National Paediatric Diabetes Audit (NPDA) annual reports

Our annual, national reports, 'Care processes and outcomes' highlight the main findings on the quality of care for children and young people with diabetes mellitus in England and Wales. On this page you can download our latest and previous reports, and find links to our reports especially for parents and carers.
Front covers of NPDA report 2020-21 and #npda2021

The impact of disruption to care is evident in the health check completion rates achieved during this year, which this report shows to be lower than in previous audit years. However, there is still much to celebrate within this report, including lower national average HbA1c than in previous years, increases in the use of diabetes related technologies within all ethnic and socio-economic groups, and a participation rate of 100% amongst paediatric diabetes teams in England and Wales.

Professor Camilla Kingdon, RCPCH President

Annual report 2020-21: Care processes and outcomes

Published in April 2022, the 2020-21 report covers the health checks (care processes) and outcomes for children and young people with diabetes who have attended PDUs (paediatric diabetes units) from 1 April 2020 to 31 March 2021.

The report aims to address a series of questions relating to paediatric diabetes care, which include:

  • What proportion of children and young people with diabetes are reported to be receiving key age-specific processes of diabetes care, as recommended by NICE?
  • How many achieve outcomes within specified treatment targets?
  • Are children and young people with diabetes demonstrating evidence of small vessel (microvascular) disease and/or abnormal risk factors associated with large vessel (macrovascular) disease prior to transition into adult services?

You can download the 2020-21 report below.

Key messages

  • Paediatric diabetes teams should be commended for 100% participation in the 2020/21 NPDA despite the challenges associated with delivering, recording and submitting details of care provided, and with participation being voluntary during this first year of the COVID-19 pandemic.
  • There were 3,662 children and young people newly diagnosed with Type 1 diabetes receiving care from paediatric diabetes units in 2020/21. This is 789 more than the average number newly diagnosed and being managed in a PDU between 2013/14-2019/20. For comparison, the mean number of children and young people with all types of diabetes being managed within a PDU in 2020/21 was 185. The incidence of Type 1 diabetes amongst those aged 0-15 increased from 25.6 new cases per 100,000 in 2019/29 to 30.9 in 2020/21 – an increase of 20.7%. The consistent seasonal pattern of new cases of Type 1 diabetes observed in previous audit years was also disrupted in 2020/21.
  • The impact of the pandemic on paediatric diabetes care can be seen in lower completion rates of all recommended health checks and the smaller percentage of children and young people starting insulin pump therapy if diagnosed in 2020/21, compared to previous years.
  • National median HbA1c (a measure of blood glucose control) reduced from 61.5 mmol/mol to 61.0mmol/mol between 2019/20 and 2020/21 following several years of year on year decreases (improvement) in the national median.    
  • Trusts and health boards must support paediatric diabetes services to reset, restore and recover following disruption to services caused by the COVID-19 pandemic, with reference to RCPCH principles for doing so.

Individual unit level reports

You can download a PDF generator for 2020-21 unit level summary reports (MS Excel file with macros).

You can access individual unit level reports since 2014 on our interactive tool, NPDA Results Online.

And, to help your unit communicate and share the main national and unit level findings from the audit, you can download a 2020-21 NPDA slide deck template below.

Individual unit level posters

You can download our PDF generator for 2020-21 unit level posters (MS Excel file with macros) to view summary and feedback posters for your unit level 2019-20 audit year results. These posters can be printed for display in your clinic waiting area, or can be shared with your contacts via email.

Additional data files

As part of our commitment to open data, we have made available our data files on specific measures from the audit.

Previous years' reports

We have been running the audit since 2010-11. You can download reports from previous years, and download PDF generators (MS Excel files with macros) for 2017-18 , 2018-19  and 2019-20 unit level summary reports.

Parents and carers reports

Our parents and carers reports provide a lay summary of the findings from the NPDA annual reports. We produce versions in English and Welsh. 

You can download our latest reports, as well as those from previous years on our parents and carers report page

Background and audit aims

NPDA was established to compare the care and outcomes of all children and young people with diabetes receiving care from Paediatric Diabetes Units (PDUs) in England and Wales. The audit is commissioned by the Health Quality Improvement Partnership (HQIP), funded by NHS England and the Welsh Government, and is managed by the Royal College of Paediatrics and Child Health.

Our aims:

  • Monitor the incidence and prevalence of all types of diabetes amongst children and young people receiving care from a PDU in England and Wales
  • Establish which key care processes are being received by children and young people with diabetes
  • Enable benchmarking of performance against standards of care specified by the National Institute for Health and Care Excellence (NICE) guidance at PDU and national level
  • Determine the prevalence and incidence of diabetes-related complications amongst children and young people with diabetes

You can read more about the audit and what we measure.