Improved diabetes care in a UK health district.

The present study reports an analysis of diabetes care in general practice in a London Health District. A specialist nurse facilitator used various techniques to obtain practice information building up individual practice profiles. Four groups of constraints were identified as affecting the provision of GP diabetes care. Individual practice plans were formulated, working with key staff, to apply various interventions to ameliorate identified constraints. Using a non-prescriptive approach, GPs were encouraged to become involved in diabetes care in the way they felt most appropriate for their practice. Using this method, GP involvement in diabetes care has increased from 17 to 53% during the three years of the study.