_{11 Sept 2012}

National Pregnancy in Diabetes Audit

The National Pregnancy in Diabetes Audit is planned for autumn 2012. 

The Pilot

The pilot, funded by NHS Diabetes, developed and tested in two stages a national dataset for measuring the quality of pre-gestational diabetes against three NICE guideline based criteria.

• Was the woman adequately prepared?
  
• Were adverse foetal outcomes minimised?
  
• Were adverse effects on the mother minimised?
  

The first stage tested the dataset retrospectively using three established regional surveys, and demonstrated its capability to measure and benchmark the quality of care and outcomes for women with diabetes in pregnancy (NHS Diabetes in Pregnancy Dataset Development Group). In the second stage, 13 units recorded 527 pregnancies prospectively to test how data recording can be taken up more widely. This further validated the dataset and clarified what can be done centrally, and what will still require local recording by participating teams.

All this preparatory work has been invaluable to the development of the audit and the work of the many contributing teams is hugely appreciated.

What’s happening now?

In March 2012, the development and incorporation of the dataset into the National Diabetes Audit (NDA) commenced. The NDA is commissioned by Healthcare Quality Improvement Partnership (HQIP) and between 2011 and 2014 is expanding to include Inpatient Diabetes, Pre-Gestational Diabetic Pregnancy, Diabetes Patient Experience and Diabetes Footcare. A multi-professional national group with user representation chaired by Dr Nick Lewis-Barned is taking the Pre-gestational Diabetes Pregnancy audit forward within the NDA governance structure.

A key part of the initial work has been to confirm what information is already routinely recorded and returned to the HSCIC by maternity units, which can be used in order to minimise the burden of audit data collection for local teams. This has resulted in an approved small dataset that still needs local collection.

A one page local data recording form is being designed for participating units, and the processes that will be needed to support this are being worked through and tested.  Because this is a NCAPOP audit there is an expectation by the Department of Health and regulatory bodies that all Trusts will participate.

How does this Audit link with the National Diabetes in Pregnancy Network?

Dr Rosemary Temple, chair of the National Diabetes in Pregnancy network is a part of the steering group.  This National Network, which is coordinated by NHS Diabetes, is providing a valuable link with all of those who have expressed an interest in diabetes in pregnancy and with the other work that is going on nationally. The pregnancy network will be an invaluable forum for collectively reviewing the NDA Pregnancy results, setting priorities for improvement and using shared best practice to inform action planning.

How can I get involved?

The aim of the Pregnancy in Diabetes Audit is to support clinical teams to deliver better care and outcomes for women with diabetes who become pregnant. For this to happen, the support of everyone involved in diabetes in pregnancy in every unit across England and Wales is going to be key.

Recording and submitting the data required to participate will not be burdensome and will give you reliable, benchmarked feedback about both compliance with NICE guidance and pregnancy outcomes. Your Trust Chief Executive, Medical Director and Clinical Audit department have all been informed that this National Audit is starting.

In preparation for ‘go live’ the NDA project team needs to identify a key contact in every unit where pregnant women with diabetes are being seen. The key contact will take responsibility for coordinating local data collection and liaising with the NDA team. So please email NPID@ic.nhs.uk with:

• The name of your hospital and maternity unit
  
• The name and title of your key contact
  
• The e-mail address of your key contact
  

If you would like further information on the audit, please email laura.fargher@diabetes.org.uk.