Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, who is responsible for auditing compliance with National Institute for Health and Care Excellence guidelines relating to the care of patients with diabetes.

The National Institute for Health and Care Excellence (NICE) is an independent organisation established by Government to provide national guidance and advice to improve health and social care. It has published clinical guidance and quality standards on the treatment of diabetes and its complications. The NICE Diabetes Quality Standard is clear that people with diabetes who are at risk of foot ulceration should receive regular reviews by a foot protection team in accordance with its clinical guidance. The Health and Social Care Act (2012) places a duty on NHS England to have regard to the NICE Quality Standards. Clinical commissioning groups (CCG) should also have regard to them in planning and delivering services, as part of a general duty to secure a continuous improvement in quality.

As part of the Quality Outcomes Framework (QOF), general practitioners are remunerated for assessing nerve damage and poor blood supply to the feet in people with diabetes on an annual basis. Information is collected annually both through QOF returns and through the National Diabetes Audit (NDA).

The NDA provides information of local practice against NICE guidelines and can be used by local areas to compare their own performance over time and against others, helping to drive service improvement. The latest published NDA report shows that more than 85% of all those with diabetes in England and Wales, received these checks in 2011-12.

In July 2014, NHS England will be launching the National Diabetes Footcare Audit. This is a new module of the NDA, and will provide information on the effectiveness and quality of the entire diabetes foot care pathway, including the elements delivered in primary, community and secondary care settings.