Diabetic care is high on the agenda of all primary care organisations. There are currently over 3 million people with Type 2 diabetes. Type 2 diabetes can usually be prevented and the NHS are piloting the National Diabetes Prevention programme (NDPP) which aims to identify those at high risk and refers them onto a behavior change programme.

The NHS DPP is a joint commitment from NHS England, Public Health England and Diabetes UK (NDPP).

During the pandemic it has been recognised that Diabetic patients and those at risk of diabetes may be more vulnerable from COVID 19 than some other members of the population.


Ardens has produced searches to help practices monitor their diabetic and pre diabetic patients more closely particularly during the pandemic.

To locate the searches, access the Population Reporting module > Ardens Searches > 4.12 Conditions - Diabetes > National Diabetes Prevention Programme (NDPP) folder.

National Diabetes Prevention Programme (NDPP)

This folder contains four sub folders.


The first folder includes searches that measure the latest NDPP status in the last 12 months, including patients who have DNA, declined and unsuitable.

The final three searches show separately the NDPP status completed or unsuitable, invited and referred or unsuitable in the last year.


The parent search identifies patients that meet the criteria for referral to NDPP, this is then further broken down by those patients not yet referred (neither have they declined or been recorded as unsuitable).


The housekeeping searches folder includes three searches that are looking at the practice population reporting on: 

  • Adults with no HBA1C or fasting glucose in the last 2 years who are not on the QOF diabetes register.
  • Adults whose latest HBA1C is high at 42-47 or a abnormal or impaired glucose result but they are not on either the Diabetes or non-diabetic hypoglycemia QOF registers. (Patients who are currently pregnant are automatically excluded from this search).
  • And finally patients who have an abnormal or impaired glucose result but who are not on the Diabetes or non-diabetic hypoglycemia QOF registers

These housekeeping searches should help practice ensure that their diabetic and pre-diabetic patients are picked up by QOF and therefore monitored appropriately.


The invitations folder can be used to invite your patients for a NDPP referral.  The folder uses the eligibility search ? For NDPP referral as >=18y + HbA1c 42-47 in last 12m + no NDDP activity as the parent population, and then displays searches for patients that require a first or second invitation and those that have already been coded with 2 invitations in the last 12 months.


Each of the three searches have a hierarchy of searches below them grouping patients into the best way to contact them:

  • By SMS (patients who have a mobile number and not opted out of being contacted by text)
  • By email (patients whose preference is to contacted by email)
  • By letter (patients who are not included in either of the above)
  • And a search including all patients in the relevant search.


These can be used to send text, emails or mail merge. If the practice prefers to do a mail merge for all patients it is recommended that the practice use the search including all patients.


If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk