Reassessment of a hospital diabetes clinic after audit

A previous audit had identified deficiencies in the care provided by a hospital diabetes clinic. Improvements were needed but the number of available doctors had decreased and extra resources were not available, therefore simple changes In the organisation of the clinic were made. Minimum standards were set: annual recording of HbA1c, blood pressure and fundoscopy; and more appropriate use of specialists (eg dietitians, health visitors, nephrologists). The audit was repeated and the activity in the clinic was found to have improved in most of the categories which were observed. The proportion of patients who had undergone recent fundoscopy remained unsatisfactory, however.