Quality standard
Quality statement 2: Structured education programme
Quality statement 2: Structured education programme
Quality statement
Adults with type 2 diabetes are offered a structured education programme at diagnosis. [2011, updated 2023]
Rationale
Type 2 diabetes is a progressive long-term medical condition that the person predominantly self-manages. Managing type 2 diabetes involves lifestyle changes, and treatment can be complex. Structured education programmes can help adults with type 2 diabetes to improve their knowledge and skills and increase patient activation to self-manage effectively. Structured education should also be offered to family members and carers of adults with type 2 diabetes, if appropriate. Structured education programmes should be offered in a timely manner following diagnosis, recognising that adults may be more open to change at this time, and key messages reinforced periodically.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly. Services may want to use these measures to focus on dimensions of health inequality, for example by reporting data grouped by age, ethnicity or indices of deprivation.
Process
a) Proportion of adults with type 2 diabetes who are offered a structured education programme at diagnosis.
Numerator – the number in the denominator who are offered a structured education programme at diagnosis.
Denominator – the number of adults with a new diagnosis of type 2 diabetes.
Data source: The National Diabetes Audit's care processes and treatment targets report collects and reports data on the number of adults with type 2 and other types of diabetes (excluding type 1 diabetes) who have been offered structured education within 1 and 2 years of diagnosis and with no time limit from diagnosis. NHS Digital's Quality and Outcomes Framework indicator DM014 reports data on the percentage of patients newly diagnosed with diabetes who have a record of being referred to a structured education programme within 9 months of entry on to the diabetes register.
b) Proportion of adults with a new diagnosis of type 2 diabetes who attend a structured education programme.
Numerator – the number in the denominator who attend a structured education programme.
Denominator – the number of adults with a new diagnosis of type 2 diabetes.
Data source: The National Diabetes Audit care processes and treatment targets report collects and reports data on the number of adults with type 2 and other types of diabetes (excluding type 1 diabetes) who have attended structured education within 1 and 2 years of diagnosis.
c) Proportion of adults with a new diagnosis of type 2 diabetes who complete a structured education programme.
Numerator – the number in the denominator who complete a structured education programme.
Denominator – the number of adults with type 2 diabetes who attend a structured education programme.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
Outcome
Patient confidence to self-manage their type 2 diabetes after attending a structured education programme.
Data source: No routinely collected national data for this measure has been identified. Data can be collected locally by healthcare professionals and provider organisations, for example, from patient surveys and confidence scaling.
What the quality statement means for different audiences
Service providers (such as GP practices, community healthcare providers and secondary care providers) ensure that systems are in place for adults with type 2 diabetes to be offered a structured education programme at diagnosis, with key messages reinforced periodically. The services providing the education programme should ensure that it is available in a format suitable for the person, such as in-person or online, and at times suitable for them, including outside standard working hours.
Healthcare professionals (such as GPs, practice nurses, community healthcare providers, dietitians, consultant diabetologists and diabetes specialist nurses) ensure that they offer a structured education programme to adults with type 2 diabetes at diagnosis, with key messages reinforced periodically. They should ensure adults with type 2 diabetes are given clear information on the structured education programme and help to access it. Healthcare professionals ensure they highlight the importance of attending the structured education programme to encourage attendance.
Integrated care systems ensure that structured education programmes of proven benefit are available for adults with type 2 diabetes. They ensure that programmes are made available in a format suitable for the person, such as in-person or online, and at times suitable for them, including outside standard working hours.
Adults with type 2 diabetes are offered a course to help them improve their understanding of type 2 diabetes and how to manage it in their everyday life. The course should be offered at the time of the diagnosis of type 2 diabetes and reviewed periodically. Their family and carers should be able to attend the course, if appropriate.
Source guidance
Type 2 diabetes in adults: management. NICE guideline NG28 (2015, updated 2022), recommendation 1.2.1
Definitions of terms used in this quality statement
Structured education programme
Adults with type 2 diabetes should be offered group education programmes as the preferred option. Any structured education programme for adults with type 2 diabetes should:
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be evidence-based and suit the needs of the person
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have specific aims and learning objectives, and should support the person and their family members and carers to develop attitudes, beliefs, knowledge and skills to self-manage diabetes
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have a structured curriculum that is theory-driven, evidence-based and resource-effective, has supporting materials and is written down
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be quality assured and reviewed by trained, competent, independent assessors who measure it against criteria that ensure consistency
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have outcomes that are audited regularly
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meet the cultural, linguistic, cognitive and literacy needs of people in the local area
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be delivered by trained educators who:
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understand educational theory appropriate to the age and needs of the person
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are trained and competent to deliver the principles and content of the programme.
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[Adapted from NICE's guideline on type 2 diabetes in adults, recommendations 1.2.2, 1.2.4 and 1.2.5]
Equality and diversity considerations
Structured education programmes should meet the cultural, linguistic, cognitive and literacy needs in the local area and consider the characteristics of the target population, including socioeconomic status and social context.
Structured education programmes should be adapted to ensure they are accessible to adults with type 2 diabetes and a learning disability, such as accommodating views of those with a learning disability, short sessions and the programme rolled out over longer periods in community settings.
Group education programmes are the preferred option, but an alternative of equal standard should be provided for adults who are unable or prefer not to take part in group education. Adults with type 2 diabetes should be given information that they can easily read and understand themselves, or with support, so they can communicate effectively with educators. Information should be in a format that suits their needs and preferences. It should be accessible to adults who do not speak or read English, and it should be culturally appropriate and age appropriate. Adults should have access to an interpreter or advocate if needed.
For adults with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.