Table 1 Targeted clinical behaviours and evidence of performance from the iQuaD study, and associated NICE quality standards

1. Over the past 12 months provided general education about diabetes for patients with type 2 diabetes

Received by 73% of patients (via patient survey)

QS1 - ‘People with diabetes and/or their carers receive a structured educational programme that fulfils the nationally agreed criteria from the time of diagnosis, with annual review and access to ongoing education’

2. Over the past 12 months provided advice about weight management to patients with type 2 diabetes whose BMI is above a target of 30 kg/m2 even following previous management

Received by 51% of people whose BMI was above a target of 30 kg/m2, even following previous management (via patient survey)

QS2 - ‘People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme’

3. Over the past 12 months provided advice about self-management for patients with type 2 diabetes

Received by 68% of patients (via patient survey)

QS3 - ‘People with diabetes participate in annual care planning which leads to documented agreed goals and an action plan’

4. Over the past 12 months prescribed additional therapy for the management of glycaemic control (HbA1c) in patients with type 2 diabetes whose HbA1c is higher than 64 mmol/mol (8.0%) despite maximum dosage of two oral hypoglycaemic drugs

Received by 59% of people whose HbA1c was higher than 8.0%, despite maximum dosage of two oral hypoglycaemic drugs (via practice-held prescribing data)

QS4 - ‘People with diabetes agree with their healthcare professional a documented personalised HbA1c target, usually between 48 mmol/mol and 58 mmol/mol (6.5% and 7.5%), and receive an ongoing review of treatment to minimise hypoglycaemia’

QS5 - ‘People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance’

5. Over the past 12 months prescribe additional antihypertensive drugs for patients with type 2 diabetes whose blood pressure is 5 mmHg above target of 140 mmHg (systolic) or 80 mmHg (diastolic) even following previous management

Received by 40% whose blood pressure (BP) is above a target of 140 mm Hg for Systolic BP or 80 mm Hg for Diastolic BP, even following previous management (via practice-held prescribing data)

QS5 - ‘People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance’

6. Over the past 12 months examined foot circulation and sensation in the feet of patients with type 2 diabetes

Received by 91% of patients (via patient survey)

QS10 - ‘People with diabetes at risk of foot ulceration receive regular review by a foot protection team in accordance with NICE guidance’

QS11 - ‘People with diabetes with a foot problem requiring urgent medical attention are referred to and treated by a multidisciplinary foot care team within 24 hours’