The National Diabetes Foot Care Audit of England and Wales: achievements and challenges

Abstract

The aim of the National Diabetes Foot Care Audit (NDFA) is to collect details of all newly occurring foot ulcers in England and Wales. It is designed to impose minimal burden on clinical staff because the use of the NHS number enables additional detail to be obtained by electronic linkage to data held by NHS Digital, hospital activity databases (admissions, operations) and the Office of National Statistics (death). Thus, details were obtained from over 33,000 ulcer episodes in over 27,000 people between from 2015–2018. The principal findings are: that ulcers referred for specialist assessment within 14 days are significantly less severe and are significantly more likely to have healed within 12 weeks; that time to referral and ulcer severity are also significantly related to other outcomes, including hospital admission and amputation; and that there is very wide geographical variation in the time to first specialist assessment.