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National Diabetes Audit Programme

The National Diabetes Audit (NDA) Programme was originally developed to help improve services and monitor the impact of the diabetes national service framework (NSF). Since 2011 the child (paediatric) component has been delivered by the Royal College of Paediatric Child Health (RCPCH).

The NDA programme also run occasional audits such as:

  • Diabetes Prevention Programme
  • Insulin Pump
  • Structured Education
  • Transition
  • Diabetes Care for people with Learning Disabilities and Severe Mental Illness

Aims and objectives of the NDA

The NDA helps improve the quality of diabetes care by enabling participating NHS services and organisations to:

  • assess local practice against National Institute for Health and Care Excellence (NICE) guidelines
  • compare their care and 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, 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 Royal College of General Practitioners (RCGP) to help practices use their diabetes data to improve services.

Legal basis information

NHS England has instructed NHS Digital to establish and operate a system for the collection and analysis of the NDA. This type of instruction is commonly known as a Direction.

This legal basis for this data collection (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.

NHS England is only able to give a Direction where it considers the information to be collected or analysed necessary to provide NHS services.

A Direction must specify the information to be collected and include relevant details such as why the information is needed and what analysis is to be carried out. This information is included in the NDA Programme requirement specification and Technical Specification documents.

Collecting patient identifiable data

People with diabetes should receive annual care checks and should achieve a target for their blood glucose, cholesterol and blood pressure values; see the NICE Clinical Guidelines and Quality Standards.

As a result, Core NDA, NPID and NDFA all collect patient identifiable data. This data allows patient records to be linked across the diabetes audit programme and to other health care datasets, such as hospital episode statistics (HES), patient episode database for Wales (PEDW) and Office for National Statistics Mortality dataset.

The NDA does not collect patient names. The patient identifiable data we collect is:

  • NHS number
  • date of birth
  • postcode

Linking to other datasets decreases the burden on services of entering the data. Demographics such as ethnicity, diabetes type and postcode recorded in Core NDA can be used for patients registered in NDFA or NPID so it doesn’t need entering twice. Data linkage allows us to understand the types of complications people with diabetes can experience. These linkages help us to give a better picture of diabetes care whilst managing the burden on services for data collection.

NHS Digital has strict criteria to make sure patient data is kept safe. All data is held securely upon encrypted servers. Access to patient records is restricted to crucial personnel. Once the data is received the datasets are pseudonymised to protect patient identity. This means that:

  • data items such as date of birth are converted to age, or year of birth
  • postcodes are converted to lower layer super output areas (LSOA)
  • NHS numbers are converted to a unique ID for that person

NHS Digital will only share patient identifiable data with another provider if they have a clear and approved legal basis to receive such data. For example, a research project that has Section 251 support, or consent from patients for us to share the data.

Management and governance of the audit

The NDA is commissioned and managed under contract by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England and the Welsh Government. The NDA is delivered by NHS Digital in collaboration with Diabetes UK.

The NDA collection has been assured through the Data Standards Assurance Service (DSAS) process, with the findings presented to the national Data Coordination Board (DCB). The DCB acts with delegated authority from the Digital Delivery Board (DDB) and directly from Secretary of State as the main governance route through which data and standards requirements are agreed.

As part of this assurance the data items, collection process and guidance documentation have been reviewed and an assessed to understand the burden on services. The DCB have fully approved the NDA as a collection, awarding it a certificate of assurance.

Contact us

For further information about the audit please email diabetes@nhs.net or call 0300 303 5678. Lines are open Monday to Friday 9am to 5pm. For general enquiries please email enquiries@nhsdigital.nhs.uk.

Related pages

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    NDA reports - Diabetes UK

    Find out what reports have been published in the latest audits of diabetes care in England and Wales. Download and read our easy-to-read versions aimed at people with diabetes and the general public.

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    Diabetes UK

    We are Diabetes UK. Our vision is a world where diabetes can do no harm. We’re leading the fight against the UK's biggest and growing health crisis.

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Last edited: 13 September 2019 11:00 am