National Diabetes Audit (NDA) PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS

1. National Diabetes Audit (NDA)PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS Laura Fargher Diabetes UK

2. National Diabetes Audit (NDA)PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS Introduction “This national report from the eighth year of the National Diabetes Audit (NDA) presents key findings on care processes and treatment target achievement rates from 2010-2011 in all age groups. The care processes and treatment target standards are specified in NICE Clinical Guidelines 2, including CG153, CG104, CG665 and CG876 and the NICE Diabetes in Adults Quality Standards7......” “The NDA questions addressed in this report are: 1. Registrations: Is everyone with diabetes diagnosed and recorded on a practice diabetes register? 2. Care Processes: What percentage of people registered with diabetes received the nine key processes of diabetes care? These include five risk factors (weight (BMI), blood pressure, smoking, glucose levels (HbA1c), and serum cholesterol) and four tests for early complications (digital eye photography, laboratory urine microalbumin: creatinine ratio, serum creatinine and foot nerve and circulation examination). 3. Treatment Targets: What percentage of people registered with diabetes achieved NICE defined treatment targets for glucose control, blood pressure and blood cholesterol? “

3. National Diabetes Audit (NDA)PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS Priority Recommendations Four areas have emerged that we would recommend all commissioners and all providers of diabetes care should prioritise for improvements. • General Practices should review their organisation and recording of annual reviews for people with diabetes to improve the proportion who receive ALL nine annual checks. • General Practices and Specialist Diabetes services should improve the effectiveness of glucose control and cardiovascular risk reduction in people with diabetes. Structured patient education and individual care planning are recommended. Patients with exceptionally high risk levels should be identified and plans for addressing their risk drawn up in conjunction with the patient and co-ordinated between primary and secondary care. • Localities should review their services for people with Type 1 diabetes and consider what improvements might lead to risk reduction. Early identification of patients with Type 1 diabetes and better co-ordination of care between primary and secondary care is likely to reduce the risk to these patients. • Localities should review their provision of services for younger people with both Type 1 and Type 2 diabetes to see whether alternative arrangements would better meet the needs of younger people and thereby reduce current and future health risks.

4. National Diabetes Audit (NDA)PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS

5. National Diabetes Audit (NDA)PARTNERSHIP WORKING WITH PATIENTS AND SERVICE USERS • Diabetes UK is a partner in the delivery of the (NDA), with responsibility for governance and engagement • People with diabetes involved in the planning and implementation of the NDA via 5 project steering groups and a strategic board • NDA information for patients is produced in collaboration with the NDA patient representatives and people with diabetes who are not involved in the NDA (to get a completely ‘lay’ perspective)

6. National Diabetes Audit (NDA) Some outcomes from partnership working with patients and service users • A review of the terms of reference for the governance groups, following some insightful questioning of their role and the role of the group • Changes in language used and, in some cases, the focus of audit reports • Re-wording of the patient experience questionnaire • Patient information leaflets for each of the audit streams that are accessible in language and format • Improved communications to people with diabetes, following advice on formats and channels of communication

7. National Diabetes Audit (NDA) NDA support for partnership working with patients and service users • Formal recruitment process – application, interview and induction • Ongoing support by email and phone • Biannual workshops for all patient representatives to share experiences and information, network and receive relevant training