The X-PERT programme meets audit standards

The X-PERT Programme was developed to increase knowledge, skills and confidence in people with diabetes so that they can take charge and self-manage their condition. It has been shown to improve clinical, lifestyle and psychosocial outcomes in people with newly diagnosed and existing diabetes (Deakin et al, 2006) and be a cost saving strategy for the NHS (Deakin, 2011). There are 73 X-PERT Centres in the UK and Ireland that deliver X-PERT Diabetes and/or X-PERT Insulin to people with type 1 and type 2 diabetes. 

Educators attend a training course where they undertake practical and knowledge assessments to develop the competencies to deliver the structured curriculum using the educational theories that underpin it. Once qualified, educators commence delivery to people with diabetes and are required to be assessed via the X-PERT quality assurance programme within 1 year. In order to ensure the national implementation of the X-PERT Programme continues to meet the standards identified in the published randomised control trial, it is necessary to conduct an ongoing audit of participant clinical and psychosocial data.

Methods
To meet the key criteria identified by Diabetes UK and the Department of Health to implement the NICE guidance, X-PERT Educators enter baseline, 6 monthly and, thereafter, annual results onto the X-PERT Audit Database and reports are generated presenting the attendance statistics, the mean participant evaluation and empowerment score and the mean result at baseline, 6, 12 and 24 months for each clinical indicator (Table 1 and Figure 1). X-PERT Health undertakes a comprehensive audit annually and provides each organisation with an audit report. 

Results 
The latest audit was undertaken in January 2012. Fifty-two of the 73 (71%) X-PERT Centres have entered data for 23 610 people with diabetes. Audit standards have been met with excellent attendance scores: 95% attend at least one session and 81% four sessions or more; participant satisfaction score 94%; the empowerment score increased by 23% post education programme and by 26% at 1 year. Clinical outcomes all improved and met audit standards.

Conclusions 
National implementation of the X-PERT Programme has met audit standards. X-PERT increases skills, knowledge and confidence for diabetes self-management, resulting in increased health and empowerment among people with newly diagnosed and existing diabetes. All audit standards have been met with significant improvements in HbA_1c, body weight, lipid and blood pressure values.