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:
- West London
- East and North Hertfordshire
- Norfolk and Norwich
- North East Lincolnshire
- North West Cheshire
- St Helens
- Cambridge and Peterborough
- Durham Dales
- South East
- East Midlands
Source: NHS England