The GP perspective: problems experienced in providing diabetes care in UK general practice.

AIMS: To describe the problems and barriers perceived by general practitioners (GPs) whilst providing diabetes care in primary care in England and Wales and to identify those health authorities (HAs) in which primary care reported the most and least difficulty.
DESIGN: Descriptive postal survey using a self-administered questionnaire.
SUBJECTS: One thousand eight hundred and seventy-three randomly sampled GP practices (one in five practices).
RESULTS: One thousand three hundred and twenty (70%) responded. Getting patients to alter their lifestyles was perceived as causing the most difficulty in managing individual patients, followed by lack of time, patients' nonattendance, noncompliance with medical regimens and poor communication with secondary care. The greatest barriers to practices providing desirable care were lack of time/under-funding and keeping up to date in the area of diabetes, followed by lack of space, inadequate chiropody, dietetics, ophthalmology and access to secondary care. There are important differences between HAs in the difficulties experienced by primary care teams and we have ranked the HAs accordingly.
CONCLUSION: The study has identified what problems need tackling in order to assist primary care to deliver good quality diabetes care, and has highlighted HAs where primary care needs further help, and HAs where examples of good practice may be found and useful lessons learnt. This should form the basis of a needs-based research and development programme for diabetes in primary care.