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National Diabetes Audit

The National Diabetes Audit (NDA) is the largest annual clinical audit in the world, integrating data from both primary and secondary care sources, making it the most comprehensive audit of its kind.

What does it measure?

The National Diabetes Audit (NDA) answers four key questions based on the diabetes National Service Framework (NSF):

  • Is everyone with diabetes diagnosed and recorded on a practice diabetes register?
  • What percentage of people registered with diabetes received the nine NICE key processes of diabetes care?
  • What percentage of people registered with diabetes achieved NICE defined treatment targets for glucose control, blood pressure and blood cholesterol?
  • For people with registered diabetes what are the rates of acute and long term complications (disease outcomes)?

The 2011-2012 audit also includes high-level analysis on what percentage of people registered with diabetes receive accredited structured education in line with NICE guidance. 

By 2014, the NDA will also report on:

  • patient experience of diabetes care
  • diabetes care in pregnancy
  • diabetes footcare.


The NDA aims to improve the quality of patient care by enabling NHS organisations to:

  • compare their outcomes of care with similar NHS organisations
  • identify and share best practice
  • identify gaps or shortfalls in commissioning services
  • assess local practice against NSF for diabetes and NICE guidelines and drive service improvement
  • provide a more comprehensive picture of diabetes care and outcomes in England and Wales

Through participation in the audit, local services are able to benchmark their performance and identify where they are performing well, and improve the quality of treatment and care they provide. On a national level, wide participation in the audit also provides an overview of the quality of care being provided in England and Wales.

Who manages the audit?

The NDA is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), and delivered by the Health and Social Care Information Centre, working with Diabetes UK.

How to participate

Get involved in 4 simple steps

1. pdf icon Register your organisation for the audit [36kb]

2. pdf icon Extract required data [71kb]

3. pdf icon Submit data [24kb]

4. pdf icon Check data quality [25kb] for your submitted data

Analysing your data

A series of reports are available in the catalogue that will provide you with information on:

  • Audit participation in primary and secondary care

Data tables with information:

  • care processes (percentage recorded)
  • HbA1c results
  • patient age distribution
  • average age and BMI
  • diabetes type distribution
  • ketoacidosis episodes

Further in-depth analysis at a national and local level on:

  • registration and prevalence
  • complications
  • care processes
  • treatment targets

PCT/Local Health Board (LHB) Analysis Profiles which present key PCT findings from the 2009-2010 audit onwards in all age groups and is benchmarked against the national findings and provides time trend analysis.

The National Diabetes Audit is expanding to cover: 

Pregnancy care in women with diabetes

This will be an audit of the structures, processes and outcomes of pregnancy care for women with pregestational diabetes.

The diabetes in pregnancy audit will seek to answer the following key questions:

  • Were women with diabetes adequately prepared for pregnancy?
  • Were appropriate steps taken during pregnancy to minimise adverse outcomes?
  • Were adverse outcomes minimised during pregnancy?

Diabetes footcare

This audit will cover the structures, processes and outcomes of foot care services for people with diabetes. The audit is currently being developed and piloted by NHS Diabetes and is expected to be handed over to the NDA for national roll out in 2013.

Data Access Requests

Please submit NDA data access requests to the audit commissioner, HQIP, using the following link:

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