Purpose

The Diabetes Footcare Audit Project aims to:

• Scope and define the current and future requirements for a national diabetes foot care dataset
• Pilot modules of the diabetes footcare audit as proof of concept
• Prepare for inclusion in the National Diabetes Adult Audit (NDAA)
• Support the development of networks that can share learning and improve quality and drive service improvement

Leadership

The work has been led by a steering group chaired by Professor William Jeffcoate supported by project manager Heather Stephens. Members of the steering group are listed in the attached document.

Approach

The content and structure of the footcare audit has been developed and refined by the steering group in conjunction with feedback from the expert reference group. The National Diabetes Footcare Audit asks the following questions:

• Are the correct structures in place for identifying people at increased risk?
• Are processes and measures in place to mitigate risk?
• What are the outcomes of interventions

In order to answer these questions three audit modules have been developed, these are a structural audit questionnaire, an ulcer audit and diabetes footcare activity profiles.

Achievements

Structure audit questionnaire – this aspect of the audit captures the structure of healthcare services for people with diabetic foot disease. The questions have been devised to assess the level and type of foot protection and multidisciplinary footcare services within a locality or organisation. 

It was piloted by 42 separate sites and resulted in a new module being added to DiabetesE on September 1^st 2011. This is now available for footcare teams to complete and can be accessed at: www.diabetese.net/. Once completed organisations will be able to select the ‘How Do I Compare’ option to compare their answers with other organisations who have completed the audit.

Foot Ulcer Audit – a twelve month prospective ‘proof of concept’ foot ulcer audit is now underway in 19 sites across England. This audit will capture:

• The proportion of patients with at risk feet included in a footcare protection programme
• The proportion of patients with a new ulcer seen by a specialist footcare team in within 24 hours
• Data on healing outcomes.

For details of the data items being collected click here. 

Diabetes Footcare Activity Profiles – these profiles have been developed to provide information on the inpatient care of people with diabetes who are admitted to hospital for a range of footcare conditions. They are designed to allow those involved in the provision of this care to appreciate the scale of activity and relate this to similar trusts across England. To view your Diabetes Footcare Activity Profile click here.

Final steps

• Finalise and agree the National Diabetes Footcare Audit dataset
• Formal handover to the National Diabetes Adult Audit team (a consortium of the NHS Information Centre, Diabetes UK and Diabetes Health Intelligence)
• National implementation in March 2013
• Development of diabetes footcare networks to support quality improvement.