Stuff that occurs to me: Trying to find this year's QOF stats on diabetes

This is an unfinished post that I last saved on 10 February 2013. I was in the middle of updating my own stats website at DiabetesStatistics and (a) discovered that all the previous links to stats files were now out of date because people will keep moving things around and (b) I found conflicting numbers and hadn't managed to resolve it. I'm publishing this now as I was so surprised to read of 'new' figures today... which seem to be the October 2012 QOF figures. Odd.

--------------------------------------------------------------------------

When I worked at Diabetes UK one of my tasks was to contribute to our "Diabetes in the UK" document which began to be updated annually to take account of new QOF (Quality and Outcomes Framework) figures for people with diabetes. You can see the history of the document from 1988 to the present at this page on diabetes prevalence here.

Here are the 2011/2012 figures I've found for each nation.

England: 2,566,436 people over age of 17 with diabetes (any type)
Scotland: 234,871 or possibly 247,278 (not sure about this one, see explanatory text below)
Northern Ireland: 75,837
Wales: 167,537

Total: 3,018,610 / 3044681

http://www.gpcontract.co.uk/child/UK/DM%2019/12

Numerator	Denominator	Ratio	Centile
Wales	167537	3185538	5.3%
England	2544197	55068625	4.6%
UK	3018610	65358176	4.6%
Scotland	231248	5210522	4.4%
Northern Ireland	75628	1893491	4.0%

Briefly, and probably somewhat simplistically, QOF is a form of accounting so that each GP practice in the various nations gets the appropriate payment for the number of people they are looking after with different conditions. I'm not sure that it was particularly designed to provide health charities with a handy record of how many people (over the age of 17) have a particular condition, but that info is there and that's the only reason I've ever looked at the data.

Taking England (because I live there and it's got the biggest population) as an example, the data is available at the level of 'everyone in England', 'everyone in a particular Strategic Health Authority', 'everyone at a particular practice' - using the latter you can also find out information about how many people in a particular town (eg with 5 practices) have a particular condition.

I won't pretend that I've ever gone to the QOF's landing page and gone straight to the relevant file and picked out the answer I want. Usually it's a case of clicking on a few things, trying to remember how I did it last year and eventually finding it. Or asking a colleague.

The QOF figures for 2011/2012 came out in October but I paid little heed to them as I'm no longer in the business of updating statistics, but then I remembered my very large DiabetesStatistics google site and I thought... I really ought to try and update it.

Easier said than done.

I created it largely for me but also for colleagues and anyone else who might be interested in statistics. Its strength, for me, is that I left reasonably good instructions on how I got hold of the figures rather than just the figures themselves.

However an additional challenge is that statistics websites often move things around, so while the instructions are good, you can't 'follow along' using previously captured figures as a guide to how to do it now because all the pages and files are '404 not found' or worse, take you to the sites' homepages.

Every single link in this section below, of this QOF overview page is now non-functioning ;)

NHS Information Centre's pages on QOF ENGLAND

Landing page (2010/2011) » data tables » Prevalence data tables » SHA level QOF tables (opens .xls)

Below is the very detailed record of my attempts to correct the links for 2010/2011 data and find 2011/2012 data. It's quite long...

In the text below the addresses are shown as embedded links but for URL hackers I've left the full addresses at the end, though the NHS IC ones don't really lend themselves to that unfortunately.

Firstly, I found where the 2010/2011 data for England had been moved, here are the links for each of them... this was partly to correct the links but also to refamiliarise myself with the process of where to look for the relevant number.

2010-2011 QOF data for ENGLAND - published in 2011

Start at landing page for Quality and Outcomes Framework - 2010-11
then look for Quality and Outcomes Framework - 2010-11, England level - click to open page
Once on page, look for: Quality and Outcomes Framework - 2010-11, England level: Prevalence data tables [.xls] - clicking will open a spreadsheet, called qof-10-11-data-tab-prev-eng.xls
Once opened look for Column A, Clinical Area and find Diabetes Mellitus (Diabetes) (ages 17+) then read corresponding figure in Column B = 2,455,937

So, now onto the four nations...

2011-2012 QOF data for ENGLAND - published on 26 October 2012

Start at landing page for Quality and Outcomes Framework - 2011-12
then look for Quality and Outcomes Framework - 2011-12, England level - click to open page
Now on page http://www.ic.nhs.uk/catalogue/PUB08661 =
Once on page, look not for the diabetes spreadsheet but keep scrolling for Quality and Outcomes Framework - 2011-12, England level: Prevalence data tables [.xls] - - clicking will open a spreadsheet, called qof-11-12-data-tab-eng-nat-prev.xls
Once opened look for Column A, Clinical Area and find Diabetes Mellitus (Diabetes) (ages 17+) then read corresponding figure in Column B = 2,566,436

Checking as we go...
For fun (your mileage may vary) you can also fact-check you've got the correct stat by googling that number along with the word diabetes - I found this question asked and answered in Parliament, which mentioned this specific figure, so this is an independent verification.

I also searched on Google for million Diabetes UK and then restricted to the most recent month to see any instances of things like "there are X million people" on DUK's site, or "According to Diabetes UK there are x million people with diabetes". I found a couple of references to 3.7 million, so then searched for that to find their September 2012 report which specifically mentions 3.7 million people with diabetes in the UK - this will include all England, Scotland, Northern Ireland and Wales 'known cases' of diabetes - this just tells me that once I've got all my figures they should probably combine to form 3.7 million (unless they're including an estimate of people with undiagnosed diabetes which is about 850,000 but I doubt it).

NORTHERN IRELAND

Start at landing page for NI Direct's QOF data - this landing page doesn't seem to change location, it just updates with each new year's data which is helpful. I already had the link on my own stats pages for Northern Ireland.
Scroll down for the right year, choose Local Commissioning Group Level
Look for 'Achievement in the Clinical Areas' and select Diabetes PDF or Diabetes XLS, whose filename is diabetes_indicators_by_lgc_2011-12.xls
Look for Total register size (cell F13) = 75,837

And Googling for 75,837 diabetes brings up plenty of evidence that others have picked the same figure, which is always heartening.

SCOTLAND
This one was a wee bit tougher because the relevant spreadsheet has macros and regardless of whether or not I enabled or disabled them the file wouldn't work on my computer (a Mac) and I couldn't select the QOF register I wanted to look at. Fortunately I spotted there was a second tab, which presents the data in a different way, so I went for that one instead. On Googling the resulting number (234,871) I didn't find much evidence of it having been used by anyone, so possibly another figure is in use.

However it is similar to the figure for last year's Scotland prevalence 2010/2011 on Diabetes UK's page (223,494) and slightly larger, so it's pretty plausible.

It's also possible that I picked the wrong file, so corrections would be appreciated! So many files...

Start at ISD Scotland's Quality and Outcomes Framework
Scroll to 'Links to QOF data tables for Scotland' and make sure you're on the right year (2011/2012 data table links)
then click on Register and prevalence data at Scotland, NHS Board and CHP level
scroll down to NHS Board and Scotland level data and from the spreadsheets below that I chose the one called Prevalence reported from QOF registers (practices with any contract type)
Once opened I clicked on the second tab 'by QOF register' and read off the number for Diabetes which, in cell i21, is 234,871 (*)

Incidentally my page on Scotland stats took me to the 2011 register information, from which I was able to work out the landing page above.

(*) It should be possible to do it using the first tab ('by NHS board') but the macros weren't friendly. Where it says (near the top) 'please select QOF register' it should be possible to select Diabetes from a drop-down menu and get the relevant information for NHS Scotland as a whole, and then for each NHS region.

Other figures I found
Diabetes rate in Scotland continues to increase BBC News (20 August 2012) - 247,278 people, this figure comes from the Scottish Diabetes Survey.

The Scottish Diabetes Survey seems to be consistently a bit higher than QOF because for 2010/2011 prevalence Diabetes UK was using QOF figures of 223,494 and SDS for 2010 had it as 237,468.

Last year I probably knew why there was a difference ;)

WALES

After a lot of false starts, I discovered this helpful page from the GP Contract website, called QOF Database - Wales - DM 19
Look for DM 19 | 2012 = 167,537

Or StatsWales has it too: Patients on Quality and Outcomes Framework (QOF) by local health board and disease registers (make sure you select the correct year from drop down menu)

Start at the landing page for the Welsh Government's General Medical Services Contract: Quality and Outcomes Framework Statistics, 2011-12. You can also use the StatsWales pages
Scroll down to the Document Download bit and click on QOF Data Summary for Wales and LHBs, 2011-12

GP Contract - QOF Database - Wales - DM 19
http://www.gpcontract.co.uk/timeline/WAL/DM%2019

http://www.gpcontract.co.uk/child/WAL/DM%2019/12
167,537

42,713

General Medical Services Contract: Quality and Outcomes Framework Statistics, 2011-12
http://wales.gov.uk/topics/statistics/headlines/health2012/1209271/?lang=en
QOF Data Summary for Wales and LHBs, 2011-12
http://wales.gov.uk/docs/statistics/2012/120927datasummaryen.xls

StatsWales
https://statswales.wales.gov.uk/Catalogue/Health-and-Social-Care/NHS-Primary-and-Community-Activity/GMS-Contract

Unless you are tasked with trying to find information from scratch and the links above don't work you probably don't need to look further. If the links above don't work you may be able to draw some conclusions about site hierarchies from the links' structures below.\

Other useful resources
Association of Public Health Observatories (APHO)'s Diabetes Prevalence Model
http://www.yhpho.org.uk/default.aspx?RID=81090 (England, Scotland, Wales only)

Raw URLs / addresses
2010-2011 QOF data for ENGLAND - published in 2011
Quality and Outcomes Framework - 2010-11
http://www.ic.nhs.uk/catalogue/PUB04396
Quality and Outcomes Framework - 2010-11, England level
http://www.ic.nhs.uk/catalogue/PUB05673
Quality and Outcomes Framework - 2010-11, England level: Prevalence data tables
http://www.ic.nhs.uk/catalogue/PUB05673/qof-10-11-data-tab-prev-eng.xls

2012 data
ENGLAND
Quality and Outcomes Framework - 2011-12
http://www.ic.nhs.uk/catalogue/PUB08135
Quality and Outcomes Framework - 2011-12, England level
http://www.ic.nhs.uk/catalogue/PUB08661
Quality and Outcomes Framework - 2011-12, England level: Prevalence data tables
http://www.ic.nhs.uk/catalogue/PUB08661/qof-11-12-data-tab-eng-nat-prev.xls

The chances are that next year's file might be called qof-12-13-data-tab-eng-nat-prev.xls which you can search for, although it's not clear from the PUB0123 type numbers in the URL where it will be located so file searching probably best unless the landing page helps you.

My DiabetesStatistics page on England
https://sites.google.com/site/diabetesstatistics/uk-and-local-stats/nations/england

NORTHERN IRELAND
NI Direct QOF data
http://www.dhsspsni.gov.uk/index/stats_research/stats-resource/stats-gp-allocation/gp_contract_qof/qof_data.htm
Local Commissioning Group Level (for relevant year)
http://www.dhsspsni.gov.uk/index/stats_research/stats-resource/stats-gp-allocation/gp_contract_qof/qof_data/statistics_and_research-qof-lcg-2011-12.htm
Achievement in the Clinical Areas table: Diabetes XLS
http://www.dhsspsni.gov.uk/diabetes_indicators_by_lcg_2011-12.xls

My DiabetesStatistics page on Northern Ireland
https://sites.google.com/site/diabetesstatistics/uk-and-local-stats/nations/northern-ireland

SCOTLAND
ISD Scotland's Quality and Outcomes Framework
http://www.isdscotland.org/Health-Topics/General-Practice/Quality-And-Outcomes-Framework/
Register and prevalence data at Scotland, NHS Board and CHP level
http://www.isdscotland.org/Health-Topics/General-Practice/Quality-And-Outcomes-Framework/2011-12/Register-and-prevalence-data.asp
Prevalence reported from QOF registers (practices with any contract type)
http://www.isdscotland.org/Health-Topics/General-Practice/Publications/2012-09-25/QOF_Scot_201112_Boards_all_prevalence.xls

Scottish Diabetes Survey
http://www.sci-diabetes.scot.nhs.uk/

My DiabetesStatistics page on Scotland
https://sites.google.com/site/diabetesstatistics/uk-and-local-stats/nations/scotland

WALES

Quality and Outcomes Framework (QOF) by local health board and disease registers
https://statswales.wales.gov.uk/Catalogue/Health-and-Social-Care/NHS-Primary-and-Community-Activity/GMS-Contract/PatientsOnQualityAndOutcomesFramework-by-LocalHealthBoard-DiseaseRegister

My DiabetesStatisitcs page on Wales
https://sites.google.com/site/diabetesstatistics/uk-and-local-stats/nations/wales

Stuff that occurs to me