Improving diabetes care in Ealing, London: an analysis of the NDA and diabetes-related admissions data during first year of COVID-19

June 2022

In this paper, we present and analyse National Diabetes Audit (NDA) and diabetes-related emergency admissions data in Ealing during the period 1 January 2020 to 31 March 2021. Care for diabetes and other long-term conditions was disrupted and significantly impacted during this initial period of the COVID-19 pandemic.

The NDA analysis shows that for type 1 and type 2 diabetes Key Care Processes (KCPs), both the eight and nine KCPs fell between 2019/20 and 2020/21, but the relative fall for NHS Ealing was lower than that seen for England. Type 1 diabetes Three Treatment Targets (3TTs) for NHS Ealing increased from 22.6% in 2019/20 to 26.4% in 2020/21; in contrast the 3TTs for England increased slightly from 19.8% in 2019/20 to 20.8% in 2020/21. Type 2 diabetes 3TTs for NHS Ealing changed from 40.9% in 2019/20 to 38.9% in 2020/21, while in England it was 40.3% in 2019/20 and 35.5% in 2020/21.

The diabetes-related emergency admissions analysis shows that there were reductions in the number and rate of emergency admissions for cerebrovascular accident and myocardial infarction; admissions and rates for diabetic ketoacidosis and amputations were the same; those for diabetes mellitus and hypoglycaemia increased. There were overall cost savings of £874,147 due to estimated avoided admissions.

In Ealing, the NDA data, diabetes-related emergency admissions and estimated avoided admissions data show that improvements in diabetes care achieved in previous years in Ealing, faltered, but were broadly sustained in the first pandemic year. Support from the Ealing diabetes care teams, improved self-management of diabetes and the empowering of people with diabetes through digital technologies could explain these trends in Ealing. Continued access to health care practitioners during the COVID-19 pandemic is important to ensure the appropriate management of long-term conditions such as type 1 diabetes mellitus and type 2 diabetes mellitus.