Diabetes: NDH annual HbA1c or FPG test
Indicator
The percentage of people with non-diabetic hyperglycaemia who have had an HbA1c test or FPG test in the preceding 12 months.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
Patients with an elevated HbA1c between 42 and 47 mmol/mol (fasting plasma glucose 5.5 to 6.9 mmol/l) are at increased risk of developing Type 2 diabetes. NICE guidance recommends annual HbA1c testing in these patients in order to ensure early identification of those who have developed Type 2 diabetes so that treatment may be instigated promptly and before complications have developed.
Source guidance
Type 2 diabetes: prevention in people at high risk. NICE guideline PH38 (2012, updated 2017), recommendation 1.6.5
Specification
Numerator: The number of patients in the denominator who have had an HbA1c test or FPG test in the preceding 12 months.
Denominator: People with non-diabetic hyperglycaemia.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: Under 18s; patients with an unresolved diabetes diagnosis.
Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines, does not attend or a HbA1c test or FPG is not appropriate.
Expected population size: QOF data for 2022 to 2023 (indicator NDH001) shows that 5.7% of people aged 18 and over in England have non-diabetic hyperglycaemia: 569 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.
Note: the code used in NHS England's (2024) QOF guidance for 2023 to 2024 is NDH002.