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Over 100,000 patients referred to flagship diabetes prevention programme

GPs have referred 110,000 patients to NHS England’s Diabetes Prevention Programme since its launch in June 2016 but 55% have failed to attend the programme after referral, according to data from NHS England.

The data, released alongside a study published in Diabetic Medicine, revealed that 43,603 patients were referred to the programme between June 2016 and March 2017, with an additional 70,000 referrals since March.

An NHS England statement added that of those referred, 50,000 took up places on the programme in the last 18 months – 5% more than their 40% target.

The report adds that a quarter of attendees are from black, Asian and minority ethnic communities, which are at significantly greater risk of developing type 2 diabetes.

Professor Jonathan Valabhji, NHS England’s national clinical director for obesity and diabetes, said the new figures ‘are positive’ and ‘clearly showing that the programme is reaching those that need it most’.

NHS England also told Pulse that emerging data from the scheme suggests that people are reducing weight as a result of participation and hence reducing their risk, adding that further data will be published as more people complete the programme.

This comes as a study released earlier this month found that type 2 diabetes can be reversed following an intensive weight management programme, with remission is a ‘practical target for primary care practices’.

Dr Andrew Green, clinical and prescribing policy lead for the BMA’s GP committee, said that there is increasing evidence ‘that intensive treatment of lifestyle factors can be beneficial for patients with type 2 diabetes or HbA1c readings in the 42-47 range’. 

But he added: ‘We remain concerned that there has been no provision made for properly resourcing practices for the work entailed in following up these patients.

‘This activity is screening for the development of disease in an at-risk population rather than the treatment of disease itself and so does not fall within General Medical Services, and should be separately commissioned.’

NHS England launched the programme in June 2016, which encourages GPs to target people with ‘non-diabetic dysglycaemia’ who are at high risk for diabetes and refer them to intensive lifestyle change programmes, involving group activities like cookery and Zumba classes.

NICE recommended in September that GPs be incentivised to refer patients to the scheme, after Pulse revealed that by the end of January 2017 just over 7,000 of the 20,000 places for patients on the programme had been filled.

What is the Diabetes Prevention Programme?

Under the national ‘Healthier You’ diabetes prevention programme GPs have been encouraged to target people who are at high risk of developing diabetes and refer them to intensive lifestyle programmes with activities like cookery and Zumba classes.

Launched in 2016 by NHS England and Public Health England, the scheme piloted at seven sites and rolled out to a further 20 sites this year.

The programme has come under criticism from some GP experts for potentially over-exaggerating the potential benefits of intensive lifestyle intervention in ‘real world’ patients, who may be less able or motivated to take up exercise and change their diet than trial participants.

Early evidence suggested the impact has been limited with uptake disappointing in demonstrator sites for the programme – although some have pointed to the role of GPs, with uptake of up to 60% in places where GPs were highly proactive in chasing people

The scheme aims to achieve full national coverage next year, with as many as 200,000 people referred and 80,000 on programmes in 2018/19.

Official figures presented by Diabetes UK at their annual conference in May showed that by the end of January GPs had referred 25,687 at-risk individuals to the programme, against a target of 24,605. Pulse however found that patient participation in the programme was struggling in terms of actual uptake, with only 7,232 of 20,000 places filled.


          

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