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Benefits case study: use of health care data by Diabetes UK to inform the Putting Feet First campaign

Putting Feet First Campaign

In March 2012, Diabetes UK launched the Putting Feet First campaign, which aims to reduce the rate of lower limb amputations in people with diabetes by 50%, by 2017. The Health and Social Care Information Centre (HSCIC) has produced a benefits case study describing how the campaign was informed by HSCIC's data and statistical outputs and what benefits the campaign is contributing to.

How HSCIC's Hospital Episode Statistics (HES) data informed the campaign driver

Hospital Episode Statistics (HES) data was used to establish that there are higher rates of amputation in people with diabetes (2.51 per 1,000 person-years vs 0.11 per 1,000 person-years) and that the number of amputations in people with diabetes is expected to reach 7,000+ by 2014/15. These two factors, plus the inpatient expenditure on amputations and the viability of preventing many amputations through changes in care services and improved awareness, have driven the need for the Putting Feet First campaign.

How HSCIC's audit data informed the campaign aim and objectives

HES and Quality and outcomes Framework (QOF) data have informed the campaign aim of reducing the amputation rates in people with diabetes by 50%, by 2017, as measured against the 2009-2012 baseline of 2.6 annual lower limb amputations per 1,000 adults with diabetes. National Diabetes Audit (NDA) and National Diabetes Inpatient Audit (NaDIA) publications data have informed three of the four campaign objectives:

  • Ensure people with diabetes have annual foot examinations
  • Improve access to multi-disciplinary footcare teams (MDFTs)
  • Increase foot examinations during hospital stay

Examples of promotional activities informed by HSCIC's statistical data

  • In July 2012, Diabetes UK published on their website a list of 84 sites in England and Wales that were without MDFTs in 2011, based on bespoke NaDIA 2011 data HSCIC supplied to Diabetes UK.
  • In June 2013, Diabetes UK sent letters to 50 clinical commissioning groups (CCGs) and associated NHS trusts to inform them of high amputation rates in their areas and, where relevant, gaps and concerns in the NHS trust's footcare services. HSCIC's HES, QOF and NaDIA 2012 data informed this activity.
  • In September 2013, Diabetes UK issued press releases in areas they'd targeted with high amputation rate letters, with the aim of raising awareness with local people and local stakeholders.

Intermediate benefits (improvements) realised

The behavioural and service changes that are likely to have resulted from the campaign activities have contributed to the following benefits, as measured between 2011 and 2013:

  • Percentage of hospital sites with MDFTs increased from 58.3% to 71.8%
  • Percentage of patients receiving foot examinations during hospital stay increased from 25.8% to 42.4%
  • Percentage of patients receiving foot examinations within the first 24 hours of their hospital stay increased from 21.3% to 36.3%.

End benefits anticipated

The intermediate benefits are anticipated to contribute to the following end benefits:

Reduction in amputation rate in people with diabetes

Fewer people with diabetes experiencing reduced quality of life

Improved survival rates in people with diabetes

Reduced NHS expenditure on amputations

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