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GP diabetes prevention programme ‘will reduce workload’

Exclusive GPs will see a reduction in their workload in the long run as a result of their participation in the national diabetes prevention programme, the head of public health services in England has insisted.

Public Health England (PHE) chief executive Duncan Selbie insisted the evidence shows that the programme – which will see GPs screening millions of patients and referring those at risk for lifestyle interventions – ‘could avoid almost a quarter of [pre-diabetic] people going on to develop diabetes’.

This is despite some experts warning the programme will not work because it is too dependent on a clinical approach based around GP practices, and may result in over-medicalisation.

Speaking exclusively to Pulse at PHE’s annual conference, Mr Selbie said the programme was vital to putting the NHS on a sustainable footing for the long term and GPs would see a benefit from reducing the burden of diabetes.

He said: ‘We can save the NHS money, but more importantly we can save the NHS and general practice some workload by trying to avoid things in the first place.’

Mr Selbie added that PHE and NHS England would be piloting different approaches ‘to learn how we can do that over the next 12 to 18 months’ and that ‘general practice is crucial to that’.

And he indicated GPs should take responsibility for guarding against any potential over-medicalisation.

Mr Selbie said: ‘I’m confident GPs – as they always have done – will follow best practice, so we hope they’ll be very cautious about the overmedicalisation concerns.’

The PHE chief also insisted public health advisors were putting pressure on the Government over the wider determinants of diabetes and obesity – including the food industry – but that there was not enough evidence yet to support doctors’ call for a 20% tax on sugary drinks.

Mr Selbie said: ‘We recommended… the proportion of our nutritional intake from sugar should be halved, to 5%. This is a monumental moment for the Government, which has accepted this as a new standard.’

He added: ‘Evidence suggests the most important [approach] is reformulation of food. There are countries that have looked into price but there’s little published evidence about its effect.’

Mr Selbie defended the Government’s flagship NHS Health Check programme, which has continued to be dogged by poor uptake and critics’ claims it is wasting resources and widening health inequalities since PHE relaunched it two years ago.

The RCGP recently called for the programme to be scrapped altogether, but Mr Selbie insisted the evidence shows it is identifying and treating many more at-risk people than previous opportunistic approaches and closing gaps in treatment between rich and poor.

And he dismissed claims that PHE is blindly following political will by forging ahead with the programme whatever the cost.

He told Pulse: ‘We have a research strategy for the programme and, of course, if evidence came through – not just a view or an opinion – then we would rethink the programme.’