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An annual and comprehensive review is regarded as a crucial element of structured diabetes care, 1 2 and general practice is increasingly providing this service.3 Developments in diabetes care in general practice have been encouraged by changes in national policy, which since 1993 have included specific payments for doctors offering structured diabetes care, and local initiatives including diabetes education programmes and multipractice audits.View this table:Numbers (percentages) of patients with diagnosed diabetes reviewed in general practices and diabetes outpatient clinics between 1990 and 1995We examined attendance by diabetic patients at outpatient clinics and general practices between 1990 and 1995 to determine whether there had been a change in the proportion of patients with diabetes reviewed in primary and secondary care. The practices were running diabetes programmes that qualified for payments for management of chronic diseases in 1995. …

Shifting of care for diabetes from secondary to primary care, 1990-5: review of general practices