"Action is needed now and escalating diabetes costs threaten to wreck the NHS budget so this is an issue that affects all of us, not just people with diabetes." Care Services Minister Paul Burstow said: "There is no excuse for delivering anything but the best diabetes care. "Nice (National Institute for Health and Clinical Excellence) guidance and Quality Standards set out what good care looks like. "By exposing poor practice and shining a light on best practice, we are determined to drive up standards for everyone. "We are already working on a new outcomes strategy covering long-term health conditions and are committed to publishing a companion document on diabetes later this year."

    The worst offenders were Mid Essex and Swindon PCTs where less than 9% of patients were given the nine basic tests which are recommended by the Department of Health (DH). The report authors said: "The Department holds information to assess performance but there is a lack of accountability for PCTs who fail to ensure that the recommended standards of care are met." It also claimed the NHS does not "clearly understand" the costs of diabetes at a local level and is therefore finding it difficult to deliver diabetes services in the most effective way. The report said: "People with diabetes require regular review of clinical indicators of disease progression. "Without regular monitoring and treatment, this damage can lead to complications such as blindness, amputation and kidney disease."