Diabetics (Type 2) all 9 care processes - ICP Outcomes Framework - Birmingham and Solihull

This dataset presents the percentage of people with type 2 diabetes who received all nine recommended care processes within the audit period. The delivery of a complete set of annual clinical checks is central to effective diabetes management and the prevention of serious long-term complications, including cardiovascular disease, chronic kidney disease, neuropathy, and vision loss. Monitoring the proportion of patients receiving complete structured care at a local level is an important measure of diabetes service quality and helps identify where improvements in care delivery are needed. ## Rationale Type 2 diabetes is one of the most prevalent long-term conditions in Birmingham and nationally, placing significant demand on primary care and specialist services. Receipt of all nine care processes is a recognised marker of high-quality, proactive diabetes management and is associated with better clinical outcomes and reduced risk of complications. Variation in completion rates across practices and localities can reflect differences in practice capacity, recall systems, patient engagement, and the effectiveness of local diabetes pathways. Tracking this indicator supports commissioners and providers in targeting quality improvement activity where it is most needed. ## Numerator The numerator is the number of people with type 2 diabetes who received all nine care processes within the audit period, among practices participating in the National Diabetes Audit. The nine care processes are: * Body mass index (BMI) measurement * Blood pressure check * Smoking status recorded * Blood glucose test (HbA1c) * Cholesterol measurement * Urine albumin test * Serum creatinine test * Foot nerve and circulation examination * Retinal screening ## Denominator The denominator is the number of people registered with type 2 diabetes among practices that participate in the National Diabetes Audit, sourced from the National Diabetes Audit (NDA) via NHS England. ## Caveats Users should be aware of several important considerations when interpreting this indicator. National Diabetes Audit data is collected over a 15-month period, running from 1st January in the first year to 31st March in the second year, which spans the financial year reporting period. A number of people with diabetes are excluded from the audit if they are not registered with a GP practice at the time of data collection, which may mean that some of the most vulnerable or less engaged patients are not captured in the figures. Only practices participating in the National Diabetes Audit contribute data, so coverage may not be universal across all local practices. Users should also note that the source metadata for this indicator contains an inconsistency, with the numerator definition referencing 8 care processes rather than 9 — this is believed to be a data entry error, and the figure of 9 processes is used here in line with the indicator description, label, and NICE quality standards. ## External References Data is sourced from the National Diabetes Audit (NDA), NHS England. The nine care processes align with NICE quality standards for diabetes care: * [NICE Quality Statement 6 – 9 Key Care Processes for Type 2 Diabetes in Adults] [Click here] to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.