NHS England’s Diabetes Prevention Programme is placed under the spotlight by Open Access Government
NHS England’s Diabetes Prevention Programme takes a personalised approach to tackling one of the biggest challenges facing the health service. The statistics on diabetes in England are stark. Type 2 diabetes, where the body doesn’t produce enough insulin or the body’s cells don’t react to insulin, affects around 3.5 million people, accounting for nine out of 10 of all cases of diabetes.
One in six patients currently in a hospital has diabetes and dealing with the condition and its potentially devastating complications, which can include sight loss, limb amputation and being a contributing factor to kidney failure, heart attack and stroke, costs over £6 billion every year.
Type 2 diabetes is closely linked to obesity and a lack of exercise – poor diet and being overweight are all risk factors for developing the disease. There is, however, strong evidence that onset can be delayed – or stopped – through a range of lifestyle changes.
Speaking at Diabetes UK’s Professional Conference in March 2018, NHS England chief executive Simon Stevens said: “Obesity is the new smoking and the scale of our response needs to match the scale of the crisis.”
Part of this response has seen Stevens order hospitals to remove super-sized chocolate bars and sugary stacks from shops, as well as the launch of a voluntary scheme for NHS trusts that aims to reduce sales of sugary drinks to 10% or less of sold beverages. Some trusts have banned sugary drinks altogether. During the last two years, NHS England, which every year distributes £100 billion in funding to commission health services, has also been rolling out the Healthier You NHS Diabetes Prevention Programme to help those at high risk of developing Type 2 diabetes reduce that risk – and potentially avoid diabetes altogether – through face-to-face support. Personalised interventions can include education on lifestyle choices, such as drinking less alcohol, advice on how to reduce weight through healthier eating and bespoke physical activity programmes.
The NHS Diabetes Prevention Programme is the first nationwide initiative of its kind in the world. In December 2017, the first set of analyses of the programme showed it had exceeded expectations.
Between June 2016 and March 2017, it received 43,603 referrals – 16% higher than forecast. Attendance for men, for people from black, Asian and minority ethnic (BAME) groups and for those from the most deprived areas, suggest the programme had reached both those at greater risk of developing Type 2 diabetes and those typically less effective at accessing healthcare.
Subsequent analysis by NHS England and Public Health England showed that another 70,000 people have been referred since March. In March 2018, Simon Stevens provided the Diabetes UK conference with a further update. In the 21 months of the rollout, more than 154,000 people had been referred, with around 66,000 people taking up places.
Just under half of those signing up were men – a much higher proportion than typically attend weight loss programmes. Roughly a quarter were from BAME backgrounds, who are at significantly greater risk of developing Type 2 diabetes. The programme had also launched digital support to patients, with around 5,000 people benefiting from a pilot project to test a range of apps, gadgets and wristbands. In 2017-18, NHS England invested around £42 million to advance care and treatment for diabetes patients and Stevens confirmed a further £40 million for 2018-19.
This will help to fund an additional 94,000 education places a year, up to 864,000 extra interventions a year for individual patients, 185 additional staff for new or expanded foot care teams across 80 hospital sites and 96 additional inpatient specialist nurses and related staff.
In a blog to mark the start of Diabetes Prevention Week (April 16-22), Professor Jonathan Valabhji, National Clinical Director for Obesity and Diabetes at NHS England, said Wave 3 of the programme would launch that month, achieving full national coverage.
In addition to exceeding to initial targets for referrals and equity of access, Professor Valabhji said the first sets of encouraging weight loss results are starting to emerge.
“So far, well over 50% of people have completed the flagship scheme in terms of attending at least eight support sessions over a nine-month period – losing an average of 3.3kgs,” he wrote.
“However, when excluding those who already had normal weight and BMI but [are] on the programme due to other health and lifestyle risks associated with developing Type 2 diabetes, this average weight loss figure is 3.7kg, 1kg higher than we had predicted at the outset.”
He also revealed that nearly 1,400 people had been referred to the digital arm of the programme in its first two months, with more than 820 logging on and accessing diabetes and obesity prevention services.
“Behaviour and lifestyle change is a challenge for us all but for those with diabetes and at risk of Type 2 diabetes, it takes on an even greater focus,” Professor Valabhji wrote.
“By putting people in control of their health, the programme is helping to improve the outlook of thousands of people and hopefully next year, this will add up too many more thousands as the gift of technology extends our horizons.”
Open Access Government
editorial@openaccessgovernment.org
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