---

Diabetes: Screening

Answer

The nine health care checks for diabetes as recommended by the National Institute for Health and Clinical Excellence (NICE) are: HbA1c (a measurement of residual glucose), body mass index, blood pressure, urinary albumin, creatinine (a measure of kidney function), cholesterol, eye examinations, foot examinations and smoking status. NICE guidance recommends that diagnosed diabetics receive these nine health care checks (also known as care processes) annually. Primary care trusts (PCTs) are accountable for delivery of care and should be monitoring service delivery at local level.There are two sources of data for assessing the extent to which the nine health care checks are provided: the National Diabetes Audit (NDA), and the Quality and Outcomes Framework (QOF) achievement data.The NDA covers 81.1% of the 2.34 million people aged 17 years and over with diagnosed diabetes reported by the QOF. Results for all PCTs that submit data to the annual NDA can be accessed via the NDA dashboard on the following link:"www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/national-diabetes-audit/analysis/pct-analysis-profiles"Ranking of results is colour coded enabling easy comparison of performance between PCTs.In addition, two maps in the NHS Atlas of Variation (2011) can be accessed via the following link:"www.sepho.org.uk/extras/maps/NHSatlas2011/atlas.html"These are specific to delivery of the nine care processes, and use data from the NDA. The atlas shows that, depending on their PCT area, between 5.4% and 47.9% of people with Type 1 diabetes received all nine health care checks, and between 7% and 71.4% of those with Type 2 diabetes received all the nine health care checks.The QOF achievement data show higher numbers of patients receiving each of the health care checks than does the NDA (when comparing the QOF and NDA figures for each of the tests separately). The QOF data tables for each QOF year including 2009-10 at national strategic health authority and PCT levels are at:"www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/the-quality-and-outcomes-framework/the-quality-and-outcomes-framework-2009-10"The differences may be ascribable to variations in scope and data assessment methodology. We intend to work with stakeholders to understand the reasons for the differences and to identify what needs to be done as a result.

Secondary information

Type

Written question

Reference

98744; 542 c121-2W

Session

2010-12

Subjects

Diabetes Screening

Link

View this Written question on www.publications.parliament.uk