The National Institute for Health and Care Excellence (NICE) provides recommendations on nine key care processes that adults with diabetes should receive to avoid short and long-term complications. Here we use audit data to look at eight processes of care.
Diabetes prevalence is calculated using patient registrations from primary care and patient registrations from secondary care, where the patient's GP practice participated in the audit (in England and Wales). There was an increase in prevalence of diabetes (type 1 or 2) from 4.6% in 2010/11 to 6.4% in 2015/16.
The proportion of patients receiving recommended care processes for type 1 diabetes over the past six years has remained relatively steady for the majority of processes. However, as of 2015-16, just 36.5% of patients with type 1 diabetes received all eight processes of care, a fall from 43.3% in 2010-11.
Analysis by age groups reveals that rates of completion for all eight care processes are much lower for the youngest group (under 40), and especially for people with Type 1 diabetes.
Achievement of treatment targets has improved only for the recommended blood pressure target. However, this is due to the target changing to less than or equal to 140/80 rather than just being less than 140/80 in previous audits. The proportion meeting the HbA1c target of less than or equal than 58mmol/mol has declined over time and so has the proportion of people with controlled cholesterol. The proportion of people meeting all the treatment targets (patients achieving HbA1c
Overall, younger people and those with Type 1 diabetes should receive more attention in the future. It would also be interesting to look at A&E visits and unplanned hospital admissions for short and long-term complications for people with diabetes.
About this data
The prevalence and registration sections of the report are based on data collections from both primary and secondary care. The remainder of the report (including the appendices) includes only patients registered in primary care to ensure that the population based denominators are comparable. The vast majority of patients are registered in primary care with only a relatively small percentage (3.8%) of records appearing only in secondary care submissions.
Here we look at eight processes of care as eye screening is organised by NHS Diabetes Eye Screening.