Diabetes Processes of Care Toolkit

This toolkit has been developed after consultation with the Diabetes Managed Clinical Network (MCN) and to support practices to undertake quality improvement work related to Diabetes as part of the 2025 Lothian Local Enhanced Services review.

For adults living with diabetes, there are nine processes of care that should be checked on an annual basis – these are HbA1c, BP, weight, smoking status, screening, renal function, albuminuria, cholesterol, retinal and foot screening.

Albuminuria testing and foot screening remain the two most challenging areas, and this approach supports primary care teams to improve systems and monitoring to help prevent diabetic complications.

The resources included are guides for how to implement this work in your practice, but they should be adapted so that they best suit and reflect your practice’s environment and context. You can contact us if you require any support in using them. 

Please let us know if you implement this toolkit within your practice. Feedback is welcome.

Please save the toolkit to your computer so that you do not need to download it multiple times.

Toolkit version 1.6, January 2025