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National Diabetes Audit: Latest report shows improvements but care variability remains

The latest report of the National Diabetes Audit has been published, detailing the care processes and treatment target achievement rates for people with diabetes in 2015–2016 in England and Wales, along with information on offers and attendance for structured education places.

Participation rates increased last year to 82.4%, up from 57.3% in 2014–2015. Participation is expected to increase again next year, following the recent announcement that participation will be mandatory in the new GMS contract.

The proportion of people achieving target HbA1c, blood pressure and cholesterol levels remained stable but is still considerably lower in people with type 1 diabetes than in those with type 2 diabetes.

Timely offers of structured education continue to improve, with around 80% of people with type 2 diabetes and 40% of those with type 1 diabetes offered structured education within 1 year of diagnosis.

However, the 2013–2014 fall in BMI checks and the 2014–2015 fall in urinary albumin checks have not recovered, and the variation in care processes and target achievement remains high, both between and within Clinical Commissioning Groups (CCGs), even after adjustment for case mix. For both types of diabetes, people aged under 65 years receive the worst care.

This year, for the first time, data on people with diabetes who also have a learning disability were included. The results suggest that this group had similar care process and treatment target results to the general diabetes population.

In response to these findings, a number of recommendations are made:

  • Structured education providers and their commissioners should follow the recently agreed communication guidance to improve recording of structured education attendance.
  • GP and specialist services and CCGs/Local Health Boards should use relevant parts of the report and the accompanying local-level information to compare themselves to similar services and identify areas for improvement and implement local action plans.
  • All services should seek new approaches to diabetes service delivery for those aged under 65 to narrow the gap between them and older people.
  • People with diabetes should review the results for their practice or specialist service and support any improvement initiatives.

The report and supporting data can be accessed in full here.

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