National Diabetes Audit

Summary

The National Diabetes Audit is one of the largest annual clinical audits in the world, integrating data from both primary and secondary care sources, making it the most comprehensive audit of its kind.

Important information

NHS England has directed NHS Digital to establish and operate a system for the collection and analysis of the National Diabetes Audit (NDA) including the National Diabetes Audit Core Audit, which is part of the NDA programme of clinical audits.

This legal basis for data to be collected for the NDA (Direction under section 254 of the Health and Social Care Act 2012), means that GP practices and specialist services are now legally required to supply the data for their practice or diabetes clinic.

People with diabetes should receive annual care checks each year and should be achieving a target for their blood glucose, cholesterol and blood pressure values; these annual checks and targets are outlined in the National Institute for Health and Care Excellence (NICE) Clinical Guidelines and Quality Standards.

The main national diabetes audit, known as the core audit, collects information from general practices and specialist diabetes out-patient services to look at whether people with diabetes are receiving their annual care checks, are achieving their treatment targets and looks at their health outcomes along with whether they have been offered and attended structured education.

Latest Reports

Access the National Diabetes Audit reports

National diabetes audit reports

The National Diabetes Audit Insulin Pump Report 2016-17

The National Diabetes Audit Insulin Pump 2016-17 Report was published on 14 June 2018. The Insulin Pump Audit collects information on the number 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 National Diabetes Audit Report 1: Care Processes and Treatment Targets 2016-17

The National Diabetes Audit Care Processes and Treatment Targets 2016-17 Report was published on 14 March 2018.

This full report details the findings for the 2016-17 audit. The audit collected data during the Summer of 2017, for the period 1 January 2016 to 31 March 2017 and contains the full key findings, recommendations, case-mix adjusted results and banding for performance, ranking of practices within CCGs, results of analysis for multiple readings, and information for learning disability and severe mental illness.

A short report for the NDA 16-17 collection was published on 10 November 2017. This is a small national report accompanied by GP, CCG, LHB and specialist service level data.

The National Diabetes Audit report 2: Complications and Mortality 2015-2016

This report, Report 2a and an accompanying Report 2b, from the National Diabetes Audit (NDA) covers complications of diabetes.

NDA data collection

Keeping up to date with the latest information about the audit collections

So that the team can keep you up to date with the latest information about the audit, please make sure we have your latest contact details. You can register your details with the NDA team – when doing so, please include the following:

  • name;
  • email address (nhs.net address preferable);
  • job title;
  • organisation;
  • organisation code.

2018-19 collection

The National Diabetes Audit (Core Audit) collects information for a 15-month audit period:

  • 2018-19 audit collects for the period 1 January 2018 to 31 March 2019
  • 2019-20 audit collects for the period 1 January 2019 to 31 March 2020

Primary care data collection

For General Practice, the collection will be facilitated via the General Practice Extraction Service (GPES). The NHS Digital audit team, GPES team and system suppliers have worked together to define the specifications and timescales for the quarterly collections which will take place automatically according to a defined schedule. Details of this along with guidance for practices is provided below.

All eligible practices will receive an invite via the Calculating Quality Reporting Service (CQRS) to participate in the audit. Once the invite has been accepted the practice will automatically be included in all extracts for that audit period. Practices will need to opt in again at the start of each audit period. Information regarding how NHS Digital collects information from primary care practices is available at https://digital.nhs.uk/GP-Collections.

The data is extracted from general practices on a quarterly basis via the GPES service. Timings for extraction for 2018-19 is as follows:

  • 6-16 August 2018 (data for 1 January to 30 June 2018)
  • 14-24 November 2018 (data for 1 January to 30 September 2018)
  • 8-16 February 2019 (data for 1 January to 31 December 2018)
  • May 2019 (data for full audit period): dates tbc.

Primary care services can check within the participation management screen on their own local system to verify that they have accepted the CQRS invitation to participate in the 2018-19 NDA: this can be filtered to show a list of which services have been accepted. If this invitation has accidently been rejected, please contact support@cqrs.co.uk, or call 0800 440 2777, to request CQRS to resend the offer. CQRS can also check live/current approvals. Further information re CQRS is available on their website at https://training.cqrs.nhs.uk/web/training/home.

Specialist services / secondary care data collection

For specialist services and secondary care providers, the 2018/19 NDA collection will utilise the full Clinical Audit Platform (CAP) for the first time: this is currently in development and will be a continuous collection whereby services can enter data at any time throughout the year. A data cut off point of May each year will be announced, at this point a snapshot of the collection will be taken for analysis.

Specialist diabetes out-patient service providers will be able to either enter the data directly into the Clinical Audit Platform (CAP) or complete the specialist service template for their service and upload to the Platform. Users must register to use this online tool via NHS Digital’s single sign on services, and will require Caldicott Guardian approval to be granted access to the relevant section of CAP.

Further information regarding the new process will be made available on this page as soon as possible.

Who manages the audit?

The National Diabetes Audit (NDA) is managed by NHS Digital under an agreement with the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England and the Welsh Government. The NDA is delivered by NHS Digital (previously known as 'the Health and Social Care Information Centre, HSCIC'), in partnership with Diabetes UK and the National Cardiovascular Intelligence Network (part of Public Health England).

What does the NDA measure?

The National Diabetes Audit (NDA) is a major national clinical audit which 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 NDA answers five key questions: -

  • Is everyone with diabetes diagnosed and recorded on a practice diabetes register?
  • What percentage of people registered with diabetes received the nine National Institute of Health and Care Excellence (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?
  • What percentage of people registered with diabetes are offered and attend a structured education course?
  • For people with registered diabetes, what are the rates of acute and long-term complications (disease outcomes)?

Aims and Objectives

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

Through participation in the audit, local services are able to benchmark their performance and identify where they are performing well and improve the quality of treatment and care they provide.

A Quality Improvement Toolkit has been developed in collaboration with the RCGP to help practices use their diabetes data to improve services http://www.rcgp.org.uk/clinical-and-research/toolkits/quality-improvement-toolkit-for-diabetes-care.aspx

Analysing your data

The Audit reports will provide you with information on:

  • Audit participation in primary and secondary care / specialist services
  • National-level Information for:
  • Prevalence
  • Care process completion
  • Treatment target achievement (HbA1c, blood pressure, cholesterol)
  • Referral and attendance at structured education
  • Comparisons for people with a learning disability compared to their peers
  • Comparisons for people with a severe mental illness compared to their peers
  • Complication rates (cardiovascular, amputations, ketoacidosis episodes)
  • Local-level information for: 
    • Registrations
    • Demographic distributions for age, diabetes type, social deprivation, ethnicity
    • Complications
    • Care process completion
    • Treatment target achievement

Data Access Requests

The Core National Diabetes Audit Dataset is now available via the Data Access Request Service (DARS). This includes all published NDA data up to and including 2016-17. Full details of the process and how to apply are available on the DARS webpages.

User documents

Related websites

Further information