National Diabetes Audit – An Overview

National Diabetes Audit What is the National Diabetes Audit? The National Diabetes Audit (NDA) is part of the National Clinical Audit Programme (NCAPOP) commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England (NHSE). The NDA is delivered by NHS Digital (formerly known as the Health and Social Care Information Centre) in partnership with Diabetes UK and supported by Public Health England. The NDA started in 2004 with what is known as the National Diabetes Core Audit. Over the years the audit has grown to encompass new work-streams for specialist areas of diabetes care; these include Inpatient Care, Pregnancy, Foot-care, Insulin Pumps and Transition from paediatric to adult services.

National Diabetes Audit https://digital.nhs.uk/nda https://digital.nhs.uk/footcare National Diabetes Audit National Diabetes Footcare Audit National Pregnancy in Diabetes Audit National Diabetes Inpatient Audit Insulin Pump Audit Transition Audit https://digital.nhs.uk/npid https://digital.nhs.uk/nda_trans https://digital.nhs.uk/diabetesinpatientaudit

National Diabetes Audit - Core The National Diabetes Audit measures the effectiveness of diabetes healthcare against NICE Clinical Guidelines and NICE Quality Standards, in England and Wales. The NDA collects and analyses data for use by a range of stakeholders to drive changes and improvements in the quality of services and health outcomes for people with diabetes. The National Diabetes Audit (NDA) answers four key questions: Is everyone with diabetes diagnosed and recorded on a practice diabetes register? What percentage of people registered with diabetes received the nine NICE key processes of diabetes care? What percentage of people registered with diabetes achieved NICE defined treatment targets for glucose control, blood pressure and blood cholesterol? For people with registered diabetes what are the rates of acute and long term complications (disease outcomes)? Please check out the NDA webpage for more information https://digital.nhs.uk/nda

National Diabetes Audit - Core The NDA supports improvement in the quality of diabetes care by enabling participating NHS services and organisations to: Assess local practice against NICE guidelines Compare their care and care outcomes with similar services and organisations Identify gaps or shortfalls that are priorities for improvement Identify and share best practice Provide comprehensive national pictures of diabetes care and outcomes in England and Wales A Quality Improvement Toolkit has been developed in collaboration with the RCGP http://www.rcgp.org.uk/clinical-and-research/toolkits/quality-improvement-toolkit-for-diabetes-care.aspx Please check out the NDA webpage for more information https://digital.nhs.uk/nda

National Diabetes In-Patient Audit (NaDIA) The National Diabetes Inpatient Audit (NaDIA) started in 2011 and is a snapshot audit of diabetes inpatient care in England and Wales and is open to participation from hospitals with medical, surgical, gynaecology wards or intensive care units. NaDIA allows hospitals to benchmark hospital diabetes care and to prioritise improvements in service provision that will make a real difference to patients' experiences and outcomes. The audit sets out to measure the quality of diabetes care provided to people with diabetes while they are admitted to hospital, by answering the following questions: Did diabetes management minimise the risk of avoidable complications? Did harm result from the inpatient stay? Was patient experience of the inpatient stay favourable? Has the quality of care and patient feedback changed since the previous audit years? Please check out the NaDIA webpage for more information https://digital.nhs.uk/diabetesinpatientaudit

National Pregnancy in Diabetes Audit (NPID) The National Pregnancy in Diabetes (NPID) Audit aims to support clinical teams to deliver better care and outcomes for women with diabetes who become pregnant. The NPID Audit started in 2013, and measures the quality of pre-gestational diabetes care against NICE guideline based criteria and the outcomes of pre-gestational diabetic pregnancy. It aims to answer the following three key questions:- Were women with diabetes adequately prepared for pregnancy? Were appropriate steps taken during pregnancy to minimise adverse outcomes to the mother? Did any adverse outcomes occur? The NPID Audit is a continuous data collection. Units can enter data throughout the year. Please check out the NPID webpage for more information https://digital.nhs.uk/npid

National Diabetes Footcare Audit (NDFA) The National Diabetes Footcare Audit (NDFA) enables all diabetes footcare services to measure their performance against NICE clinical guidelines and peer units, and to monitor adverse outcomes for people with diabetes who develop diabetic foot disease. The NDFA started in 2014 and looks at the following key areas: Structures: are the nationally recommended care structures in place for the management of diabetic foot disease? Processes: does the treatment of active diabetic foot disease comply with nationally recommended guidance? Outcomes: are the outcomes of diabetic foot disease optimised? The NDFA is a continuous data collection. Units can enter data throughout the year. Please check out the NDFA webpage for more information https://digital.nhs.uk/footcare

National Diabetes Transition Audit (NDTA) The NDA and NPDA datasets are being linked so that the care of young people with diabetes can be tracked during the transition from paediatric diabetes services to adult diabetes services. The audit measures against the National Service Framework and NICE Clinical Guidelines and Quality Standards. For the first Transition report data is being linked for the years 2003 to 2014. The audit aims to answer the following questions: Is the transition from paediatric to adult care associated with changes in care process completion rates? Is the transition from paediatric to adult care associated with a change in treatment target achievements (specifically HbA1c)? Is the transition from paediatric to adult care associated with changes in the frequency of diabetic ketoacidosis (DKA)? Please check out the NDTA webpage for more information https://digital.nhs.uk/nda_trans

National Diabetes Audit – Insulin Pumps National standards for the use of insulin pumps were set out in National Institute for Health and Clinical Excellence (NICE) guidance - Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus (NICE technology appraisal guidance [TA151] Published date: July 2008). The Insulin Pump Audit collects information on the number and characteristics of people with diabetes using an insulin pump, the reason for going on an insulin pump and the outcomes achieved since starting the pump. The information is collected as part of the submission from specialist services during the National Diabetes Audit (NDA) – Core Collection Insulin pump information was collected for the first time in 2015 for the audit periods 2013-14 and 2014-15. The first insulin pump report was published in April 2016.