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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 runs occasional audits such as:

  • Structured Education
  • Transition

The National Diabetes Audit Integrated Specialist Survey (NDA ISS) has been added to the NDA programme for 2020 and NHS Digital have created an organisational survey across the programme, which encompasses all modules and workstreams.

There are already organisational surveys carried out for NADIA and NDFA, however the plan is to stop these and only carry out one survey across the programme to ease the burden and streamline the collection.

The survey will be conducted at trust level and carried out on an annual basis in October - it will look at services as of 1 October each year.

This survey will be sent out to all hospital Trusts in England and Wales.

The data will be used to look at diabetes services across England and Wales. It will highlight good quality and/or inadequate practices and look at where improvement can be made to make a real difference to patient care.

The data will be published in an aggregate form in each of the national audit reports for each workstream.

The data collection for 2020 goes live on Monday 26 October 2020. The submission deadline is 11 December 2020.

If you would like to discuss this collection please see the Contact us section below.

Download a copy of the data collection spreadsheet (this is for internal use only and cannot be used to submit the data).

Read our guidance about the survey.

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.

Diabetes UK manages Quality Improvement Collaboratives (QIC) which set local aims to improve diabetes care. Using audit data, specialist services work together with other providers to develop skills, share learning and improve clinical practice.

The NDA publish data in a variety of formats including national strategic reports, interactive spreadsheets and patient friendly reports.

View the latest publications from the:

National diabetes data is now available via the Data Access Request Service (DARS)Full details of the process and how to apply are available on the DARS webpages.

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.

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.

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.

The National Clinical Audit Advisory Group (NCAAG) has produce statistical guidance on how potentially outlying performance of healthcare providers can be identified. The outlier policy and the National Diabetes Audit Programme page summarises the policy and its impact on the National Diabetes Audit programme.

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.

Further information

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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: 25 November 2020 3:29 pm