2017/18 National Diabetes Audit - PowerPoint Presentation

1. 2017/18 National Diabetes AuditCambridgeshire and Peterborough CCG local summaryPublic Health Intelligence, Cambridgeshire and Peterborough : April 2019 Version 1

2. Registrations100% of Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) GP practices participated in the audit (102).46,695 people are registered as having diabetes in 2017/18.C&P CCG and England have a similar profile of registrations.56% of type 1 diabetes patients, and 57% type 2, were male.90% of people registered with type 1 diabetes, and 82% with type 2 diabetes were from a white ethnic group.The age profile for type 1 diabetes is younger than type 2 diabetes - 44% are under 40 years of age.42% of type 2 diabetes patients are 40-64 years of age.Fewer diabetes registrations are recorded in more deprived areas overall. This is because Cambridgeshire has proportionally fewer areas that are categorised into the more deprived quintiles. Nationally, type 1 registrations are more evenly proportioned across the deprivation quintiles and type 2 registrations are higher in more deprived areas. Total registrationsRegistrations by age; Registrations by deprivation (IMD)

3. Care Processes : type 1 diabetes2017/18 type 12016/17 type 1C&P CCG is statistically significantly better than England for care process completion of all eight care processes. Each locality has shown improvement in 2017/18 for this indicator. Peterborough is statistically significantly worse than England for urine albumin and foot surveillance. C&P CCG has improved its completion of foot surveillance in 2017/18 to a level statistically similar to England.

4. Care Processes : type 2 diabetes2017/18 type 22016/17 type 2C&P CCG is statistically significantly better than England for completion of many care processes.Despite some local improvement for some indicators, increases at a national level between 2016/17 and 2017/18 result in a red indicator locally.Foot surveillance continues to be statistically significantly worse than England for C&P CCG.

5. Treatment Targets: type 1 diabetes2017/18 type 12016/17 type 1C&P CCG is statistically significantly better than England for treatment target achievement of HbA1c (≤58mmol/mol and ≤86mmol/mol)C&P CCG is statistically significantly worse than England for treatment target achievement of blood pressure and cholesterol (<4mmol/L)Peterborough is statistically significantly worse than England for blood pressure.Cambridge is statistically significantly better than England for every treatment target. Meeting ‘all three treatment targets' is achieved where a patient has HbA1c ≤58mmol/mol, cholesterol <5mmol/L and blood pressure ≤140/80.

6. Treatment Targets: type 2 diabetes2017/18 type 22016/17 type 2C&P CCG, and each locality, continues to be statistically significantly worse than England for most treatment targets.Numerically, there has been an increase in some HbA1c and cholesterol indicators for the C&P CCG between 2016/17 and 2017/18.Cambridge is statistically significantly better than England for two HbA1c treatment targets. Meeting ‘all three treatment targets' is achieved where a patient has HbA1c ≤58mmol/mol, cholesterol <5mmol/L and blood pressure ≤140/80.

7. Treatment Targets : new for 2017/182017/18 type 12017/18 type 2New treatment targets have been introduced into the NDA.For patients of type 1 diabetes, Primary prevention and Combined prevention are statistically significantly worse for C&P CCG and Huntingdon. For patients of type 2 diabetes, the NEW treatment targets are almost all statistically significantly worse than the national average for C&P CCG and all the CCG localities.'Meeting all three treatment targets NEW' refers to the new treatment targets that have been introduced in 2017-18: 1. Primary prevention of cardiovascular disease (CVD): The percentage of people with diabetes aged 40 to 80 years with no history of heart disease that received statins during the audit period.2. Secondary prevention of CVD: The percentage of people with diabetes (any age) with a history of heart disease that received statins during the audit period.3. Combined prevention of CVD: The percentage of people with diabetes that fall into either of the primary or secondary prevention groups that received statins during the audit period.The 'Meeting all three treatment targets NEW' in this report is achieved where a person has an HbA1c value ≤ 58mmol/mol, blood pressure ≤140/80 and, for people who fall into the combined prevention of CVD group, is receiving statins. If a person does not fall into the combined prevention of CVD group, 'All three treatment targets' is defined as HbA1c and blood pressure only.For patients under 12 years of age 'All three treatment targets' is defined as HbA1c only, as other treatment targets are not recommended in the NICE guidelines for this age group.

8. EducationC&P CCG and England have a similar profile of education for newly diagnosed diabetes patients.In C&P CCG in 2016, 32% of type 1 newly registered diabetes patients were offered an education programme within 12 months of diagnosis. 9% of type 1 patients attended a course within 12 months of diagnosis. In C&P CCG in 2016, 74% of type 2 newly registered diabetes patients were offered an education programme within 12 months of diagnosis. 9% of type 2 patients attended a course within 12 months of diagnosis. Substantially more type 2 patients are offered an education programme within 12 months of diagnosis than type 1 patients, locally and nationally.Attendance of educational courses is low, locally and nationally.There is improvement between 2015 and 2016 for all indicators. Type 1 diabetes - education for new registrationsType 2 diabetes – education for new registrations

9. Useful linksNational Diabetes Audit informationFull set of the data included in this report:Previous Cambridgeshire and Peterborough CCG summaries:For further information on this report please contacthttps://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-auditNDA 2017-18 Interactive report for England, 8th November 2018https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit/report-1-care-processes-and-treatment-targets-2017-18-short-reporthttps://cambridgeshireinsight.org.uk/health/topics/diabetes/Public Health Intelligence, Cambridgeshire County Council & Peterborough City CouncilCCCPublicHealthIntelligenceTeam@cambridgeshire.gov.uk