This data is not collected. Primary diagnosis is recorded on admission to hospital, but not the complications which may have led to the admission. Where a patient is known to have diabetes, this will always be recorded on their Hospital Episode Statistic (HES) record, regardless of the actual reason for their admission.

It should be noted that where a patient is known to have diabetes this will always be recorded on their HES record, regardless of the actual reason for their admission. Within HES, the International Statistical Classification of Diseases and Related Health Problems 10th Revision code E11 is used to diagnose type 2 diabetes, so it is possible to provide a count of admissions where that is the primary diagnosis. However, this cohort will only comprise a small proportion of the total number of occasions where a complication of type 2 diabetes necessitated that the patient be admitted to hospital since, in most instances where a patient has diabetes, the primary diagnosis is likely to be recorded as something else.

There will be many other conditions that could be, but they won’t necessarily actually be complications of type 2 diabetes. For example, the National Health Service website page Complications of type 2 diabetes - NHS mentions ‘stroke’ as something that can potentially be caused by having diabetes. However, where a patient who has diabetes has been admitted to hospital with a stroke, we cannot say for certain whether this was a complication of their having type 2 diabetes or was caused for some other reason. Since diabetes, where known to be present, is always recorded on the patient record, we cannot assume that where it is recorded, the primary diagnosis will be due to a complication arising from it. For this reason, we cannot provide any meaningful data to answer the query.

The following table shows hospital admission data due to diabetes mellitus and obesity and other hyperalimentation episodes:

Source: Hospital Admitted Patient Care Activity, NHS Digital

The NHS Diabetes Prevention Programme supports those identified at high risk of type 2 diabetes to reduce their risk. Latest figures in February 2023 shows a 20% reduction in risk for those who are referred to the programme compared to those who are not.

The weight loss drug Semaglutide (Wegovy) was launched in the United Kingdom on 4 September 2023 and will be made available on the National Health Service in line with National Institute for Health and Care Excellence recommendations to ensure cost effective use. A two-year pilot backed by up to £40 million is being developed to explore ways to make these drugs accessible to patients living with obesity outside of hospital settings.

Menus within the National Health Service (NHS) are written and dietary coded, using the British Dietetic Association Nutrition and Hydration Digest, to provide appropriate nutritional information so patients can access the food and drink they want which also meets their health needs. The National Food and Drink Standards for NHS hospitals, published November 2022, requires every trust to have access to appropriate catering dietetic advice and support.

Additionally, all NHS hospital meals are nutritionally analysed to ensure the correct combination of nutrients is achieved and no patient menu is passed until this has happened. This will be done by either a trust using in house dietetic support or by the meal provider if using external delivered meal services.

A count of finished admission episodes (FAEs) with a primary diagnosis of diabetes in the years 2010-11 to 2018-19 can be found in the following table.

The following table shows the count of finished admission episodes (FAEs) with a primary or secondary diagnosis of diabetes in Coventry South constituency, Coventry and England, 2013-14 to 2017-18

Source: Hospital Episode Statistics, NHS Digital

Notes:

1. A FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

2. In order to protect patient confidentiality, all other sub-national data has been rounded to the nearest five.

The information requested is not centrally held.

A count of finished admission episodes with a primary diagnosis and a primary or secondary diagnosis of type 1 diabetes in National Health Service trusts in the years 2013-14 to 2017-18 is shown in the attached table. The primary diagnosis is the main reason why the patient is admitted to hospital. A secondary diagnosis is used where there are other diagnoses relevant to the episode of care.

This data shows a count of episodes, not patients as the same patient may have had more than one admission episode within the same time period.

Information is available on the proportion of inpatients in England and Wales with diabetes experiencing mild and/or severe hypoglycaemic episodes in the seven days prior to the date of the audit. The latest results are published in the 2017 National Diabetes Inpatient Audit (NaDIA), covering the years 2011 to 2017. A summary of the results for the last three available years from 2015 to 2017 is in the following table:

Notes:

1. Reference to associated analysis: NaDIA 2017 annual report, slide 81:

https://files.digital.nhs.uk/powerpoint/s/5/nadia-17-rep.pptx

2. A patient was included in the audit if they had been admitted to a hospital bed for 24 hours or more. Patients on an obstetric or paediatric ward were excluded from this audit. Mental health wards were also excluded due to the high prevalence of long stay patients. Other exclusions included:

- Patients who were hyperglycaemic but not yet formally diagnosed with diabetes;

- Accident and Emergency;

- Day case ward;

- Day surgery unit patients;

- Observation ward (if patients had been admitted for less than 24 hours);

- Surgical short stay unit (if patients had been admitted for less than 24 hours);

- Palliative care centres; and

- Community hospitals.

3. Mild hypoglycaemic episode; Blood glucose level = 3.0-3.9mmol/L.
4. Severe hypoglycaemic episode; Blood glucose level less than 3.0mmol/l.
5. There was no NaDIA collection or report in 2014.

NHS Digital were able to provide the following data that details the mean number of hospital bed days for people admitted to hospital who have diabetes (as recorded in the National Diabetes Audit) in 2015-16 and 2016-17.

2015-16: 13.9 bed days

2016-17: 13.9 bed days

Source: The data was taken from the Hospital Episode Statistics data set for England linked to the National Diabetes Audit, therefore the time periods used are for 2015-16 (April 2015 – March 2016) and 2016-17 (April 2016 – March 2017).

Notes:

- Bed days relating to all admissions of people with diabetes in the time period are counted, including multiple admissions by the same person.

- People with diabetes who have not been admitted to hospital during the time period are not considered within these data.

- In 2015-16, 82.4% of all general practitioner practices in England and Wales participated in the audit (95.3% in 2016-17).

- Data for 2017-18 is likely to be available in late 2018.

The information requested is not held centrally.

The number of finished admission episodes¹ with a primary diagnosis² of diabetes between 2009-10 and 2015-16 is shown in the following table.

Source: Hospital Episode Statistics (HES)

1. A finished admission episode (FAE) is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.
2. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.

The mean and median average length of stay for hospital patients with a primary diagnosis for diabetes and a primary or secondary diagnosis of diabetes in England for 2015/16 are shown in the table below.

A count of finished admission episodes where patients have been admitted from accident and emergency with a primary diagnosis for diabetes and arrived to accident and emergency by ambulance in England and within East Leicestershire and Rutland, Leicester City and West Leicestershire clinical commissioning groups (CCGs) areas of residence for 2015/16 are provided in the following table.

Data on how many diabetic patients experienced complications with that condition, separate from the reason for their admittance, while they were in hospital as inpatients is not available in the format requested.

Data on the number of ambulance call-outs for patients experiencing diabetic complications in 2016 is not available in the format requested.

Approximately 240 bids have been received for National Health Service transformation funding for diabetes prevention and treatment.

The mean and median average length of stay for hospital patients with a primary diagnosis for diabetes and a primary or secondary diagnosis of diabetes in England for 2015/16 are shown in the table below.

A count of finished admission episodes where patients have been admitted from accident and emergency with a primary diagnosis for diabetes and arrived to accident and emergency by ambulance in England and within East Leicestershire and Rutland, Leicester City and West Leicestershire clinical commissioning groups (CCGs) areas of residence for 2015/16 are provided in the following table.

Data on how many diabetic patients experienced complications with that condition, separate from the reason for their admittance, while they were in hospital as inpatients is not available in the format requested.

Data on the number of ambulance call-outs for patients experiencing diabetic complications in 2016 is not available in the format requested.

Approximately 240 bids have been received for National Health Service transformation funding for diabetes prevention and treatment.

The mean and median average length of stay for hospital patients with a primary diagnosis for diabetes and a primary or secondary diagnosis of diabetes in England for 2015/16 are shown in the table below.

A count of finished admission episodes where patients have been admitted from accident and emergency with a primary diagnosis for diabetes and arrived to accident and emergency by ambulance in England and within East Leicestershire and Rutland, Leicester City and West Leicestershire clinical commissioning groups (CCGs) areas of residence for 2015/16 are provided in the following table.

Data on how many diabetic patients experienced complications with that condition, separate from the reason for their admittance, while they were in hospital as inpatients is not available in the format requested.

Data on the number of ambulance call-outs for patients experiencing diabetic complications in 2016 is not available in the format requested.

Approximately 240 bids have been received for National Health Service transformation funding for diabetes prevention and treatment.

The mean and median average length of stay for hospital patients with a primary diagnosis for diabetes and a primary or secondary diagnosis of diabetes in England for 2015/16 are shown in the table below.

A count of finished admission episodes where patients have been admitted from accident and emergency with a primary diagnosis for diabetes and arrived to accident and emergency by ambulance in England and within East Leicestershire and Rutland, Leicester City and West Leicestershire clinical commissioning groups (CCGs) areas of residence for 2015/16 are provided in the following table.

Data on how many diabetic patients experienced complications with that condition, separate from the reason for their admittance, while they were in hospital as inpatients is not available in the format requested.

Data on the number of ambulance call-outs for patients experiencing diabetic complications in 2016 is not available in the format requested.

Approximately 240 bids have been received for National Health Service transformation funding for diabetes prevention and treatment.

Clinical commissioning groups (CCGs) are primarily responsible for commissioning services to meet the requirements of their population including Type 1 and Type 2 diabetes services. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population and are based on the available evidence and take into account national guidelines.

The National Institute for Health and Care Excellence (NICE) has published a wealth of guidance on the management and care of people with diabetes including the recently updated guidelines for the management of Type 2 diabetes in adults which are available at:

https://www.nice.org.uk/guidance/ng28/resources/type-2-diabetes-in-adults-management-1837338615493

It recommends that all people with diabetes should receive an annual health check to monitor and manage their condition, as well as reduce the risk of associated complications, such as heart, kidney and eye disease and amputations. These annual checks, some of which include blood tests, monitor body mass index, blood pressure, blood glucose, cholesterol and signs of early complications (e.g. surveillance for foot, eye and kidney disease). They provide the cornerstone of routine care for people with diabetes and the majority are incentivised through the Quality and Outcomes Framework which is a voluntary annual reward and incentive programme for all general practitioner surgeries in England, detailing practice achievement results.

The foot check enables health care professional to annually assess the risk of diabetic foot disease in people with diabetes. Guidelines help then to decide when to refer cases to a multidisciplinary foot care service or foot protection service (both of which include a podiatrist) for those identified at moderate or high risk. This is outlined in the NICE Guideline on Diabetic foot problems: prevention and management which can be found at:

https://www.nice.org.uk/guidance/ng19

The national diabetic retinopathy screening programme provides an opportunity for all people with Type 1 and Type 2 diabetes to have an annual eye check.

The National Institute for Health and Care Excellence (NICE) Diabetes Quality Standard is clear that people with diabetes who are at risk of foot ulceration should receive regular reviews by a foot protection team in accordance with its clinical guidance. The Health and Social Care Act 2012 places a duty on NHS England to have regard to the NICE Quality Standards. Clinical commissioning groups (CCGs) should also have regard to them in planning and delivering services, as part of a general duty to secure a continuous improvement in quality.

The National Diabetes Audit includes an indicator measuring the provision of access to a multidisciplinary diabetes footcare teams to enable progress to be tracked. The focus to date has been on improving access to assessment and treatment by a specialist team. The proportion of hospitals with a multidisciplinary diabetes foot care team was 60% in 2011, 72% in 2013 and 69% in 2015.

The NHS Operational Planning and Contracting Guidance 2017-19 announced NHS England’s intention to launch a £40 million programme of investment to support CCGs to improve the treatment and care of people with diabetes. This includes improving access to multi-disciplinary foot care teams for people with diabetic foot disease.