A Health Equity Audit of the Diabetic Eye Screening Programmes in Cumbria and the North East
Keywords:Health Equity Audit, NHS Diabetic Eye Screening Programmes, uptake of screening, diabetic retinopathy, Cumbria and the North East of England
We report key findings and lessons learned from a health equity audit (HEA) of six National Health Service Diabetic Eye Screening Programmes (NDESPs) in Cumbria and the North East of England. Uptake of diabetic eye screening was analysed in relation to demographic variables including age, sex, socioeconomic deprivation and geography and a combination
of these in each of the six NDESPs. A total of 196,275 records of patients with diabetes aged 12 years and over on the NDESP registers were analysed. The key finding was a lower than acceptable screening uptake (70%) in the last year among the working age population, especially those living in the most socioeconomically deprived areas. The HEA process also highlighted the need for improvements in collecting data on ethnicity and sex. It informed action plans which address inequities in uptake of screening in each of the six NDESPs, especially those targeting the working age populations and individuals who never attended screening or never responded to screening invitations. We established a method of extracting the patient data from the local systems, pseudonymising and linking to lower super output
area. This will be important for HEAs to become embedded in routine practice.
Liew G, Michaelides M, Bunce C. A comparison of the causes of blindness certifications in England and Wales in working age adults (16–64 years), 1999–2000 with 2009–2010. BMJ Open 2014;4:e004015. https://doi.org/10.1136/bmjopen-2013-004015
Scanlon PH. The English National Screening Programme for diabetic retinopathy 2003–2016. Acta Diabetol 2017;54:515–25. https://doi.org/10.1007/s00592-017-0974-1
Leese GP, Boyle P, Feng Z, Emslie-Smith A, Ellis JD. Screening uptake in a well-established diabetic retinopathy screening program: the role of geographical access and deprivation. Diabetes Care 2008;31:2131–5. https://doi.org/10.2337/dc08-1098
NHS England. Guidance for NHS commissioners on equality and health inequalities legal duties. 14 December 2015. https://www.england.nhs.uk/wp-content/uploads/2015/12/hlth-inqual-guid-comms-dec15.pdf (accessed 14 February 2019)
Department of Health. Health Equity Audit. A guide for the NHS. https://webarchive.nationalarchives.gov.uk/20130315173148 / http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4084139.pdf (accessed 14 February 2019)
PHE and NHS England. Health Equity Audit (HEA) of the NHS Diabetic Eye Screening Programmes (NDESPs) in Cumbria and the North East. Report. 2015–2016 (available from corresponding author on request).
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