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Major GP-led programme to reduce risk of diabetes in 20,000 people launches today

GPs will be at the forefront of a scheme to get 20,000 people at risk of diabetes to lose weight and take more exercise this year, as the first wave of the Government’s flagship diabetes prevention programme gets underway.

NHS England said the programme - which has been piloted in seven ‘demonstrator’ sites since last year - would be rolled out in 27 areas of England starting today at a cost of £7m for the first year and covering around half of the population. Patients will be identified by their GP, who would refer them for the scheme, or via NHS Health Checks.

In the first year, NHS England is targeting 20,000 people going through the scheme, which will see patients offered 13 education and exercise sessions lasting 1-2 hours over a nine-month period, 16 hours of which must be face-to-face or one on one.

NHS England said it aims for 100,000 people to have gone through the programme by 2020, with 100,000 coming through every year after that when it is rolled out nationally.

NHS England has previously said there would be ‘contractual targets’ to get GPs to offer the service but these are unlikely to materialise this year after contractual negotiations have concluded.

Asked whether there would be any additional funding for practices for identifying patients for the scheme, NHS England said that it was not expected to pose any increase in cost to GP practices as they would not be expected to do any active case finding in the first year.

A spokesperson said: ’Generally GPs will not incur additional costs – this is about putting in place a referral route for them.’

As previously reported, GPs are set to screen tens of millions under the new programme, as public health officials claimed as many as five million people in England are at high risk of developing type 2 diabetes and should be referred for exercise and dietary advice.

GPs will expected to refer patients found to have ‘non-diabetic disglycaemia’ – defined by a HbA1c level of 6.0% to 6.4% - for the lifestyle interventions.

But NHS England and Public Health England have been warned that mass-GP screening of patients risks boosting prescribing of diabetes medication without tackling the root causes behind the rising rates.

An article published in the Lancet last year also warned the programme risks ‘exaggerating’ expected reductions in diabetes from planned lifestyle interventions - which include Zumba and cooking classes on prescription - and called for more efforts to build physical activity into people’s everyday lives as well as tighter restrictions on sugary foods.

NHS England chief executive Simon Stevens said the scheme is being rolled out in response to diabetes ’already costing the country more than we spend on the police and fire services combined’, at a cost of £10m annually.

He said: ’By offering targeted support for at-risk individuals, the NHS is now playing our part in the wider campaign against obesity… The benefits for patients will show up as hospitalisations prevented, strokes avoided and amputations averted.’

Public Health England chief executive Duncan Selbie said that the ‘personalised, tailored programme’ would prevent people from ’developing what is potentially a life-threatening condition’ which is ’one of the biggest health challenges of our time’.

RCGP chair Dr Maureen Baker welcomed ‘whatever can be done’ to prevent type 2 diabetes but added that GPs have learned, through their work in lifestyle interventions, that helping people change their lifestyle is ‘not enough’ and often dependent on other factors such as ‘socio-economic status and deprivation’.

She said: ‘The sort of long term behaviour change we need to see is hard to inspire and requires our patients to have ongoing support and access to help over time, so we hope that this initiative will facilitate this in a way that helps them and the health service as a whole.’

The 27 areas in the first wave of the programme are:

  • Newham
  • West London
  • Camden
  • Southwark
  • Essex
  • East and North Hertfordshire
  • Berkshire
  • Herefordshire
  • Norfolk and Norwich
  • Birmingham
  • Dudley
  • Worcestershire
  • Leeds
  • Derbyshire
  • Cumbria
  • Rochdale
  • North East Lincolnshire
  • Oldham
  • Sefton
  • North West Cheshire
  • St Helens
  • Bury
  • Cambridge and Peterborough
  • Sheffield
  • Durham Dales
  • South East
  • East Midlands

Source: NHS England

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Readers' comments (16)

  • "GPs will expected to refer patients found to have ‘non-diabetic disglycaemia’ – defined by a HbA1c level of 6.0% to 6.4% - for the lifestyle interventions."

    Reassuring to see they are up to speed on the latest HbA1c testing..........

    Where is the evidence? NHS Health checks all over again?

    Regards
    Paul C

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  • Vinci Ho

    We do this in here simply because we are funded to do so via a local GP specification scheme. Not sure it is easily practical in other parts of the country depending on the CCG.
    The category is really to replace the previous labels, 'impaired glucose tolerance , IGT, and impaired fasting glucose ,IFG'. Some older literatures call it pre-diabetes . We are required to code it as impaired glucose regulation (IGR) in records for HBA1c of 42 -- 47mmol/mmol. And they are to be referred to a health trainer who had training on IGR.
    Interesting , a local survey done on patients before the launch, most preferred to be called and labelled as 'borderline diabetes',

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  • I understand that CCGs will have to find resources for GPs to be involved in this. Remember ' no new work if no new resources'

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  • The CCGs don't yet know what they will be paying for this, but we're announcing on breakfast TV again. FUBAR.

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  • Peter Swinyard

    Oh goody goody. I was sitting here at my desk thinking "what can I do today that I didn't have to do yesterday?"
    Whatever the merits of this, this is a population health altering programme and should be in the remit of the public health departments. No doubt they can screw the names of the potential victims out of our computer systems. Nice of RCGP to be so supportive to this unevidenced initiative by the way.
    And if anyone says "GPs are ideally placed to....."

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  • If GPs don't want to do it, give the funding to Pharmacists - we'll be more than happy to do it

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  • Steve Eggleston 11.33 - There is no funding.

    Oh, wait a minute, you are a pharmacist so there will be funding.

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  • My kids are allowed a mcdonalds lunch about once a month when they go to the cinema. It costs me less than £10 for 3 kids meals - the cheapest meal I buy them.

    This is the cause of the problem.

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  • LOL!
    we have no community dietetic support in south Essex for our patients with diabetes yet some how we can find them for patients who have developed it yet!
    And who runs the asylum now I wonder

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  • What advice will they give ? Diet and exercise obviously, but what dietary advice will they give ?

    All the time they advocate a low fat diet full of starches, even if they are unrefined, the problem will get worse. The advice should be to eat protein plus vegetables, and only a small amount of whole fruit.

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