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In some parts of the country services are deteriorating, and fewer PCTs had a programme for early detection of diabetes in place in 2007 than two years earlier.

In 2005, 60 per cent of PCTs had such a programme: last year this number had fallen to 57 per cent, the charity said.

Good practice is 'not universal' across the UK and significant numbers of diabetes sufferers 'do not have access to the best possible treatment, care and outcomes'.

Diabetes UK awarded the NHS two stars out of five for its delivery of the diabetes NSF.

Despite an NSF standard calling for all diabetics to receive a service that 'supports them in managing their diabetes', in 55 per cent of PCTs 10 per cent of patients or fewer had attended a course on how to manage their condition.

Although the QOF has boosted the number of diabetes patients receiving appropriate care, only 27 per cent are tested for all key factors annually, amid complaints of long waits and difficulty accessing some specialist diabetes services.

Cambridgeshire PCT diabetes specialist nurse facilitator Helen Hollern said that care would remain patchy unless NSF targets were incentivised.

'High standards are more likely to be reached universally if they are hand in hand with QOF-type incentives,' she said.

Diabetes UK chief executive Douglas Smallwood said: 'It is not good enough that almost two million people with diabetes are facing an unnecessarily increased risk of life-threatening complications because of the government's failure to address the quality of diabetes services across the country. Action is needed to safeguard the health and quality of life of everyone with diabetes in the future.'

The DoH is to publish a progress report on the NSF this summer.

Health minister Ann Keen said: 'The number of people getting key tests to help prevent or delay the complications of diabetes is rising year on year'.

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