Table 1.

UK diabetes quality statements and translation into self-management support

Diabetes Quality statements NICE 2011 (revised 2012)	How these translate into primary care self-management support or referral outside primary care
https://www.nice.org.uk/guidance/qs6/chapter/List-of-statements
Statement 1. People with diabetes and/or their carers receive a structured educational programme that fulfils the nationally agreed criteria from the time of diagnosis, with annual review and access to ongoing education.	• Referred to education programme commissioned by local Clinical Commissioning Group which takes place in the community
	• Attendance checked at annual review with Practice Nurse(PN)/Health Care Assistant
Statement 2. People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme.	• Provided by PN; or
	• Referred to specialist dietician; or
	• Covered in education programme
Statement 3. People with diabetes participate in annual care planning which leads to documented agreed goals and an action plan.	• Covered during regular and annual reviews within the practice
Statement 4. People with diabetes agree with their healthcare professional a documented personalised HbA1c target, usually between 48 mmol/mol and 58 mmol/mol (6.5 % and 7.5 %), and receive an ongoing review of treatment to minimise hypoglycaemia.	• Covered during regular and annual reviews within the practice
Statement 5. People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.	• Covered during regular and annual reviews within the practice
Statement 6. Trained healthcare professionals initiate and manage therapy with insulin [where indicated] within a structured programme that includes dose titration by the person with diabetes.	• Covered in education programme; or
	• Takes place during regular and annual reviews within the practice where PN has been trained
Statement 7. Women of childbearing age with diabetes are regularly informed of the benefits of preconception glycaemic control and of any risks, including medication, that may harm an unborn child. Women with diabetes planning a pregnancy are offered preconception advice, and those not planning a pregnancy are offered advice on contraception.	• Takes place during regular and annual reviews within the practice
	• Referred to specialised antenatal care
Statement 8. People with diabetes receive an annual assessment for the risk and presence of the complications of diabetes, and these are managed appropriately.	• Takes place during annual review within the practice
Statement 9. People with diabetes are assessed for psychological problems, which are then managed appropriately.	• Takes place during regular and annual reviews within the practice
	• Referred to appropriate mental health team
Statement 10. People with diabetes at risk of foot ulceration receive regular review by a foot protection team in accordance with NICE guidance.	• Provided by foot protection team/podiatrist following referral from primary care
Statement 11. People with diabetes with a foot problem requiring urgent medical attention are referred to and treated by a multidisciplinary foot care team within 24 h.	• Provided by foot protection team/podiatrist following referral from primary care
Statement 12. People with diabetes admitted to hospital are cared for by appropriately trained staff, provided with access to a specialist diabetes team, and given the choice of self-monitoring and managing their own insulin.	• Specialist diabetes team in secondary care
Statement 13. People admitted to hospital with diabetic ketoacidosis receive educational and psychological support prior to discharge and are followed up by a specialist diabetes team.	• Specialist diabetes team in secondary care
Statement 14. People with diabetes who have experienced hypoglycaemia requiring medical attention are referred to a specialist diabetes team.	• Specialist diabetes team in secondary care

In addition – People with diabetes need to have annual screening at accredited optician or diabetes screening service