Getting the measure of diabetes: the evolution of the National Diabetes Audit

• Published in: Practical diabetes (2011) 2018-11, Vol.35 (6), p.211-217
• Main Author: Young, Bob
• Format: Article
• Language: English
• Subjects: Audits; Continuity of care; Diabetes; diabetes care; Health care delivery; improvement; measurement; variation
• ISSN: 2047-2897; 2047-2900
• DOI: 10.1002/pdi.2198

The 2018 Arnold Bloom lecture reviewed the development of the National Diabetes Audit (NDA) and what its measurements tell us about contemporary diabetes care. From seeds sown by the St Vincent Declaration in 1988 a national system has been established for benchmarking diabetes care across primary care settings, among specialist services and between commissioning areas in England and Wales. Wherever possible the sources of the data are routinely recorded electronic records; this supports data quality and minimises participation burden. Some overall national improvements have been documented but so have areas of stagnation and deterioration. Most strikingly, however, has been the revelation of large differences between services and geographies. A variety of system changes (service re‐design) illustrate how appreciable improvements can be achieved. England and Wales now have a set of measurements of diabetes care that can focus change effort appropriately and support on‐going improvement. Arnold Bloom's old hospital provided a perfect example of NDA measurements that can quickly identify priorities for improvement at an individual service level. Copyright © 2018 John Wiley & Sons.