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National Diabetes Audit 2015–16: Significant variation in care

The National Diabetes Audit (NDA) provides a comprehensive view of diabetes care in England and Wales by measuring the effectiveness of diabetes healthcare against NICE Clinical Guidelines and Quality Standards. Participation by practices in the audit increased to 82.4% from 57.3% in 2014–15. The audit highlights that people with type 2 diabetes are now more likely to get good care, but it also flags up widespread variation between localities, especially in people with type 1 diabetes.

By Colin Kenny, GP, Dromore

The NDA examines various audit criteria, particularly how well three NICE-recommended treatment targets for people with diabetes have been met by GP practices in England and Wales: HbA1c ≤58 mmol/mol (7.5%), blood pressure ≤140/80 mmHg and serum cholesterol <5 mmol/L. The audit found that the percentage of people with type 2 diabetes receiving eight care processes had fallen by 14 percentage points from 68% in 2013–14 to 54% in 2015–16, with older people being more likely than younger people to achieve all three treatment targets.

The audit also found that 40% of people with type 2 diabetes achieved all three treatment targets, compared with only 18% of people with type 1 diabetes. The percentage of people with type 1 diabetes receiving all eight NICE-recommended care processes has fallen 8 percentage points – from 45% in 2013–14 to 37% in 2015–16. However, many more people diagnosed with diabetes are being offered structured education programmes, up from 10% in 2009 to 82% in 2014 for type 2 diabetes.

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