Diabetes: annual retinal screening

Indicator type

General practice indicator suitable for use in the Quality and Outcomes Framework.

This indicator was previously included in the Quality and Outcomes Framework as DM011 but removed in 2014/15.

Rationale

People with diabetes are at risk of developing diabetic retinopathy. The aim of the indicator is to encourage uptake of retinal screening.

Evidence shows that screening for diabetic retinal disease is effective at detecting unrecognised sight-threatening retinopathy and that the success of screening depends on continued high levels of uptake. The NHS provides a national diabetic retinopathy screening programme for all people with diabetes, as recommended by the UK National Screening Committee. GPs are not responsible for providing retinal screening under this indicator, but are responsible for ensuring that people with diabetes have annual retinal screening.

Source guidance

Specification

Numerator: The number of patients with diabetes, on the register, who have a record of retinal screening in the preceding 12 months.

Denominator: The number of patients with diabetes on the register.

Calculation: (Numerator/denominator)*100.

Exclusions: None.

Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines, does not attend or if retinal screening is not appropriate.

Expected population size: National Diabetes Audit data for 2023 to 2024 and ONS mid-year population data for 2024 shows that 6.6% of people in England are included in the audit and are included in the denominator for the retinal screening care process indicator: 655 patients for an average practice with 10,000 patients. To be suitable for use in QOF, there should be more than 20 patients eligible for inclusion in the denominator, per average practice with 10,000 patients, prior to application of personalised care adjustments.