EMERGING STANDARDS FOR DIABETES CARE FROM A CITY-WIDE PRIMARY-CARE AUDIT

Aggregated data from Manchester practices participating in the Diabete s 2000 project were used to develop peer group standards of mean perfo rmance and of excellence. The crude prevalence of known diabetes melli tus was 1.21 % of which 20.2 % had Type 1 diabetes. The aggregated mea n of patients who had the following examinations performed in the prec eding year were: glycated haemoglobin 56.8 %; weight or body mass inde x 67.8 %; foot pulses 37.3 %; ankle reflexes 31.3 %; proteinuria 60 %; fundoscopy 48.2 %; blood pressure 81.1 %; serum cholesterol or lipids 34 %. The percentage of patients referred to or seen by health care p rofessionals in the preceding year were 14.4 % to diabetes specialist nurses; 22.1 % to opticians or ophthalmologists; 25 % to chiropodists; and 21.5 % to dietitians. The best performing practices examined 79 % of patients fundi in the preceding year, 84 % of their foot pulses, 7 4 % of their ankle reflexes, and gave appropriate smoking advice in 65 % of cases. These standards were fed back to the participating practi ces so that they could compare their own performance with that of the city-wide mean, and with the best performing practices. From these dat a practices have then been able to set themselves realistic targets fo r improved performance in the following year.