National diabetes audits

The Healthcare Quality Improvement Partnership has published the results of the following audits relating to diabetes:

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  • National Paediatric Diabetes Audit: annual report 2017-18: care processes and outcomes – provides an analysis of data for children and young people with diabetes including information on prevalence of diabetes, diabetes-related outcomes and complications, compliance with health care checks and recommendations for improvements in care
  • National Diabetes Inpatient Audit – measures the quality of diabetes care provided to people with diabetes while they are admitted to hospital.  The results are presented in two reports covering the hospital characteristics survey and serious inpatient harms

Additional links: NHS Digital – National Diabetes Inpatient Audit (NaDIA) – 2018 | NHS Digital National Diabetes Inpatient Audit – Harms, 2018

Additional link: NHS Digital – National Diabetes Foot Care Audit, 2014-2018

Improving the health of rough sleepers

Adults who are sleeping rough and living with mental illness or substance misuse will benefit from £1.9 million funding to improve their access to vital healthcare | Department of Health and Social Care


The Health and Social Care Secretary has announced that £1.9 million will be given to councils by Public Health England to help improve the health of rough sleepers.

The funding will be awarded to projects that improve access to health services and continuity of care for people with mental ill-health and substance misuse problems who are sleeping rough or at risk of returning to rough sleeping.

This could include:

  • ‘in-reach’ care models where specialist substance misuse or mental health workers run sessions in hostels or day centres
  • ‘outreach’ models where specialist workers support rough sleepers at street level
  • targeted interventions such as peer health advocacy that supports individuals to access and attend health appointments

Many people who are sleeping rough experience mental and physical illness and have substance misuse needs. Rough sleepers face more barriers accessing health services, particularly those living with mental illness or substance misuse. This can contribute to a ‘revolving door’, leaving individuals repeatedly in and out of stable accommodation.

Of the people seen sleeping rough in London in 2017 and 2018:

  • 50% had mental health needs
  • 43% had alcohol misuse problems
  • 40% drug misuse problems

Full story: Funding released to help rough sleepers living with mental illness

See also:

Investing in health and care data analytics

Untapped potential: Investing in health and care data analytics | The Health Foundation


This new report from the Health Foundation highlights key reasons why there should be more investment in analytical capability. The report calls for action and investment across the system so the NHS has the right people with the right tools to interpret and create value from its data. This could result in an NHS that can make faster progress on improving outcomes for patients.

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Key points
  • The NHS generates a huge amount of data. Making better use of this growing mountain of information has the potential to improve care and how services are run.
  • Yet the NHS is failing to make the most of its data because there aren’t enough people with the right analytical skills to make sense of the information that is being collected.
  • More investment is needed in skilled analysts to unlock the full potential of NHS data to benefit patients.


Nine key reasons why there should be more investment in analytical capability:

  • Clinicians can use the insights generated by skilled analysts to improve diagnosis and disease management.
  • National and local NHS leaders can evaluate innovations and new models of care to find out if expected changes and benefits were realised.
  • Board members of local NHS organisations and systems can use analysis to inform changes to service delivery in complex organisations and care systems.
  • Local NHS leaders can improve the way they manage, monitor and improve care quality day-to-day.
  • Senior NHS decision makers can better measure and evaluate improvements and respond effectively to national incentives and regulation.
  • Managers can make complex decisions about allocating limited resources and setting priorities for care.
  • Local NHS leaders will gain a better understanding of how patients flow through the system.
  • New digital tools can be developed and new data interpreted so clinicians and managers can better collaborate and use their insights to improve care.
  • Patients and the public will be able to better use and understand health care data.

Full report: Untapped potential: Investing in health and care data analytics | The Health Foundation


Medical register reaches 300,000 for the first time

The UK medical register has hit a major milestone as it welcomed its 300,000th doctor. This comes just under two decades after we hit the 200,000 mark, which occurred just after the turn of the century.

Of the 300,040 doctors now on the register, 95,850 are on the specialist register and 70,154 are on the GP register. The rise of women in the workforce has played a major role in this growth, as the number of female doctors has more than doubled over the past two decades. Women now account for 46% of doctors on the medical register, which has become increasingly diverse in other ways too. About a third of all registrants identify as black and minority ethnic and four in ten obtained their medical degree in the EEA or further overseas.

Full detail at General Medical Council

Obesity rates are increasing more rapidly in rural areas than in cities

Mahase, E. | 2019| Obesity rates are increasing more rapidly in rural areas than in cities

A global study which looked at  over 2000 population based studies, analysed global trends in body mass index (BMI) using height and weight data for more than 112 million adults across 200 countries between 1985 and 2017. The researchers report that obesity rates have increased more rapidly in rural areas than in cities (Source: BMJ).


One of the study’s authors, Majid Ezzati, from Imperial College London’s School of Public Health, said: “The results of this massive global study overturn commonly held perceptions that more people living in cities is the main cause of the global rise in obesity. This means that we need to rethink how we tackle this health problem.

As countries increase in wealth, the challenge for rural populations changes.”

The study has now been published in the journal Nature where it can be read in full

Nature Obesity rates are increasing more rapidly in rural areas than in cities

BMJ Rising rural body-mass index is the main driver of the global obesity epidemic in adults


Primary care networks and the deprivation challenge

The newly emerging primary care networks provide an opportunity to tackle health inequalities in England but, as Rebecca Fisher and Beccy Baird explain, they will have to be careful to avoid perpetuating the problem | via BMJ


In the face of a growing health gap between rich and poor in England, the NHS long-term plan explicitly commits to a focus on “health inequality reduction.” The roots of socioeconomic inequalities lie deep within communities, and general practice—itself rooted in communities—is key to addressing the problem. As practices scrabble to organise themselves into primary care networks, making meaningful progress towards reducing health inequalities requires these networks to be part of the solution. But unless a combination of quirks, oversights, and loopholes in their design and contracting are addressed, there is a risk that they could perpetuate the problem.

Full article: Primary care networks and the deprivation challenge: Are we about to widen the gap? | Rebecca Fisher [The Health Foundation] | Beccy Baird [The King’s Fund] | BMJ

[NICE Diganostic guidance DG 35] Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care

NICE |  May 2019 | Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care

Evidence-based recommendations on lead-I electrocardiogram (ECG) devices (imPulse, Kardia Mobile, MyDiagnostick and Zenicor-ECG) for detecting symptomatic atrial fibrillation using single time point testing in primary care.

This guidance covers devices that are used to record and analyse a single time point lead-I ECG for people in primary care with symptoms of atrial fibrillation and an irregular pulse. Using the devices for taking ECGs other than a single time point lead-I ECG reading, or for screening for atrial fibrillation in people without symptoms, was outside the scope of the assessment.

Full details from NICE