NCASP
The National Diabetes Audit (NDA) is developed and delivered by National Clinical Audit Support Programme (NCASP), which is part of The Information Centre in partnership with the Healthcare Commission
The NDA is considered to be the largest annual clinical audit in the world. It provides an infrastructure for the collation, analysis, benchmarking and feedback of local clinical data to support effective clinical audit across the NHS.
Quality information is vital to the success of organisations implementing the Diabetes National Service Framework (NSF) and key to improving services for people with diabetes. The NDA supports the implementation of the diabetes NSF and aims to improve the quality of patient care by enabling NHS organisations to:
- compare the processes and outcomes of care with similar NHS organisations
- identify and share good practice
- identify gaps or shortfalls in commissioning services
- support identification of progress in meeting Diabetes NSF and NICE guidelines
- provide a local health economy view of care and outcomes where primary and secondary care organisations actively participate.
The National Diabetes Audit works in partnership with the following groups:
What does the audit measure?
The National Diabetes Audit looks at four key areas and answers four key questions based on the diabetes NSF:
- 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?
How does the audit work?
The NDA provides a technical infrastructure to allow PCTs, GP practices, Hospitals and specialist Paediatric 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 extract data from clinical systems using MIQUEST queries or via the Automated Data Extract.
Secondary care and specialist paediatric units also use specified extract queries developed by the system supplier where clinical systems are present. Alternatively, specially designed Excel and Access databases are used to collect the required data.
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.
How can the audit data be used?
The NDA data can be used to prepare reports for and inform discussions with commissioners. Local data from the NDA can be used to support recommendations for service charges and improvements.
The NDA can inform the wider requirements for diabetes strategies, service development, improvement, delivery and assessment. The NDA provides critical data for conducting health needs assessments at a local level. Comparing actual achievement of service provision against expected or commissioned services allows organisations to understand where achievement is good or where it can be improved and can establish a baseline for future development. This can assist in the development of service improvement action plans.
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