Draft diabetes strategy implementation plan out for comment

The long-awaited draft implementation plan for the Australian National Diabetes Strategy has quietly appeared on the Federal Government’s Health Department website, and has left diabetes community experts underwhelmed and ‘disappointed’.

The draft plan has been released for ‘targeted consultation’, but stakeholders only have until the end of March to complete a survey and make their comments. The document clearly states that no extensions will be considered.

The strategy itself was released some 15 months ago, and the Australian National Diabetes Strategy Implementation Working Group (IWG) was established in early 2016.

According to the Health Department’s preamble to the draft, this group had been tasked “to operationalise each of the Strategy’s goals through development of an Implementation Plan that will recommend ways to direct funding in a cost-effective and sustainable way to agreed actions over the life of the Strategy.”

“The Implementation Plan should guide the Australian, state and territory governments in planning, funding and implementing action to improve the health of all Australians, specifically to prevent people developing diabetes and/or minimising the risks of complications associated with diabetes,” it continued.

“The priority actions identified in the Implementation Plan are intended to complement initiatives already underway across all sectors, and do not address all of the potential areas for action listed within the Strategy. They highlight areas of action that are of high importance, or where there are identified gaps within currently delivered programs and services.”

Professor Stephen Colagiuri, Professor of Metabolic Health and Director of the Boden Institute and a member of the original National Diabetes Strategy Advisory Group (not the IWG), said he was disappointed with the draft implementation plan.

“I am personally disappointed, it’s essentially what we feared would be produced,” he said.

However he said the working group had been “fairly careful” to indicate that it was a plan for the government, not necessarily for clinicians and diabetes organisations.

“The diabetes community was not involved in the development of this draft plan so I am not sure why they had to wait 16 months for it to come out,” he said.

“My expectation was there would be some involvement of the diabetes community before it was finalised. But it is clearly a government response to the National Diabetes Strategy.”

He said there also seemed to be some confusion over how people should consider the document given the instruction in the third paragraph.

“This Plan should be read in conjunction with the Strategy and the National Strategic Framework for Chronic Conditions (the Framework) (NOT yet released). The Framework provides high-level guidance to all sectors and better caters for the shared health determinants, risk factors and multi morbidities across a broad range of chronic conditions, including diabetes,” it stated.

And just a few paragraphs later it foreshadows the likelihood that improvements may not be seen within the timeframe of the strategy.

“The timeframe for this Plan aligns with the Australian National Diabetes Strategy. However, it is recognised that improvements in diabetes outcomes, as determined by changes in indicators, may not be seen within this short timeframe and the impact of the priority actions may extend beyond the life of this Plan,” the report states.

The 35-page report goes on to ‘operationalise’ each of the seven goals listed in the strategy, including to:

  • Prevent people developing type 2 diabetes
  • Promote awareness and earlier detection of type 1 and type 2 diabetes
  • Reduce the occurrence of diabetes-related complications and improve quality of life among people with diabetes
  • Reduce the impact of pre-existing and gestational diabetes in pregnancy
  • Reduce the impact of diabetes among Aboriginal and Torres Strait Islander peoples
  • Reduce the impact of diabetes among other priority groups
  • Strengthen prevention and care through research, evidence and data

The report concedes that the priority actions identified in this Plan are not inclusive of all the potential areas for action listed within the original strategy.

“They have been chosen because of their importance, or due to the identification of gaps within currently delivered programs and services,” it states.

“The potential areas for action not flagged in this document, nevertheless, are important and warrant continued attention and effort.”

It also suggested non-government organisations would be able to use the plan to “better focus their attention on key areas where they are best placed to provide additional support and ensure their investment is appropriately directed.”

Professor Colagiuri said he was not surprised the draft plan was “vague” in its details, and didn’t address any funding issues.

“It’s a plan which outlines a process for implementation of possible activities sometime in the future,” he said. “There’s hardly anything immediate here which I think is a missed opportunity.”

On a positive note, he said the release of the plan meant the diabetes community could move forward with its own plans to take action on the strategy.

“We have to assume some responsibility to progress the implementation of the National Diabetes Strategy,” he said.

“We will rally and I think there are things we can do within existing resources, and that is what we will have to focus on. It’s going to be up to us to see what we can do at federal and state levels as well.”

Monash University professor and honorary president of the International Diabetes Federation, Professor Paul Zimmet, co-chaired the government-appointed National Diabetes Strategy Advisory Group. He told the limbic he could not discuss his own thoughts about the draft given his involvement as co-chair of the advisory group.

However prior to the release of the draft, he said he had heard there were growing concerns within the diabetes community about how it would achieve the seven goals set out in the strategy.

“I am aware of considerable concern within the diabetes community and organisations that the implementation will go the same way as other strategies that achieved nothing,” he said.

Related stories:

Disappointment over lack of action on diabetes strategy

Diabetes strategy will result in action

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