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Step 5: Measure the impact of change

Commissioners need to know if services are delivered as they are commissioned, and whether service changes are delivering improvements to outcomes and NHS cost reductions.


The National Diabetes Footcare Audit enables commissioners and providers to measure the performance of their diabetic foot services against NICE clinical guidelines. The audit produces annual reports looking at structures, processes and outcomes.  


If your footcare service has not yet registered to take part in the NDFA, instructions for participation are provided here

Information on the quality of care at ICB-level can be found in the 'Your Local Area' section of this website. Further information is available in diabetes footcare profiles. 

Local areas will often need additional data, and service change can offer the opportunity to introduce Key Performance Indicators for robust data collection along the pathway.



In North West London, a foot care dashboard has been created. The aim is to provide weekly data at patient-level from all providers of diabetic foot care, enabling commissioners and providers to monitor quality, identify and solve problems in the pathway, and measure costs and savings.

Dr. Raquel Delgado is a GP and diabetes commissioner in Hounslow.

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