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CARMS e-bulletin

Issue 12 - Spring 2017

The quarterly bulletin from the Clinical Audits and Registries Management Service (CARMS)

National Diabetes Inpatient Audit

The National Diabetes Inpatient Audit (NaDIA) Annual Report 2016 has also been published, providing a snapshot of the quality of diabetes care for people with diabetes during their hospital stay.

This year the full report is also available as short reports, allowing readers to easily access specific sections, such as staffing levels, patient experience and medication errors.

The reports are available as PDFs or PowerPoints. Hospital level analysis is available in the usual Excel format.

The report showed there have been improvements in care and reduced patient harm:

  • Intravenous insulin infusion was reduced to 9 per cent
  • The incidence of all hypoglycaemia episodes was reduced to 20 per cent
  • Patient development of foot ulcers during their stay was reduced to 1.3 per cent in England
However, there are still areas for improvement: 
  • Almost half of patients treated with insulin had a medication error related to their insulin
  • More than a quarter of hospital sites have no diabetes inpatients nurses
  • 1 in 25 of patients with Type 1 diabetes developed diabetic ketoacidosis in hospital
The 2017 NaDIA will take place between 25 and 29 September 2017. Registrations are now open. If you did not take part in the 2016 audit and would like to register for this year’s audit please contact nadia@nhs.net.

For more information about NaDIA visit the NaDIA webpage.

National Audit of Pulmonary Hypertension Annual Report and patient report

The National Audit of Pulmonary Hypertension (NAPH) has published its 7th Annual Report.

Pulmonary hypertension is a serious medical condition that can damage the right side of the heart.

The annual report uses professionally agreed standards for the first time and includes patients with a new referral between 1 April 2015 and 31 March 2016.

During this period, the participating centres in England and Scotland managed 9,068 patients.

Other findings included:

  • 86 per cent of patients referred to a specialist centre attended a consultation or were discharged within 90 days and 45 per cent were seen or discharged within 30 days.
  • 92 per cent of patients referred to a specialist centre were seen, assessed and diagnosed within six months.
  • 80 per cent of patients had a WHO functional class and six-minute walk or shuttle exercise test recorded before being given drugs to treat PH.
The audit has taken place each year since 2010 and is the largest of its kind in the world. To find out more about the audit, visit the NAPH webpage.

The Pulmonary Hypertension Association UK has published a patient report based on the audit findings.


National Diabetes Footcare Audit

The National Diabetes Footcare Audit (NDFA) Annual Report 2016 is also available for download.

The audit enables all diabetes foot care services to measure their performance against NICE clinical guidelines and other comparable units; and to monitor adverse outcomes for people with diabetes who develop diabetic foot disease.

This is the second annual report and includes data on 11,073 patients who underwent first expert assessments between 14 July 2014 and 8 April 2016 for 13,034 ulcer episodes at 173 specialist foot care services.

Key findings include:

  • Two-fifths of the ulcer episodes referred by a health professional had an interval of two or more weeks before their first expert assessment
  • Almost one-third of ulcer episodes were self-referred. Self-referring patients were less likely to have severe ulcers
  • Almost half of ulcer episodes were graded severe at assessment
All organisations which provide a diabetic foot ulcer treatment service are eligible for inclusion in the audit.  Any hospital wishing to register should visit the NDFA webpage for more information. 


The National Third Molar Audit is recruiting

CARMS are working with Saving Faces - The Facial Surgery Research Foundation carrying out an audit on third molars (wisdom teeth).

This is the first national audit examining the incidence of problems from third molars, the decisions made in treating them and the long-term outcomes of those decisions.

We would like to get involvement from all centres that carry out third molar care and extractions so that the audit data derived is robust and can help to improve care and outcomes in the future.

Potential centres can find out more by visiting the Third Molar Audit webpage or by emailing nforcaudits@nhs.net.