31 January: Report shows variations in diabetes care

Page contents

Note: GP and specialist service level information is available within this report.

31 January 2017

The National Diabetes Audit 2015-16, published by NHS Digital in partnership with Diabetes UK, found that the percentage of patients with Type 1 diabetes achieving NICE-recommended treatment targets for glucose control, blood pressure and cholesterol varied from 11 per cent in some CCGs/LHBs to 34 per cent in others.

In general, more patients with Type 2 diabetes achieve treatment targets, but there is a sixteen percentage point variation, from 33 to 49 per cent, across localities.

The variation between CCGs is matched or exceeded by variation between General Practices within CCGs and between specialist services.

Dr Bob Young, a consultant diabetologist and clinical lead for the audit said:

"Achieving treatment targets is central to staying healthy with diabetes. GP and specialist services need to work together and all aim for the level of the best. Everyone with diabetes should be confident they are getting high quality care."

Other findings from the audit - commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme - include:


  • The last six years have seen improvements nationally in achievement of all three treatment targets, in both Type 1 (1.6 percentage points) and Type 2 (5.1 percentage points) diabetes
  • Older people are more likely than younger ones to achieve all three treatment targets; the difference for those with Type 2 diabetes is greater (46% of people aged 65 to 79 achieved all three treatment targets compared with 27% of people aged under 40) than for those with Type 1 diabetes (24% of people aged 65 to 79 and 18% for those aged under 40)
  • People with Type 2 diabetes are more likely to achieve all three treatment targets - 40% of people with Type 2 diabetes achieved all three treatment targets compared to only 18% of people with Type 1 diabetes
  • The percentage of people with Type 1 diabetes in England and Wales receiving all eight NICE-recommended care processes has fallen eight percentage points - from 45 per cent in 2013-14 to 37 per cent in 2015-16. For people with Type 2 diabetes, the decline is greater - from 68 per cent in 2013-14 to 54 per cent in 2015-16. These declines are almost entirely due to reductions in delivery of the urine albumin care process (the check for early kidney disease)
  • The percentage of people diagnosed with diabetes that have been offered structured education within one year of diagnosis has increased markedly, from 10 per cent in 2009 to 82 per cent in 2014 for those with Type 2 diabetes (this has increased from 5 per cent to 39 per cent for those with Type 1 diabetes)
  • People with Learning Disabilities who have Type 1 diabetes are slightly more likely to get their annual checks whilst those with Type 2 diabetes are slightly less likely to get them


Chris Askew, Chief Executive of Diabetes UK, said:

"Achieving treatment targets is absolutely vital when it comes to staying healthy with diabetes as doing so helps people reduce their risk of developing serious and life-threatening complications such as amputation, blindness, heart disease, stroke and kidney disease.

"It is positive that more CCGs and General Practices have taken part in this year's audit than in recent years. High levels of participation enables us to shine a light on the issue and showcase what good care looks like."

Read the full report at: www.digital.nhs.uk/pubs/ndauditcorerep1516


a The three NICE-recommended treatment targets for all patients with diabetes aged 12 years and over are:

1. HbA1c (blood test for glucose control) - HbA1c less than or equal to 58mmol/mol

2. Blood pressure (measurement for cardiovascular risk) - blood pressure less than or equal to 140/80

3. Serum cholesterol (blood test for cardiovascular risk) - cholesterol less than 5mmol/L


Notes to editors

1. NHS Digital is the national information and technology provider for the health and care system. Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend. During the 2015/16 financial year, NHS Digital published 294 statistical reports. Our vision is to harness the power of information and technology to make health and care better. NHS Digital is the new trading name for the Health and Social Care Information Centre (HSCIC). We provide 'Information and Technology for better health and care'. Find out more about our role and remit atwww.digital.nhs.uk

2. The National Diabetes Audit (NDA) programme, is commissioned by The Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit programme (NCA). The NDA is managed by NHS Digital in partnership with Diabetes UK and is supported by Public Health England (PHE). Development and delivery of the NDA is guided by a multi-professional national group of diabetologists, GPs, consultants, public health physicians, and service user representatives. The NDA is chaired by Dr Bob Young, Consultant Diabetologist & CMIO, Clinical Lead NDA (National Diabetes Audit) & NCVIN (National Cardiovascular Intelligence Network). Data has been collected as part of the NDA since 2003-04.

3. Diabetes UK is the leading UK charity that campaigns on behalf of all people affected by and at risk of diabetes. For more information on all aspects of diabetes and access to Diabetes UK activities and services, visit www.diabetes.org.uk

4. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales.HQIP holds the contract to manage and develop the National Clinical Audit Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands. www.hqip.org.uk

5. Regional and provider level data are available in this report.

6. Within this release, percentages are rounded to the nearest whole number.

7. For media enquiries please contact media@nhsdigital.nhs.uk or telephone 0300 30 33 888.