, in the UK, diabetes leads to: 
    • 140-170 amputations;
    • 680 strokes;
    • 530 heart attacks. 

How much does diabetes and its complications cost the NHS?

  • 10% of the NHS’s total budget is spent on diabetes and its complications.
  • Caring for diabetes inpatients costs the NHS £2.5 billion each year.
  • Diabetes-related ulceration and amputation care costs the NHS up to £1 billion each year – almost 1% of total NHS budget in England. 
  • The total cost of compensation claims from negligent diabetes care is unknown.

Why is diabetic footcare so important?

Over time, high blood sugar causes damage to nerve cells and blood vessels, which can lead to footcare problems, including ulcers and amputations.

  • 20% of people with diabetes are at a higher risk of developing these conditions. 
  • 10% of people with diabetes will probably have a foot ulcer at some time in their lives.  
  • 80% of the 140 leg, foot and toe amputations which take place weekly in the UK, follow (mostly preventable) ulceration. 
  • Around 50% of people with a diabetic foot ulcer die within five years. 
  • People with diabetes are 20 times more likely to have an amputation than those without diabetes.
  • Up to 70% of people die within five years of an amputation.
  • Around half of those who have a major amputation die within two years.
  • One in six hospitals in England does not have a multidisciplinary foot care team (MDFT).

Are people with diabetes receiving safe inpatient care in hospital?

  • Up to 20% of hospital inpatients have diabetes.
  • Only 8% of inpatients with diabetes come to hospital because of their diabetes.
  • More than 90% of hospital inpatients with diabetes are admitted for unrelated conditions, such as pneumonia, fractures or surgery.   
  • 19-25 year olds with type 1 diabetes have a higher admission rate to hospital than other type 1 patients. 
  • Inpatients with diabetes have higher infection rates, longer lengths of stay, and 6% higher mortality (death rate) than those without diabetes.
  • 25% (a quarter) of hospitals don’t have a diabetes inpatient specialist nurse. 
  • 28% of inpatients needing to see a diabetes specialist didn’t during their admission, because none was available.
  • Only 8% of hospitals have a weekend service for diabetic patients.
  • Nearly 40% of patients treated with insulin suffer an insulin error whilst in hospital.
  • In 2017, around 9,600 people needed rescue treatment after falling into hypoglycaemic coma in hospital. 
  • 2,200 people suffered from diabetic ketoacidosis (DKA) from undertreatment with insulin in hospital. 

Despite these shocking statistics, GIRFT’s most alarming finding was that the majority of the harm currently suffered by NHS patients with diabetes would be prevented with improvements in care. 

If you would like more details on this report you can read it in full here or our commentary here.

If you have suffered amputation or other severe disability as a result of negligent care of diabetes and would like to find out more about making a claim, contact us by email at or call us free on 0800 124 4845.