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To start with a brief introduction, I succeeded Barbara Young as Chief Executive of Diabetes UK last September, arriving from the breast cancer research and support charity, Breakthrough Breast Cancer, where I had worked for eight years, initially as Director of Fundraising and then as Chief Executive, leading the charity into a merger with a smaller breast cancer charity to form Breast Cancer Now. Before that, I held an interim role at JDRF, which marked my entry into the health sector. Since arriving at Diabetes UK, I have understood the immense challenges of diabetes, at an individual and system level, but also the unique opportunity offered by the broader recognition of these challenges by politicians, health service leaders, healthcare professionals, people with diabetes, the public and the media. Our recent news release that the numbers of people with diabetes in the UK population has topped 4 million for the first time attracted huge attention. Public debate around addressing our obesogenic environment appears to be coalescing to a consensus that now is the time to take action. The National Diabetes Prevention Programme should be acknowledged as a first nation-wide investment in applying evidence to prevent the growing tide of Type 2 diabetes and it is right that Diabetes UK is central in driving this work forward. But there is much more yet to achieve. The findings of November’s National Audit Office report on adult diabetes services, re-emphasised in a Public Accounts Committee’s review earlier this year, make for a sobering read; whilst there's been progress in lowering additional risk of death from diabetes (in truth, a change which has come about as a result of improvements in delivering the nine recommended care processes and achieving three treatment standards in the late 90s and early 2000s), there is little progress reported in other key areas since the initial report of 2012. In the words of the report itself "significant geographic variations persist in the quality of care for people with diabetes and in their outcomes...", "some groups of diabetes patients, such as patients with Type 1 diabetes, receive worse routine care and have poorer outcomes....", "the percentage of hospital beds occupied by diabetes patients is increasing but levels of diabetes specialist staff have not changed...", "current payment mechanisms within the NHS are not offering incentives to integrate diabetes care ....", "few people with diabetes are recorded as receiving patient education...". The more recent National Diabetes Audit looks set to report improved blood pressure across Type 1 and Type 2, but highlights the lowest level of completion of the eight care processes, since at least 2009, at 38.7% and 58.7% for Type 1 and Type 2 respectively. I know that these issues concern us all hugely; I feel strongly that Diabetes UK’s role, alongside highlighting the problems, is to work in partnership with specialists and others in the system, to develop effective solutions that help to change the picture for diabetes care. In this article I want to highlight some of the key challenges that stand out from my initial conversations with diabetologists and to outline some of the work that can help us, together, to grasp the opportunities to improve diabetes care.

The way forward at Diabetes UK