Abstract
One of the main drivers in the development of the National Service Framework (NSF) for Diabetes (Department of Health (DH), 2001a) was the need to reduce inequalities of service provision. The problem was that there were, and still are, unacceptable variations in treatment, as well as in the outcomes of that treatment across England. According to an analysis of the latest Quality and Outcomes Framework (QOF) data from primary care, this variation in diagnosis and treatment is still continuing. For example, the percentage of patients with diabetes with a record of the presence or absence of peripheral pulses in the previous 15months varies from 50.7% to 99.2% between PCTs (National Diabetes Support Team (NDST), 2006). More information on the QOF data relevant to diabetes care can be seen at www.diabetes.nhs.uk/downloads/Factsheet_QOF.pdf .
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