08 • Careers


As the number of people being diagnosed with the condition soars, the time could be right to consider becoming a GP with a special interest in diabetes


D


IABETES is nearly four times as common as all types of cancer combined and is fast becoming a major 21st century crisis. Around 2.9 million people in the UK have been diagnosed with a form of the disease but it’s thought that as many as 850,000 people have type 2 diabetes


but do not yet know. The fi gures are staggering and are a major source of


concern for healthcare professionals across the UK. As part of the attempt to fi ght this rising tide, the Department of Health is carving out a greater role for primary care physicians in the prevention, early detection and treatment of this condition. Part of this strategy involves a greater role for GPs with a


special interest (GPwSI) in diabetes. A GPwSI is a doctor, working principally in the


community, who takes referrals that may otherwise have gone directly to a secondary care consultant and delivers a clinical service beyond the scope of their core generalist role.


They will have demonstrated appropriate competences


to deliver those services without direct supervision. In some cases they work with the specialist team to present the views of general practice in discussions on local guidance and policy, and also provide advice on commissioning There are many GPs who currently provide specialist


diabetes services but who do not consider themselves to be special interest practitioners. For those doctors who do wish to achieve offi cial GPwSI status, there is a formally accredited framework set out by the Department of Health in their document Guidance and competences for the provision of services using practitioners with special interests – Diabetes. (www.tinyurl.com/bpq7ewm)


Training The GPwSI competency framework document for diabetes details the type of evidence and competences that may be expected from GPwSIs in diabetes during the accreditation process.


The competences are as follows:


• Understand the clinical management of diabetes •


Provide and monitor drug therapy for clinical management of diabetes


• • • • Manage the delivery of diabetes care Deal with diabetic emergencies


Understand the special needs of older people with diabetes


Understand and manage the complications of diabetes:


- screening -


microvascular disease


- eye disease - -


renal disease and hypertension


neuropathy, foot disease and erectile dysfunction.


GPwSIs are expected to demonstrate that they have completed recognised training which may include acknowledgement of prior learning and expertise. Training can be acquired in several ways and would be expected to include both practical and theoretical elements. It is essential to undertake attachments to specialist care diabetes services over a reasonable period of time to reach the necessary level of competence. Other routes through training include gaining experience


of working in relevant departments; self-directed learning with evidence of completion of individual tasks; attendance at recognised meetings/lectures/tutorials on specifi c relevant topics; practising as a trainee under the supervision of a diabetes specialist/consultant in the secondary care service; and completing a recognised university course. Recognised courses include the postgraduate diploma in diabetes for practitioners with a special interest, off ered by


TACKLING A DIABETES


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