Celebrating Diabetes Week 2026: collaboration, innovation and the view from Wales

Healthcare in Wales faces well recognised challenges, but its strengths are less often highlighted. Ours is a close knit system that enables strong relationships between colleagues, services and professions. Health board structures support collaboration across primary and secondary care, and there is a deep sense of national pride in the legacy of pioneers such as Aneurin Bevan and Julian Tudor Hart. Alongside this, the pressures are clear – particularly around workforce capacity and digital infrastructure.

In diabetes care, one important marker of quality is completion of the eight essential care processes, which help prevent and detect complications. In Wales, the absence of comprehensive secondary care databases means that processes initiated in secondary care are not consistently captured. This limits our ability to demonstrate performance against standards and to fully contribute to national audits. Work is underway to improve data capture and provide a more accurate picture of care.

Advances in treatment offer real opportunities to improve outcomes. Newer therapies for type 2 diabetes, including GLP 1 receptor agonists, provide cardiovascular and renal protection as well as supporting weight loss. NICE guideline NG28 recommends targeting these therapies to those most likely to benefit. This includes people diagnosed under the age of 40, where earlier intervention can make a significant difference. Strengthening services to identify people at high risk or currently undiagnosed is therefore critical. In Wales, the Community by Design approach supports this ambition, with a focus on prevention, remission, pre conception care and access to optimal therapies.

For people with type 1 diabetes, NICE Technology Appraisal 943 has brought both new opportunities and new challenges. Implementation has taken place without ring fenced funding, and the progress achieved reflects the commitment and adaptability of the workforce. Around a quarter of adults with type 1 diabetes in Wales are now using hybrid closed loop systems, supported by streamlined education and onboarding pathways. However, further progress will require additional investment to fully realise the benefits of the technology.
Innovation is also improving the way services are delivered. Digital triage models are being introduced to enhance follow up and improve outcomes. This includes the first UK deployment of the Diabeter CloudCare™ platform at the Royal Glamorgan Hospital, alongside use of the CareLink Premium™ platform in Cardiff. These approaches are helping teams manage demand more effectively while maintaining high quality care.

There are, however, ongoing priorities. Improving diabetes care in pregnancy, developing early type 1 diabetes services, and strengthening inpatient care all require sustained focus. Inpatient care is particularly important: people with diabetes account for around one in five hospital inpatients, and there remains a need to reduce harm from insulin and medication errors, as well as to address longer lengths of stay.

Wales has taken an important step forward through the Diabetes Care Accreditation Programme (DCAP), delivered by the RCP in partnership with Diabetes UK and the Joint British Diabetes Societies for Inpatient Care. DCAP supports services to improve quality through clear standards and external review. Wales has played a leading role, with three services participating in the pilot and three currently enrolled, two of which are awaiting level 1 accreditation. This work is helping to establish consistent, high quality inpatient diabetes care across the system.

Despite the pressures facing healthcare, there is a strong foundation to build on in Wales. By combining collaboration, innovation and a clear focus on quality, there is a real opportunity to continue improving diabetes care for patients across the country.