Diabetes Newsletter – August 2018

www.berkshirewestdiabetes.org.uk August 2018
Monthly diabetes news for healthcare professionals and
others in Berkshire West

  PQS Diabetes Cholesterol Target 2018/19  
Working collaboratively with the Berkshire West CCG Medicine Optimisation Team we have agreed this target for 2018/19 PQS.
The Medicines Optimisation Team will identify all type 2 diabetic patients aged 45 to 75 with a cholesterol greater than 5mmol/ml. 
The practice must undertake a medication review of these patients and consider whether the current cholesterol treatment is appropriate.
Evidence of actions to be submitted.

There have been some queries from clinicians that NICE recommends use of QRISK > 10% rather than a cholesterol of 5mmol/ml. We have chosen this figure as it is one of NDA's treatment targets. NDA remains one of the largest annual clinical audits in the world and has not altered this target in the 15 years it has been running. We are measured on the percentage of patients achieving all three of these targets (BP ≤ 140/80, HbA1c ≤ 58 and TC < 5.0 and are compared to other CCGs.

Treatment Targets are particularly important as they are closely linked to patient outcomes. Individual practice performance is also compared by NDA. The NHS has stated that all practices should reach at least 40% overall for their T2 Treatment Targets by 2020.
Please note that NDA is measuring patients with a TC < 5.0. NDA also records patients with a TC of < 4.0 but this is not currently part of the Treatment Target percentage.

NDA include the following caveat in recognition of the issue:

“NICE cardiovascular risk reduction guidance now focuses on the use of statins rather than achieved cholesterol levels (‘Offer atorvastatin 20 mg for the primary prevention of CVD to people with type 2 diabetes who have a 10% or greater 10-year risk of developing CVD and consider for all people with Type 1 diabetes’). The NDA will be able to report against these new standards from 2017-18. Meanwhile, to maintain continuity, attainment of the old Total Cholesterol <5mmol/l target is reported for 2016-17 as before.”
  Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors in Type 2 diabetes management: Key evidence and implications for clinical practice.  
A comprehensive article on SGLT 2s from the Improving Diabetes Steering Group is available here.
  Training to deliver foot assessments for diabetic patients  
There are two dates for the above training being held later this year:
  • 5 October: 10am - 12pm, Skimped Hill Health Centre, Bracknell
  • 12 November: 10am - 12pm, West Berkshire Community Hospital
Further details are available here.

Contact: julie.beckett@berkshire.nhs.uk
  2018-2019 National Diabetes Audit: primary care data extraction  
A reminder that the National Diabetes Audit (NDA) is moving to quarterly collections of data from GP practices in England. This message is for all participating practices in relation to the NDA (National Diabetes Audit) 2018-19 CQRS service.
The GPES service has been asked by NHS England to prioritise the scheduling of an additional collection. This relates specifically to a payment supporting extract after it emerged that there had been some issues experienced during the July collection. This unfortunately means that the NDA Extract (and its August 2018 collection), has been postponed from 06/08/18 – 16/08/18 to 22/08/18 – 29/08/18.
Details of CQRS services, including the live collections timetable can be found on the GP Collections website, which will be updated to reflect the changes.
As was the case for the 2017/18 extraction, in order to take part primary care services will need to “opt in” via the Calculating Quality Reporting Service (CQRS). Please note that services that were signed up via CQRS for the 2017/18 audit will be automatically included in the 2018/19 audit so don't need to sign up again. These services will therefore be included in the August, November, February and May extracts. Those services who are unsure whether they have signed up or not can check within the participation management screen on their own local system. This can be filtered to show a list of which services have been accepted.
If someone has accidently rejected the CQRS invitation, they can contact support@cqrs.co.uk or call 0800 440 2777 to have the offer resent. CQRS can also check live / current approvals. Further information re CQRS is available on their website
Further information can also be found here.

Extraction of General Practice data via GPES will commence on the following dates:
• August 2018 – progress check: Jan-Jun 2018 data.
• November 2018 – progress check: Jan-Sep 2018 data.
• February 2019 – progress check: Jan-Dec 2018 data.
• May 2019 – full and complete data extraction for final report.
If you have any questions about the audit, please contact: diabetes@nhs.net.
Diabetes Specialist Nurse Hotline: 07879 814922 (Monday to Friday 10am – 4pm) Consultant Hotline: 07717 867448. Email: virtualdiabetes@royalberkshire.nhs.uk
Visit our website: www.berkshirewestdiabetes.org.uk
Click here to read this update online