NHS Improving Quality has taken over the functions of NHS Diabetes and does not hold this information.

NHS Improving Quality has taken over the functions of NHS Diabetes and does not hold this information.

As well as NHS England providing clinical commissioning groups (CCGs) with information to compare the quality and outcomes in diabetes care through the Clinical Commissioning Group Outcomes Indicator Set (CCG OIS) and the NHS Outcomes Framework, the National Diabetes Audit measures the effectiveness of diabetes healthcare against the National Institute for Health and Care Excellence (NICE) clinical guidelines and quality standard. NHS Improving Quality, hosted by NHS England, is also working to improve health outcomes for people by providing improvement and change expertise. As part of its ‘Living Longer Lives’ and ‘Enhancing quality of life for people with long term conditions’ work streams, it is working with primary care and CCGs to support improvements and transformational change which will improve the quality of care for people with diabetes.

Data on the proportion of NHS England's annual budget spent on resources to help local CCGs improve variations in the quality of diabetes is not available. Information on improving variation in the quality of diabetes care could potentially be drawn from several budgets but it is not possible to disaggregate it to provide the information requested.

A sample diabetes service specification, designed to meet the NICE diabetes quality standard, was published on the NHS Commissioning Assembly website in July 2014. This was provided for CCGs to use if they choose and so no information is collected on the number of CCGs that use it.

As well as NHS England providing clinical commissioning groups (CCGs) with information to compare the quality and outcomes in diabetes care through the Clinical Commissioning Group Outcomes Indicator Set (CCG OIS) and the NHS Outcomes Framework, the National Diabetes Audit measures the effectiveness of diabetes healthcare against the National Institute for Health and Care Excellence (NICE) clinical guidelines and quality standard. NHS Improving Quality, hosted by NHS England, is also working to improve health outcomes for people by providing improvement and change expertise. As part of its ‘Living Longer Lives’ and ‘Enhancing quality of life for people with long term conditions’ work streams, it is working with primary care and CCGs to support improvements and transformational change which will improve the quality of care for people with diabetes.

Data on the proportion of NHS England's annual budget spent on resources to help local CCGs improve variations in the quality of diabetes is not available. Information on improving variation in the quality of diabetes care could potentially be drawn from several budgets but it is not possible to disaggregate it to provide the information requested.

A sample diabetes service specification, designed to meet the NICE diabetes quality standard, was published on the NHS Commissioning Assembly website in July 2014. This was provided for CCGs to use if they choose and so no information is collected on the number of CCGs that use it.

As well as NHS England providing clinical commissioning groups (CCGs) with information to compare the quality and outcomes in diabetes care through the Clinical Commissioning Group Outcomes Indicator Set (CCG OIS) and the NHS Outcomes Framework, the National Diabetes Audit measures the effectiveness of diabetes healthcare against the National Institute for Health and Care Excellence (NICE) clinical guidelines and quality standard. NHS Improving Quality, hosted by NHS England, is also working to improve health outcomes for people by providing improvement and change expertise. As part of its ‘Living Longer Lives’ and ‘Enhancing quality of life for people with long term conditions’ work streams, it is working with primary care and CCGs to support improvements and transformational change which will improve the quality of care for people with diabetes.

Data on the proportion of NHS England's annual budget spent on resources to help local CCGs improve variations in the quality of diabetes is not available. Information on improving variation in the quality of diabetes care could potentially be drawn from several budgets but it is not possible to disaggregate it to provide the information requested.

A sample diabetes service specification, designed to meet the NICE diabetes quality standard, was published on the NHS Commissioning Assembly website in July 2014. This was provided for CCGs to use if they choose and so no information is collected on the number of CCGs that use it.

Information on the number of patients in the National Diabetes Audit (NDA) registered in primary care that were newly diagnosed with diabetes in the 2009-10, 2010-11, 2011-12 and 2012-13 audits is shown in the following table. Information is provided for England and eight clinical commissioning groups (CCGs) in the Lancashire Area Team.

Number of people newly diagnosed with diabetes in each audit year for England and CCGs in the Lancashire Area Team

Source: The Health and Social Care Information Centre – NDA

Notes:

1. Participation in the NDA, which audits diabetes registrations in primary and secondary care, is not mandatory. The NDA does not have 100% coverage or participation so the information in the table will be incomplete.

2. The Royal College of Paediatrics and Child Health is the authoritative source for all paediatric diabetes audit data.

3. The NDA currently only holds data for 2009-10, 2010-11, 2011-12 and 2012-13. Each audit covers a 15 month period, for example the 2012-13 audit was for the period 1 January 2012 to 31 March 2013.

4. Due to the 15 month audit period from January to March, a patient could be classed as newly diagnosed in two audit periods, for example if the patient were diagnosed in 2012 and appeared in the 2011-12 and the 2012-13 audit they could be counted twice, once in each year.

5. The data at CCG level is collated by mapping data from GP practices for each audit year to their current CCG. Prior to the 2011-12 audit, the NDA reported at primary care trust (PCT) level. Where PCT and CCG boundaries differ, the figures here will differ to published figures from the 2009-10 and 2010-11 audits.

6. NDA 2012-13 comprised data from 1.9 million people with diabetes in England. The Quality and Outcomes Framework states there are approximately 2.7 million people aged 17 or over with diabetes in England alone.

7. NDA 2012-13 comprised data from 5,666 practices in England, there are around 8,000 practices in England.

The National Health Service annual workforce census published by the Health and Social Care Information Centre provides information on the number of nursing, midwifery and health visiting staff employed in the NHS in England but it does not separately identify diabetes specialist nurses. However, there are now over 6,300 more nurses, midwives and health visitors working in the NHS in England compared to May 2010.

It is for local NHS organisations with their knowledge of the healthcare needs of their local population to invest in training for specialist skills and to deploy specialist nurses. Specialist nurses provide invaluable support for patients and their families. They are able to provide specialist treatment and advice and act as a gateway to other members of the multidisciplinary team, which can both save the NHS money and, more importantly, improve care and outcomes for patients.

In 2013-14, the latest year available, the net ingredient cost of insulin dispensed in primary care was £328.3 million and in secondary care the cost was £8.1 million. Insulin has been defined as all medicines included in British National Formulary section 6.1.1 Insulins.

Public Health England in partnership with NHS England and Diabetes UK are currently developing proposals for a nationally scaled diabetes prevention programme. This will consider the contribution of public campaigns to raise awareness of the risks of Type 2 diabetes and the lifestyle modifications that can prevent and reduce risk.

NHS Improving Quality (NHS IQ) was founded on 1 April 2013 through a collaboration agreement between the Department of Health and NHS England. This was in recognition of the need for a system wide focus on improvement to be provided by establishing an improvement body within NHS England. The responsibilities of NHS Diabetes have now been passed to NHS IQ.

NHS IQ has a number of programmes of work under way to reduce premature mortality from diabetes and improve the care of people with diabetes including:

- piloting new pathways of care to detect and manage asymptomatic coronary heart disease in patient groups with diabetic foot disease with the aim of reducing premature mortality in these patients by 600 lives per year from 2015-16;

- supporting the NHS Health Check programme, a key component of which is detecting the risk factors for diabetes;

- supporting the implementation of the Cardiovascular Disease Outcomes Strategy;

- working to achieve patient centred, co-ordinated services for people living with long-term conditions, including diabetes; and

- providing signposting and links to useful improvement resources relating to diabetes.

More information on this work can be found on the NHS IQ website at:

www.nhsiq.nhs.uk

The table below shows the completion rate for all eight measurable care processes assessed in the National Diabetes Audit (NDA), the number of patients completing all eight care processes and the number not completing all eight care processes. This is provided for England and the eight clinical commissioning groups (CCGs) in the Lancashire area. Also provided is the participation rate for England and each CCG.

The care processes are those which the National Institute of Health and Care Excellence recommend should be part of an annual check for people with diabetes.

Data is not available in the format requested as figures on the completion of annual checks are not held centrally at county level.

The data provided is from the 2012-13 audit year.

¹All diabetes includes maturity onset diabetes of the young, other specified diabetes and not specified diabetes

²The eye screening care process has been removed from this figure due to data quality issues. This figure comprises the following care processes:

HbA1c

Blood pressure

Cholesterol

Serum creatinine

Urine albumin

Foot surveillance

Body Mass Index

Smoking

³Participation is calculated from the percentage of general practices (GP) practices participating in the NDA 2012-13 out of all GP practices within the CCG