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Article History

Received: 10 November 2023

Accepted: 20 February 2024

First Online: 8 April 2024

Data availability

: Data from the National Diabetes Audit can be requested through the NHS Digital Data Access Request Service process at:

: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

: JV was the National Clinical Director for Diabetes and Obesity at NHS England from 2013 to September 2023. NH is funded by NHS England to use the National Diabetes Audit data to explore questions relevant to health policy. RY has been Clinical Lead for the National Diabetes Audit of England and Wales since 2003. DVC was clinical lead for diabetic foot services at Poole Hospital 2014–2017. CG was a member of the National Diabetes Footcare Audit Committee 2014–2021. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: JV conceived the pilot study and evaluation, and all authors contributed to the design and operational delivery. NH performed the analyses. All authors contributed to the drafting and critical review of the manuscript, and to the final approval of the submitted version. JV is the guarantor of this work and is responsible for the integrity of the work as a whole.