You are asked to lead a local needs assessment on rising type 2 diabetes rates in a diverse urban population. Talk me through, step by step, how you would design the assessment, including data sources you would use (quantitative and qualitative), how you would address health inequalities, and how you would ensure the findings are robust enough to inform commissioning decisions.

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I’d start by agreeing the key questions with the ICB and local authority: incidence, late diagnosis, complications, and where inequalities are most pronounced. Quantitatively, I’d use QOF, NCRAS, HES, GP extraction, NHS Health Check data, and PHE Fingertips, analysing trends over 5–10 years, with breakdowns by age, sex, ethnicity, deprivation quintile, and ward. I’d map prevalence against factors like obesity, housing, and food environment using GIS. In parallel, I’d run qualitative work: focus groups and interviews with about 60–80 residents from priority ethnic groups and high‑risk estates, plus clinicians and community leaders, using community researchers where possible. To ensure robustness, I’d pre‑specify methods, use multivariate regression to control for confounders, and triangulate findings across datasets. Draft findings would be tested at a stakeholder workshop and with our Healthwatch panel. The final output would include clear, costed options with estimated impact on the 10‑year gap in control rates between least and most deprived groups.

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