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Core National Diabetes Audit

The Core National Diabetes Audit (NDA) 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.

This audit is part of the National Diabetes Audit Programme. For information on the legal basis and governance of the audit, please see the main programme page.

Access the data entry system (CAP)

Access for registered users. The submission deadline for specialist/secondary diabetes services is Wednesday 24 May 2023.

Overview of the audit

The Core NDA answers 5 important questions.

  1. Is everyone with diabetes diagnosed and recorded on a practice diabetes register?
  2. What percentage of people registered with diabetes received the nine National Institute of Health and Care Excellence (NICE) key processes of diabetes care?
  3. What percentage of people registered with diabetes achieved NICE defined treatment targets for glucose control, blood pressure and blood cholesterol? 
  4. What percentage of people registered with diabetes are offered and attend a structured education course? 
  5. For people with registered diabetes what are the rates of acute and long-term complications (disease outcomes)?

Also included within the Core NDA are the following other components:

  • Diabetes Prevention Programme
  • Diabetes Care for people with Learning Disabilities and Severe Mental Illness

Participation in the audit

General practices are required to participate in the audit using the General Practice Extraction Service (GPES). Secondary care and structured education providers submit data manually via the Clinical Audit Platform.

Patients included in the Core NDA

The Core NDA includes data recorded about all people of all ages with diagnosed diabetes in England and Wales before the audit period end date.

Included are:

  • people with all types of diabetes mellitus, with the exclusion of gestational diabetes
  • people who are at high risk of developing diabetes, either with a diagnosis of non-diabetic hyperglycaemia, impaired glucose tolerance or pre-diabetes
  • information about referral and attendance on the Diabetes Prevention Programme (DPP) - this data is collected as part of the Core NDA primary care extract

Are children included in the NDA?

Although we collect data for all ages from primary care, we do not specifically collect data from paediatric specialist units. The Royal College of Physicians and Child Health (RCPCH) is commissioned to deliver the National Paediatric Diabetes Audit. We work closely with the RCPCH improve the care of children with diabetes.

Where a collection is directed under this mechanism, the national data opt out does not apply. Therefore, all patients’ records must be submitted to NHS Digital.

This is detailed in section 6.4 ‘When does a national data opt-out not apply?’ of the National data opt-out operational policy guidance document.

We are obliged to apply the national data opt out if we supply the data onwards to any other organisation. For example, if a research body applies for NDA data via the Data Access Request Service (DARS) run by NHS Digital, then we are required to apply the NDO to the data before supplying the data extract to the research body. We do this by checking the patient cohort against the national register.

Raise awareness of the NDA

NHS Digital and Diabetes UK have created resources to help organisations inform their patients about the audit. Patient information leaflets and posters for display in your practice/clinic are available to download.

Diabetes UK produces patient-friendly versions of the audit reports.

Data collection

The Core NDA collects information for a 15-month audit period, for example 1 January to 31 March the following year.

Primary care data collection

The data is extracted quarterly from general practices via the General Practice Extraction Service (GPES).

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. Exactly how this opt-in model will work depends on the clinical system used.

Find more information about how NHS Digital collects information from primary care practices.

Indicative timings for extraction are:

  • August: collection of data from January to June
  • November: collection of data from January to September
  • February: collection of data from January to December
  • May: collection of full audit year data 

Actual dates of data extraction are subject to change without notice.

The NHS England NDA, Primary Care support, and GPES teams have worked together to define the specifications and timescales for the quarterly collections which will take place automatically.

A full list of data items, including the SNOMED codes used for the extraction, are available in the Core NDA Business Rules document (archive content).

Secondary care and specialist services data collection

Secondary care and specialist services have access to the Clinical Audit Platform which enables continuous data collection throughout the audit year.

Data submitters can add updated clinical information as and when an individual patient has a new observation (such as blood pressure check or HbA1c reading), and there is also the option to complete a bulk upload of information at a suitable time (rather than waiting for a finite submission window). Data submitters will also be able to review their submitted data throughout the year. 

There is a final cut-off date each year when the data will be extracted from all providers to build the reports from, but the providers will be able to continue to enter data at any time. 

The submission deadline for specialist/ secondary diabetes services is Wednesday 24 May 2023 at 11:59pm.

Submissions of data (for all patients seen between 1 January 2022 and 31 March 2023) should take place before this cut-off date to ensure your patients are included in the 2022-23 audit.

Full guidance documents and the user registration form can be found below.  

Specialist diabetes out-patient services should work with their insulin pump clinics and either:

  • add clinical information as and when a patient has a new observation
  • complete the specialist service specification for their hospital/trust to create 5 .csv files

The resulting files can then be uploaded to the Clinical Audit Platform (users will first need to register for this platform).

Submission guidance 2022 - video

Specialist Services guidance

Structured Education Providers

Services that only provide diabetes structured education services should register to have access to the National Diabetes Audit Structured Education (NDASE) Portal. 

Access to the NDASE portal is restricted to:

  • organisations in England which only provide structured education services (and no other specialist diabetes services)
  • any organisations in Wales which provide structured education services

Structured Education providers should either:

  • add attendance information to the portal as and when the patient is offered and attends a diabetes structured education programme
  • complete the Structured education provider template and upload on the NDA Structured Education portal. Users will first need to register to this platform using the CAP registration form. When sending the form, please indicate that Structured Education access is required

Full guidance documents can be found below:

Structured Education providers guidance

Access the National Diabetes Audit reports

NDA Core Audit reports (and pre-June 2022 specialised reports). From June 2022, the specialised audit reports are published separately

Analyse your data

The audit reports and dashboards will provide you with information on audit participation in primary and secondary care/specialist services. The state of the nation reports focus on key findings/topics at a national level and the dashboards provide both a local and national picture of diabetes care.

In the audit reports and dashboards you can find information on:

  • prevalence
  • demographic distributions for age, diabetes type, social deprivation, ethnicity
  • care process completion
  • treatment target achievement (HbA1c, blood pressure, cholesterol)
  • referral and attendance at structured education
  • complication rates (cardiovascular, amputations, ketoacidosis episodes)

Contact us

For further information about the audit, email [email protected] or call 0300 303 5678. Note that lines are open Monday to Friday 9am to 5pm. For general enquiries, email [email protected].


Further information


Last edited: 4 April 2023 11:06 am