A Health Equity Audit of the Diabetic Eye Screening Programmes in Cumbria and the North East

Authors

  • Balsam Ahmad Public Health England (1) Newcastle University (2)
  • Fergus Neilson Public Health England

DOI:

https://doi.org/10.15277/bjd.2019.203

Keywords:

Health Equity Audit, NHS Diabetic Eye Screening Programmes, uptake of screening, diabetic retinopathy, Cumbria and the North East of England

Abstract

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.

Author Biographies

Balsam Ahmad, Public Health England (1) Newcastle University (2)

Specialty Registrar in Public Health in PHE

Associate Lecturer in Public Health, Newcastle University

Fergus Neilson, Public Health England

Senior Screening and Immunisations Manager, Public Health England North East Centre

References

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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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Published

2019-06-27

Issue

Section

Learning from practice