National Paediatric Diabetes Audit (NPDA) - outlier identification and management

This page contains NPDA resources on the identification and management of outlier results. Here you can access the NPDA Outlier Management and Identification Policy, annual outlier analysis reports, and supporting documentation. These materials explain how outliers are defined, reported, and addressed, ensuring transparency in the monitoring of paediatric diabetes service performance.

NPDA Outliers - Overview

The NPDA identifies paediatric diabetes units (PDUs) whose results sit noticeably above or below expected performance on key audit measures. The policy sets out how outliers are identified and the steps taken to ensure the data is accurate, transparent and used to support quality improvement.

How outliers are identified

The NPDA assesses performance using two main indicators:

  • Overall health check completion rate for children and young people with Type 1 diabetes
  • Unadjusted Mean HbA1c for children and young people with Type 1 diabetes

Units whose results differ significantly from the national average may be identified as positive outliers, or as alert or alarm level (negative) outliers.

Non-participation

Units that do not submit enough data to calculate performance metrics will be recorded as negative outliers due to non-participation.

What happens when a unit is identified

Potential outliers are contacted and asked to review their data. For alarm-level outliers, the NPDA works directly with the clinical team to understand the findings and confirm whether any data quality issues are present. Confirmed alarm-level cases are shared with the relevant healthcare regulator.

Publication of results

Confirmed outlier status is published within:

  • The Annual Outlier Management and Identification Report
  • PDU-level annual reports
  • The NPDA annual dashboard

Roles of national bodies

The CQC, NHS England, the Welsh Government and Health and Community Services Jersey oversee how providers respond to confirmed outlier findings, in line with their local processes.

Further information

Read the full NPDA Outlier Identification and Management Policy below. For any queries about the NPDA outlier identification and management process, please contact the NPDA team.