The government has announced the first phase of a new evidence based NHS diabetes prevention programme, which will target up to 10 000 patients at high risk of developing type 2 diabetes.
The programme, a joint initiative between NHS England, Public Health England, and the charity Diabetes UK, aims to significantly reduce the number of people—estimated at four million—in England otherwise expected to develop type 2 diabetes by 2025.
Seven demonstrator sites have been chosen to test new ways to reduce the incidence of type 2 diabetes through intensive lifestyle change interventions. The programme will then be rolled out nationally from April next year.
The seven sites comprise clinical commissioning group areas and local authorities in Birmingham, Bradford, Durham, Herefordshire, Medway, Salford, and Southwark. The local schemes include initiatives on weight loss, physical activity, cooking and nutrition, peer support, and telephone and online support. Bradford City Clinical Commissioning Group, for example, will send a letter to everyone aged over 40 and to all south Asian patients over 25, inviting them to see their GP for an initial health check.
The programme aims to replicate the results of randomised controlled trials in Finland, the United States, Japan, China, and India, which have achieved reductions of 30-60% in the incidence of type 2 diabetes over three years in adults at high risk, through intensive lifestyle change interventions.
Simon Stevens, NHS England’s chief executive, announced the initiative in a speech at the Diabetes UK conference in London. He said, “It’s time for the NHS to start practising what we preach. For over a decade we’ve known that obesity prevention cuts diabetes and saves lives. If these results were from a pill we’d doubtless be popping it, but instead this programme succeeds by supporting people to lose weight, exercise, and eat better.”
Chaand Nagpaul, chair of the BMA’s General Practitioners Committee, welcomed the initiative, saying that it had potential. But he added, “We do need to ensure that this programme enables all patients to access appropriate preventive treatments and empowers clinicians to help design the correct services. It must also avoid producing any additional bureaucratic burden on GP services and the wider NHS.”
Public Health England is also working with Imperial College Healthcare NHS Trust on a £134 000 (€190 000; $200 000) weight loss pilot programme for NHS staff, which if successful will be rolled out nationally. All staff, including doctors, nurses, porters, and support workers, with a body mass index of ≥25 will be offered one of three weight management programmes.
Level 1 includes a 12 week group session delivered in local communities by the membership organisation Slimming World. Level 2 is a 12 week group programme delivered by the weight management company MoreLife within the hospital trust, which uses cognitive behavioural therapy to focus on each person’s relationship with food. Level 3 is for staff members with more complex medical needs and offers a series of one to one consultations by a consultant endocrinologist, a clinical psychologist, and a specialist dietitian.
The programme will be evaluated by measurement of dietary quality, physical activity levels, problematic eating behaviours, and quality of life, as well as the amount of weight lost.
Jonathan Valabhji, national clinical director for obesity and diabetes at NHS England, said, “The NHS and our staff are role models for patients, and while we all appreciate that losing weight can be hard, as with smoking, it can be done. As an employer the NHS needs to support our staff to try to achieve that.”
