The Company Chemists' Association (CCA) has called on the government and the NHS to commission a national diabetes screening service from within community pharmacies.

This should be underpinned by 'seamless IT referral pathways' and patient pathways allowing independent prescribing pharmacists to initiate treatment where needed, the trade body, which represents large multiple pharmacies, said.

Making such a service available from community pharmacies nationwide could identify over 45,000 undiagnosed diabetics and 180,000 people with pre-diabetes every year, the CCA estimated.

And proactively treating these people could prevent nearly 7,000 heart attacks or strokes every year, the CCA said.

It highlighted that diabetes costs the NHS an estimated £15bn - 10% of its total budget. And said this is expected to grow to 17% by 2035/36.

Almost a month’s worth of GP appointments is dedicated to managing type 2 diabetes every year, according to the CCA.

Point-of-care screening for diabetes and pre-diabetes in community pharmacies would be cost effective and accessible to patients, the CCA suggested.

It highlighted the popularity of pharmacy services in more deprived areas, where the prevalence of diabetes is 40% higher than in the least deprived areas.

And it profiled one service already privately running in community pharmacy that combined glucose testing with lifestyle coaching, and allowed 87.5% of type 2 diabetics in trial to achieve remission.

The cost of a private service 'creates a barrier to access', the CCA said.

'A publicly funded solution is urgently needed,' its report concluded.

It suggested that a national diabetes screening service could replicate a similar pathway to the Pharmacy Hypertension Case Finding service, meaning that the service 'would be familiar to patients and pharmacy teams and therefore quickly scalable'.

Patients identified in pharmacies could be offered a hemoglobin A1C (HbA1c) point of care test with body measurements taken, and depending on the results they could be offered:

  • Simple healthy living advice to support continued good health, in patients where no concern was raised
  • Support with lifestyle change, underpinned by continued point of care testing, of patients identified as prediabetic
  • A referral to their GP, or, in time, a prescribing pharmacist, to begin diabetes treatment, for patients identified as un-diagnosed diabetic.

Based on its report, the CCA called for the government and the NHS to:

  • Commission a national diabetes screening service to identify and aid people either with, or at risk of, Type 2 Diabetes
  • Support and improve IT communications between pharmacies and GP surgeries so that test results can be shared seamlessly
  • And develop patient pathways to provide newly diagnosed diabetics with easily accessible treatment through community pharmacy.

Malcolm Harrison, CCA chief executive officer, said such a service 'makes sense for patients, the NHS and the UK economy'.

'This service would align closely to the objectives of the NHS and could be a step-change for the 4 million people with Type 2 Diabetes and 2 million people at high risk of developing it,' he said.

A spokesperson for the Department of Health and Social Care (DHSC) told The Pharmacist that as part of the NHS health check, those aged between 40 and 74 with risk factors are also offered tests to assess their risk of type 2 diabetes.

The health check aims to detect people aged 40 to 74 at risk of heart disease, stroke and kidney disease.

And they noted that the government was developing a new digital NHS Health Check 'that people can use at home to understand and act on their CVD and diabetes risk', which they said aimed 'to increase both availability and uptake of the NHS Health Check'.