Skip to main content

Health: Diabetes

Volume 705: debated on Monday 17 November 2008

asked Her Majesty's Government:

Whether, in the next review of indicators in the quality and outcomes framework, they will adjust relevant indicators to support diabetes testing in patients with established risk factors for the condition. [HL6233]

Assessment of diabetes risk is included in the Government's programme of vascular checks which is being rolled out nationally on a phased basis from April 2009. With regard to future changes in the quality and outcomes framework (QOF), we launched a public consultation on the proposed new process for developing and reviewing clinical indicators in the QOF on 30 October 2008. Under these proposals, the National Institute for Health and Clinical Excellence would oversee a new independent and transparent process for England from 1 April 2009 as part of its role in providing guidance for the National Health Service based on evidence of clinical effectiveness and cost effectiveness. At national level, NHS employers would then negotiate with the British Medical Association on which indicators should be applied nationally and what the value of those indicators should be.

A copy of the consultation document has been placed in the Library.

asked Her Majesty's Government:

What systems are used to ensure effective communication between locations at which diabetic retinopathy screening takes place, specialist centres interpreting potentially positive retinal images, and general practitioners' surgeries that will manage care based on the results; and [HL6234]

What measures are used to assess the effectiveness of the reporting processes for results from the national diabetic retinopathy screening programme; and [HL6235]

What outcomes are being measured to assess the extent to which the identification of cases of diabetic retinopathy through the national screening programme are resulting in changes to patient management. [HL6236]

The English national screening programme for sight-threatening retinopathy (NSP), set up to support local delivery of diabetic retinopathy screening, has developed clear protocols for communications between screening sites, specialist grading centres and general practitioners' surgeries. Such communication is reviewed as part of quality assurance.

The NSP has set 19 national quality standards for screening programmes to measure the effectiveness of all screening programmes. These can be found on the website These include standards for the timely referral of patients with retinopathy, informing general practitioners of results of screening and the timely assessment and treatment of patients with screen-positive results.

The effectiveness of screening programmes against these standards is being assessed as part of the external quality-assurance process being undertaken by the NSP.

The NSP and the national clinical director for diabetes are working closely with a number of key stakeholders, including the Royal College of Ophthalmologists and the Association of British Clinical Diabetologists, to ensure screening for diabetic retinopathy is fully integrated with other aspects of diabetes and ophthalmology care.