Less than half of people with diabetes receive regular health checks, audit finds

Results from the National Diabetes Audit (NDA) have revealed that less than 50 per cent of people living with type 1 and type 2 diabetes in England and Wales receive their eight health checks.

According to the audit from 2021 to 2022, 35 per cent of people living with type 1 diabetes and 48 per cent of people living with type 2 diabetes received their eight health checks in England.

In Wales, just 16 per cent of people living with type 1 diabetes and 30 per cent of people living with type 2 diabetes received them.

The audit highlighted that although the figures are low, the number of people living with diabetes has increased year-on-year and, in fact, there has been improvement in the completion of all eight key care processes compared to between 2019 and 2021 (during the pandemic). However, care process completion remains below pre-pandemic levels.

The NDA provides a thorough assessment of diabetes care in England and Wales. It measures the effectiveness of diabetes healthcare against the National Institute for Health and Care Excellence (NICE) Clinical Guidelines and Quality Standards.

This NICE guidance is based on evidence that regular systematic review of people with diabetes and achievement of glucose, blood pressure and cardiovascular risk standards maintains health and reduces long term complications.

The audit also revealed that, in England, 10 per cent of 17-to-24-year-olds living with type 1 or type 2 diabetes had no health checks from 2021 to 2022. The amount of people meeting blood pressure targets in England has decreased by five per cent for people living with type 1 diabetes and seven per cent for people living with type 2 diabetes.

In Wales, 25 per cent of 17-to 24-year-olds living with type 1 or type 2 diabetes had no health checks from 2021 to 2022. The amount of people living with type 1 and type 2 diabetes meeting blood pressure targets in Wales has decreased by eight per cent since 2017.

Based on the audit results, the NDA have issued three key recommendations to improve the care of people living with diabetes in England and Wales:

• Commissioners of care should continue to work with providers in restoring and then further improving pre-pandemic care process completion levels.
• Commissioners of care should work with providers to focus particularly on improving care process completion in young people and those living in the most deprived communities. The target should be levels already attained in people older than 70 years and in people living in the least disadvantaged areas.
• Commissioners of care should work with providers of diabetes care to sustain progress in type 1 glucose control and restore pre-pandemic glucose control in people who have type 2 and other diabetes; and to first restore and then surpass pre-pandemic levels of blood pressure treatment target attainment in all people with diabetes.

The new audit report is available to view here: National Diabetes Audit 2021-22, Report 1: Care Processes and Treatment Targets, Overview – NHS Digital

The summary reports are available to view here:

England –  National Diabetes Audit, 2020-21, England (amazonaws.com)

Wales –  National Diabetes Audit, 2020-21, Wales (amazonaws.com)

For the audit, type 2 diabetes refers to those with a diagnosis of type 2 diabetes and other rarer forms of diabetes such as MODY (Maturity Onset Diabetes of the Young) and LADA (Latent Autoimmune Diabetes in Adults) or unspecified diabetes.