Barriers to Yearly Diabetic Retinopathy Screening Attendance: A Retrospective Clinical Audit

Diabetic retinopathy is the most common sight-threatening complication of diabetes, necessitating regular monitoring of progression via diabetic eye screening (DES). The National Institute for Health and Care Excellence (NICE) recommends DES annually for diabetic patients aged 12 years and older. This retrospective clinical audit assessed the reasons behind non-attendance and evaluated the adherence to guidelines set by NICE in a general practice with approximately 9000 patients.  The SystmOne patient database was used to identify patients who had missed DES in the last 15 and 36 months, with the latter being categorised as 'repeat non-attenders.' A survey of every third patient who missed screening in the last 15 months highlighted mental health issues, lack of DES awareness, and transport difficulties as primary reasons for non-attendance. The DES uptake rates recorded at the practice were 77.2% (n=465) for the 15-month cohort and 83.6% (n=503) for the 36-month cohort, exceeding the NHS DES target of 75%.  Proposed interventions to increase attendance to DES include telephone prompts for patients with mental health concerns, text message reminders, and online educational tools to improve uptake. Despite standards exceeding the national guidelines, this audit demonstrates the importance of addressing specific barriers to enhance screening rates, potentially increasing the detection of early retinopathy and improving patient outcomes.