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Publication, Part of

Report 1: Care Processes and Treatment Targets 2020-21, Full Report

Audit, Survey, Other reports and statistics

Care Processes and Treatment Targets: Variation by CCG/LHB

Treatment Targets: CCG/LHB Variation, Mapped

The range of CCG/LHB 8 care process completionfor people with type 1 diabetes, England and Wales, 2019-20 and 2020-21

For continuity with previous reports, and to avoid inappropriate comparisons between England (retinal screening data available) and Wales (retinal screening data not available), these maps illustrate the substantial geographical variation in completion of the 8 NICE-recommended care processes.

Footnotes:

  1. There is an existing clinical coding issue due to changes in NDA data extraction, resulting in a significant reduction in care process completion – this issue only still exists in Mid Essex CCG and is evident in the map above. This is currently under investigation and will be resolved for 2021-22.

The range of CCG/LHB 8 care process completion1 for people with type 2 and other diabetes, England and Wales, 2019-20 and 2020-21


For continuity with previous reports, and to avoid inappropriate comparisons between England (retinal screening data available) and Wales (retinal screening data not available), these maps illustrate the substantial geographical variation in completion of the 8 NICE-recommended care processes.

Footnotes:

  1.  There is an existing clinical coding issue due to changes in NDA data extraction, resulting in a significant reduction in care process completion – this issue only still exists in Mid Essex CCG and is evident in the map above. This is currently under investigation and will be resolved for 2021-22.

Care Processes: CCG/LHB Variation, Range

The range of CCG/LHB care process completion1,England and Wales, 2019-20 and 2020-21


The median values in these ‘box and whiskers’ plots3 show the pandemic related deteriorations illustrated on the previous page. They show also that the range of variation increased during 2020-21, most notably for BMI, blood pressure and foot checks.

GP practice and specialist service level information accompanies this report.

Footnotes:

  1. In the benchmarking tables, care process completion rates are presented with case-mix adjusted bandings that show whether a service is achieving the care process delivery levels expected for their patient population. The bandings take into account age, gender, ethnicity, duration of diabetes and social deprivation. See the accompanying methodology page of this report for full details.

  2. There is an existing clinical coding issue due to changes in NDA data extraction, resulting in a significant reduction in care process completion – this issue is still evident above in Serum Creatinine care process completion. This is currently under investigation and will be resolved for 2021-22.

  3.  See the Definitions Section for a visual guide to reading box and whisker plots

 


Treatment Targets: CCG/LHB Variation, Mapped

The range of CCG/LHB three treatment target achievement for people with type 1 diabetes, England and Wales, 2019-20 and 2020-21


The three treatment targets, consistent with NICE guidance, are: HbA1c ≤ 58mmol/mol (7.5%), blood pressure ≤ 140/80, and prescribed a statin for primary (age 40-80yr) or secondary (established cardiovascular disease) prevention.


The range of CCG/LHB three treatment target achievement for people with type 2 and other diabetes, England and Wales, 2019-20 and 2020-21


The three treatment targets, consistent with NICE guidance, are: HbA1c ≤ 58mmol/mol (7.5%), blood pressure ≤ 140/80, and prescribed a statin for primary (age 40-80yr) or secondary (established cardiovascular disease) prevention.


Treatment Targets: CCG/LHB Variation, Range

The range of CCG/LHB treatment target achievement, England and Wales, 2019-20 and 2020-21


The median values in these ‘box and whiskers’ plots1 show the pandemic related changes illustrated in earlier slides. They show also that in contrast to care processes the range of variation was similar during 2020-21. The whole population shifts in HbA1c and blood pressure may suggest that changes in behaviour rather than service delivery may be dominant here.

GP practice and specialist service level information accompanies this report

Treatment target achievement forms one of the oversight metrics in the NHS Oversight Framework 2021-22

See the accompanying methodology document for full details on demographic modelling. 

 

Footnotes:

  1. See the Definitions Section for a visual guide to reading box and whisker plots


CCG/LHB Success – What can we learn?

CCGs with the best results during 2020-21 have been identified and asked if they had any tips to share. The method was to rank all CCGs/LHBs by calculating the differences between the Care Process completion or Treatment Target achievement rates predicted by the logistic regression models1 and their actual measured rates.

 


Footnotes:

  1. The methodology behind the logistic regression models is published. 

Routine diabetes care ‘Success Factors’ identified by top performing CCGs in 2020-21

 


Footnotes:

  1.  PCN = Primary Care Network
  2.  LMC = Local Medical Committee

Last edited: 15 April 2024 3:33 pm