In What Way Has Care for Long-Term Conditions Such as Diabetes Changed over the Last Thirty Years and Why? K101

Part A: Essay
Option Number: 1

Title: (It was) my very first day as a consultant back in February 1978. The
          clinic was typical of hospital-based care at that time. There was no
          diabetes team, and I was expected to see about 45 patients in three
          hours.   (Sue Roberts, national Director for Diabetes. (England)

          In what ways has care for long-term conditions such as diabetes
          changed over the last thirty years and why?

            Healthcare, has changed dramatically for long-term conditions such as
        diabetes, over the past thirty years.   The bio-medical, ' doctor's surgery'
        approach, having been replaced by a more patient and team-based
        ' expert patient '   approach, where   patients' are more in control of
        decisions concerning their condition, and are encouraged to manage their
        own treatment.   Basically, health-care, in the community and with support,
        has become ' normal '.

              In the UK, healthcare is divided into ' primary ' and ' secondary, with primary
        being the first port of call, generally the G.P.'s surgery. Unlike thirty years ago,
        a patient presenting with diabetes, would not now simply be given medication
        and dismissed.   In the current day, patient's such as the ficticious Anwar
        Malik, would have regular consultations at a diabetes clinic, with specialist
        staff.   They would then be referred to hospital if any symptoms (such as vision
        or foot problems), became especially problematic or in fact, seemed as though
        problems may develop.

              Diabetes care, as with other conditions, in modern timés, involves a large
        network of health-care specialists, including podometrist, opticians, dieticans
        and psychologists', who all work towards :-

          ---   "Concordance..(which is)   based on the notion that the work of...