New reports published – July 2022
Published: 15 Jul 2022
New resources have been published on our website this month. These include:
- Pulmonary Rehabilitation 2021 Organisational Audit: Summary report
- National Clinical Audit of Psychosis: Early Intervention in Psychosis Audit Report (England)
- National Clinical Audit of Psychosis: Early Intervention in Psychosis Audit Report (Wales)
- National Diabetes Audit, 2020-21 Report: Care processes and treatment targets
- National Diabetes Inpatient Safety Audit (NDISA): An annual survey of GIRFT recommended staffing, systems and pathways
- National Clinical Audit of Seizures and Epilepsies for Children and Young People: Epilepsy12 Report (England and Wales 2019-21)
- National Child Mortality Database: The contribution of newborn health to child mortality across England
- National Audit of Care at the End of Life: Third round of the audit (2021/22) report
- National Audit of Care at the End of Life: Mental health spotlight audit summary report 2021/22
Pulmonary Rehabilitation 2021 Organisational Audit: Summary report 
Based on data collected between 1 November and 3 December 2021, the report presents nformation on 133 out of 200 pulmonary rehabilitation (PR) services in England and Wales, and measures data against six key performance indicators (KPIs) recommended by the National Asthma and COPD Audit Programme (NACAP). Key findings include:
- 94% of services provide PR to people with MRC grade 4 (92.4% in 2019) and 90.1% to grade 5 (88.5% in 2019)
- Of 60.9% of services conducting the 6 minute walk test (MWL), 7.4% do so using a 30m course (in 2019, 62.5% were conducting the 6MWT and, of these, 11.1% were using a 30m course)
- 69.1% of services provide clinical leads with dedicated sessional time for service development (65.9% in 2019).
National Clinical Audit of Psychosis: Early Intervention in Psychosis Audit Report (England)
Based on data from 10,557 casenotes submitted by 54 Trusts in England, the report presents national and organisation-level findings on services provided to people with first-episode psychosis (FEP) in England. Key findings include:
- 66% of teams had an increase in staff in the past year
- 71% of people with FEP received all relevant interventions for their physical health, a 10% increase from the previous audit
- For children and young people, improvements were found in relation to clozapine prescribing, physical health screening and interventions, and carer focused education and support programmes.
National Clinical Audit of Psychosis: Early Intervention in Psychosis Audit Report (Wales)
Based on data from 239 casenotes submitted by six Health Board in Wales, the report presents national and organisation-level findings on services provided to people with first-episode psychosis (FEP) in Wales. Key findings include:
- 85% of people with first episode psychosis (FEP) who had not responded adequately to treatment with at least two antipsychotic drugs were offered clozapine
36% of people with FEP who were not in work/education took up a supported employment and education programme
51% of people with FEP received all seven physical health screenings (27% increase from previous audit).
National Diabetes Audit, 2020-21 Report: Care processes and treatment targets
Based on data from 2020-21 in England and Wales, the report describes the national picture in relation to NICE recommendations and targets for people with diabetes. Key findings include:
- During the COVID-19 pandemic, care process completion declined everywhere but there was greater geographical variation than usual
The greatest impacts were on foot examination, weight measurement, and retinal screening, while Urine albumin checks remain lowest
2% of those with type 1 diabetes and 5.3% with type 2 or other types of diabetes have severe frailty, and 65,970 people with type 2 diabetes have both severe frailty and HbA1c ≤ 53 mmol/mol, and 18,690 people with diabetes with severe frailty and HbA1c ≤ 53mmol/mol are on insulin or sulphonylurea or both.
Diabetes Prevention Programme Non-diabetic Hyperglycaemia Report, 2020/21
- Based on data collected between January 2020 to March 2021, the report aims to support the delivery of evidence based behavioural interventions that can prevent or delay the onset of type 2 diabetes in adults who have been identified as having non-diabetic hyperglycaemia (NDH). Key findings include:
39% of all people with NDH had glycaemic tests and BMI checks (56% in 2019-20) - Care process rates dipped overall under COVID-19 pressures – 67% of people with NDH had a glycaemic test, and 46% had body mass index (BMI) monitoring
- There was a noticeable variation in how well people were being monitored across demographic groups, with people who were of black ethnicity, those aged under 40, and people who had been diagnosed with NDH more than 10 years ago being less likely to have had glycaemic tests or BMI checks.
National Diabetes Inpatient Safety Audit (NDISA): An annual survey of GIRFT recommended staffing, systems and pathways
Based on data from England and Wales, the report reviewed inpatient service provision and inpatient harms against the 2020 Diabetes Getting It Right First Time (GIRFT) recommendations. Key findings include:
- Only 27% of providers had a system to identify people with diabetes on admission, prioritising those at highest risk and involving networked blood glucose (BG) meters
- The rate of total inpatient harms decreased by almost 40%, from 26.3 per 100,000 occupied bed days in Jan-Mar 2019 to 16.2 in Jul-Sep 2021. This trend is largely driven by reductions in hypoglycaemic rescue (from 18.9 to 11.1), which comprise 69% of total inpatient harms
- Although the Diabetic Foot Ulcer (DFU) rate follows a similar downward trend (3.2 to 1.4), there was no apparent reduction in the rate of inpatient Diabetic Ketoacidosis or Hyperosmolar Hyper-glycaemic State.
National Clinical Audit of Seizures and Epilepsies for Children and Young People: Epilepsy12 Report (England and Wales 2019-21)
Based on data collected between December 2019 and November 2020 (and subsequent year’s care), this report focuses on children and young people who had a first paediatric assessment for a suspected seizure between 1 December 2019 and 30 November 2020. The audit then follows the patients for 12 months of subsequent care. Key findings include:
- 70% (1379 out of 1974) of children and young people diagnosed with epilepsy had evidence of an updated and agreed comprehensive care plan
- 5% (53 out of 1124) children and young people between the age of 5-15 years and diagnosed with epilepsy had an identified mental health condition
- 28% (38 out of 135) children and young people diagnosed with epilepsy who met surgical referral criteria had a referral for surgical evaluation.
National Child Mortality Database: The contribution of newborn health to child mortality across England
Based on data collected from April 2019 and March 2021, the report n the contribution of newborn health to child mortality found that for babies born alive, at or after 22 weeks gestation, who subsequently died before 10 years of age between 1 April 2019 and 31 March 2021, half of the deaths occurred in children over one month old. Other key findings include:
- Children who received additional care after birth (neonatal care) made up 83% of children who died before their first birthday, 38% of deaths in the next four years, and 27% of deaths between the ages of 5 and 9
- For child deaths reviewed by a Child Death Overview Panel (CDOP) and categorised as a perinatal/neonatal event, modifiable factors were identified in 34% of deaths.
National Audit of Care at the End of Life: Third round of the audit (2021/22) report
Based on data from June 2021 to October 2021, the report compares results to round two which took place in 2019. Key findings include:
- The possibility of imminent death (that the patient may die within the next few hours/days) was recognised in 87% of cases audited, compared to 88% in 2019.
- The median time from recognition of dying to death was recorded as 44 hours (41 hours in 2019),
- Results on all key metrics regarding the recording of conversations with the dying person remain similar to 2019, pre-pandemic levels, however
- From the Quality Survey, the proportion strongly disagreeing or disagreeing with the statement ‘staff communicated sensitively with the dying person’ increased from 7% (2019) to 11% (2021).
National Audit of Care at the End of Life: Mental health spotlight audit summary report 2021/22
Based on data from June to October 2021, the report sets out the findings of the Mental Health Spotlight Audit and compares the results with the acute and community findings, where appropriate. Key findings include:
- A relatively low volume of deaths happen in mental health settings
- Involvement in decisions regarding end of life care was reported to be in line with acute and community trusts
- There are three key audit themes where the summary scores for mental health providers are lower than those reported for acute and community hospitals: governance, workforce/specialist palliative care and staff reported feedback.
The reports are available to view and download, along with all other reports, on our dedicated reports webpage.
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