August 2026 - Letters for Diabetes Prevention - Error

Dear all,

I’m sorry to inform you that we’ve come across an error in a clinical report used to generate letters regarding diabetes prevention. This means that some patients may not have been sent a letter regarding their risk of getting type 2 diabetes and advising them to access the diabetes prevention programme (NDPP).

The fault occurred many years ago when I mistakenly used the code “Non-diabetic Hypoglycaemia” instead of “Non-diabetic Hyperglycaemia” in a clinical report. It has impacted letters that should have been sent when a patient had initially been diagnosed with NDH. The issue came to light yesterday. We’ve obviously fixed the issue and investigated extensively. We’ve built reports under Welby Innovate Pathology / HbA1c that can be used to review patients who may have been affected:

• The reports include patients who have been coded with NDH since December 2022 and at other practices. Many practices will find that these reports mainly contain patients coded with NDH long before working with us.
• We’ve excluded patients from review if they’ve been offered the diabetes prevention programme (based on codes), were previously diagnosed with Pre-diabetes, IGT, Gestational diabetes etc, or if they’re now in the main HbA1c reports to action.
• Patients who’ve had a HbA1c in the pre-diabetic range (42-47) in the last 12m, and are still eligible to be referred, are in the reports where we’re suggesting you may want to bulk message patients to offer the diabetes prevention programme. We’ve produced a letter that simply states that they’ve had a previous result that shows they’re at risk of type 2 diabetes and how to access the programme. You can use this letter or create your own version if you’d prefer.
• Of those who aren’t eligible…
  • Some will have since had a lower HbA1c and so whilst still coded with NDH, in the QOF register and invited each year, they’re not currently entitled to access the NDPP.
  • Some may still be in the pre-diabetic range but it may be more than 12m since their last HbA1c. These patients should be invited around their birth month as per normal recall. If they’re still in the pre-diabetic range at that time, they should receive offers to take part in NDPP.
  • A few may have gone on to develop Type 2 diabetes and so be managed through existing pathways
  • There will be still other patients who aren’t eligible to take part in the programme, e.g. >80y and only eligible to take part if assessed as appropriate by a clinician

You may want to breakdown these reports to only focus on those who’ve had results processed since using our system, or it may be a useful opportunity to invite other patients who may have never received information re NDPP.

As well as carrying out our own SEA regarding the incident, its also prompted us to look at the information we send to patients who have results in the pre-diabetic range but aren’t eligible to take part in the programme. This can also include patients who’ve completed the programme in the past. We’re planning to add this kind of message into the system.

Thanks again to the practice who flagged the issue; we really appreciate you letting us know if things don’t appear right. Some of these issues are very difficult to pick up and identify. We’re also continuing to build additional checks in the system to hunt for any potential issues. If you haven’t recently, please do take a minute to run the system checks reports on your practice in the folder Welby Innovate Pathology / 9 System Checks, and let us know if any patients appear in those reports.