National Paediatric Diabetes Audit

National Paediatric Diabetes Audit
Name	National Paediatric Diabetes Audit
Abbreviation	NPDA
Formation	2004
Purpose	Clinical audit of paediatric diabetes care
Headquarters	United Kingdom
Region served	England and Wales
Parent organisation	Royal College of Paediatrics and Child Health

National Paediatric Diabetes Audit

The National Paediatric Diabetes Audit is the annual clinical audit that monitors the care and outcomes for children and young people with diabetes across England and Wales. The audit collects standardized clinical and process data to benchmark paediatric diabetes services against best practice, informing professional bodies, commissioning organisations, NHS trusts, and charities. Its reports influence clinical guidelines, quality improvement initiatives, and population health monitoring across institutions such as the Royal College of Paediatrics and Child Health, NHS England, and Public Health Wales.

Overview

The audit collates individual-level and centre-level data on children and young people with type 1 diabetes, type 2 diabetes, and rarer endocrine disorders to evaluate glycaemic outcomes, complication rates, and service provision. It produces national and local reports that are used by the Royal College of Paediatrics and Child Health, NHS Digital, NHS England, Public Health Wales, and third-sector stakeholders including Diabetes UK and the Juvenile Diabetes Research Foundation to prioritise care pathways. The dataset maps onto quality standards from bodies such as the National Institute for Health and Care Excellence and contributes to registries linked with paediatric endocrinology units at university hospitals and specialist centres.

History and development

The audit originated in the early 2000s as part of a wider push for specialty-specific auditing alongside initiatives such as the National Diabetes Audit and cancer registries managed by organisations like the Office for National Statistics and the Care Quality Commission. Early collaboration involved the Royal College of Paediatrics and Child Health, paediatric diabetes clinical networks, and health informatics teams from NHS Digital and local commissioning groups. Over successive iterations, the audit expanded its dataset, introduced patient-level outcome measures, and integrated electronic reporting aligned with hospital electronic health records used in university hospitals and regional NHS trusts. Key milestones include formal endorsement by the National Institute for Health and Care Excellence, linkage projects with Public Health Wales, and methodological updates influenced by research from institutions such as Great Ormond Street Hospital and Addenbrooke's Hospital.

Scope and methodology

The audit includes all children and young people under 18 (and in some centres up to 25) with a diagnosis of diabetes treated in paediatric services across England and Wales. Data fields capture demographics, insulin regimens, HbA1c measurements, complication screening (retinopathy, nephropathy, neuropathy), and service metrics such as multidisciplinary team access. Collection methods rely on hospital information systems used by trusts, electronic case report forms, and linkage with national datasets governed by NHS Digital and Public Health Wales. Analytical approaches employ risk-adjusted benchmarking and longitudinal cohort analysis, informed by epidemiological methods used in studies from institutions like Imperial College London and the University of Oxford.

Key findings and outcomes

Audit reports have repeatedly highlighted variation in glycaemic control, with median HbA1c differing between centres and demographic groups, echoing findings from academic centres such as King's College Hospital and Manchester University NHS Foundation Trust. Reports document disparities associated with deprivation indices reported by the Office for National Statistics and differences in technology adoption—such as continuous glucose monitoring and insulin pump therapy—across paediatric diabetes services. Outcomes reported include rates of diabetic ketoacidosis at presentation, screening completion rates, and the prevalence of comorbidities including coeliac disease and thyroid disease. Findings have informed targeted interventions in clinical networks linked to hospitals like Birmingham Children's Hospital and Sheffield Children's NHS Foundation Trust.

Clinical governance and quality improvement

The audit underpins clinical governance by providing performance indicators used by provider boards, clinical commissioning groups, and professional bodies including the Royal College of Paediatrics and Child Health and the Association of British Clinical Diabetologists. Local teams use audit data to design quality improvement projects informed by models from the Institute for Healthcare Improvement and to meet standards in commissioning frameworks. Multi-centre collaboratives, involving tertiary centres such as Great Ormond Street Hospital and regional paediatric networks, have deployed audit-driven pathways to increase technology access, standardise transition care, and reduce avoidable admissions.

Data management and privacy

Data governance follows legal and regulatory frameworks operated by NHS Digital, Public Health Wales, and institutional data protection officers at university hospitals and NHS trusts. The audit uses pseudonymisation, secure transfer protocols, and data-sharing agreements consistent with information governance standards overseen by bodies like the Information Commissioner's Office. Linkage with national mortality and hospital episode statistics datasets requires approval processes and ethical oversight aligned with research governance at institutions such as the Health Research Authority.

Impact on policy and practice

Audit outputs have influenced national policy and commissioning, informing guidance by the National Institute for Health and Care Excellence, service specifications in NHS England commissioning documents, and investment decisions by local clinical commissioning groups. Charities and advocacy groups including Diabetes UK and the Juvenile Diabetes Research Foundation use audit evidence to campaign for equitable access to technologies and multidisciplinary care. Academic researchers at universities such as University College London and the University of Edinburgh have used audit data to publish studies that shape clinical practice, while paediatric diabetes clinical networks continue to use audit-derived benchmarks to reduce variation and improve outcomes.

Category:Diabetes in children Category:Clinical audits in the United Kingdom