What does the audit measure?

The National Diabetes Audit (NDA) looks at four key areas and answers four key questions based on the diabetes National Service Framework: Is everyone with diabetes diagnosed and recorded on a practice diabetes register? For people with diabetes, what is the annual rate of specific complications? What proportion of people with diabetes receive key process of diabetes care? What proportion of people with diabetes achieve treatment targets?

The 2010-11 Audit will now include evidence based treatments: What percentage of people registered with diabetes receive accredited structured education, have annual care planning and are given drug treatments in line with NICE guidance?

How does the audit work?

The NDA provides a technical infrastructure to allow PCTs, GP practices and adult outpatient secondary care units to submit data about the care that is being delivered for people with diabetes in their organisation. The audit system is based on a browser based application that uses NHSnet or N3.

Key biomedical data is extracted from primary and secondary care systems using specified extract queries. Primary care organisations can extract data from clinical systems using MIQUEST queries or via the Automated Data Extract.

Adult outpatient secondary care units can also use specified extract queries developed by the system supplier where clinical systems are present. Alternatively, specially designed Excel and Access databases can be used to collect the required data.

In addition to the data submitted by participating organisations, supplementary information relating to specific complications and procedures is sourced from the Hospital Episodes Statistics (HES) database and the Patient Episode Database for Wales (PEDW). The NDA triangulates the data from all sources. The NHS numbers of patients submitted to the audit is used to link HES or PEDW data to the correct patient record to provide a fuller analysis.

Once all the data has been linked and any duplicate patient records have been removed the NHS number is stripped from the database. This ensures any patient identifiable data can not be viewed and patient confidentiality is maintained.

The data submitted to the audit can then be analysed at a National and Local level by using the NDA toolkit. The toolkit is available to all users who have registered for the audit and enables organisations to understand and interpret their performance. Users can manipulate their data which can be stratified by a number of dimensions including age, sex, diabetes type, deprivation and duration of diabetes.