The NHS and Public Health England (PHE) are today (12 March 2015) starting a major national initiative to prevent illness by unveiling the first ever at-scale National NHS Diabetes Prevention Programme.
Simon Stevens, NHS England’s Chief Executive, is to announce the move in a major speech at the Diabetes UK conference in London.
The programme, which is a joint initiative between NHS England, PHE and Diabetes UK, aims to significantly reduce the 4 million people in England otherwise expected to have Type 2 diabetes by 2025.
It is estimated that a big proportion of Type 2 diabetes could be prevented, and England will be the first country to implement a national evidence-based diabetes prevention programme at scale, delivering on the commitment set out in the NHS Five year forward view and PHE’s Evidence into Action last year.
Well-designed randomised controlled trials in Finland, the USA, Japan, China and India show 30 to 60% reductions in the incidence of Type 2 diabetes over 3 years in adults at high risk through intensive lifestyle change programme interventions.
If the national programme could replicate this success, it could save tens of thousands of lives in the future, and millions of pounds for the NHS.
Simon Stevens, NHS England Chief Executive, said:
It’s time for the NHS to start practising what we preach. The NHS already spends an estimated £10 billion a year on potentially avoidable illnesses, and the human toll is more than 100 amputations a week and around 20,000 early deaths every year.
Yet 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.
So today we commit to becoming the most successful country on the planet at implementing this evidence-based national diabetes prevention programme.
Duncan Selbie, PHE Chief Executive, said:
This innovative programme is putting ‘evidence into action’ on the ground. Despite Type 2 diabetes being largely preventable, 2.5 million people in England already have the disease with another 9.6 million at high risk of developing it and this cannot be ignored.
The new NHS Diabetes Prevention Programme will initially target up to 10,000 people at a high risk of developing Type 2 diabetes, with national roll-out thereafter.
Seven innovative ‘demonstrator’ sites around the country have been chosen to take part in the initial phase of the programme, during which they will see more patients, monitor and test their local programmes, and help co-design and implement the national programme. They are:
- Birmingham South and Central clinical commissioning group (CCG)
- Bradford City CCG
- Durham County Council
- Herefordshire CCG/local authority (LA)
- Medway CCG/LA
- Salford CCG/LA
- Southwark Council CCG
Their local schemes include initiatives on:
- weight loss
- physical activity
- cooking and nutrition
- peer support plus telephone
- online support from trained professionals
The diabetes ‘demonstrator’ sites will test innovative ways to pinpoint those people who have a high risk of developing Type 2 diabetes including for example via the NHS Health Check. In Bradford, for example, they have a programme to target everyone who is of South Asian origin and aged 25 and over.
These sites will be supplemented with a national framework procurement for these prevention services, and a Prior Information Notice will be issued this month to formally notify potential providers about this.
PHE is also working with Imperial College Hospitals where we have started a bespoke weight loss pilot scheme for NHS staff which could provide a blueprint for national roll out.
The £134,000 pilot scheme offers the Trust’s 10,000 staff an opportunity to access expert help from a range of dieticians, clinicians and the weight-management company MoreLife.
Barbara Young, Chief Executive of Diabetes UK, said:
We are delighted to be a part of the National Diabetes Prevention Programme and welcome the fact that people most at risk of developing Type 2 diabetes will be given the opportunity to help them reduce that risk. By making this investment now thousands of people over the next 12 months could successfully avoid or delay Type 2 diabetes and when this is rolled out nationwide the results could be even more spectacular.
This is a real step change in terms of highlighting the seriousness with which Type 2 diabetes is viewed and we feel this prevention programme is hugely significant. We hope this will also send a clear message that still more needs to be done going forward to help people lead healthy lifestyles from the beginning to the ends of their lives.
The NHS Prevention Programme Board, chaired by PHE’s Duncan Selbie, brings together the main system partners, and is responsible for the overall implementation of the prevention initiative set out in the ‘Five-year forward view’. A particular focus of this is on the National Diabetes Prevention Programme, including oversight of its design, piloting and roll-out. PHE commissioned 2 evidence reviews to support the development of the programme. These will be published in early summer 2015. The ‘Five-year forward view’ invited expressions of interest from commissioners to be part of the scheme, and the 7 successful schemes were picked from 41 applications by a panel of experts. They demonstrated they could show a number of important traits, including an ambitious vision for local change and a commitment to investing time and resources.
NICE guidance highlights the strong evidence base for diabetes prevention. The clinical case for this is therefore well established, but has not been piloted for scalability in England.
For broadcast or interview opportunities at Imperial or the ‘demonstrator’ sites, please call NHS England Media Manager Christina Jones on 07900 715 132
Important facts about diabetes:
- 2.5 million people in England have Type 2 diabetes
- it costs the taxpayer 10 billion a year – a tenth of the annual NHS budget
- 20,000 people with diabetes die early every year
- it is responsible for more than 100 amputations a week
- it is a leading cause of preventable sight loss in people of working age
- it is a major contributor to kidney failure, heart attack and stroke
- Type 1 Diabetes is an auto immune condition not related to lifestyle
- 90% of people with diabetes have Type 2 diabetes - they might get Type 2 diabetes because their family history, age and ethnic background puts them at increased risk
- people with Type 2 diabetes don’t produce enough insulin, or the insulin they produce doesn’t work properly (known as insulin resistance)
- people are more likely to get Type 2 diabetes if they are overweight
- Type 2 diabetes starts gradually, usually later in life, and it can be years before people realise they have it
- Type 2 diabetes is treated with a healthy diet and increased physical activity - in addition, tablets and/or insulin can be required
- although you can’t change some of the risk factors for Type 2 diabetes, such as age, ethnicity, and genetic link, you can lower your risk significantly by reducing weight, reducing waist size through eating less and/or healthier eating, and being more physically active
Photo by Tejvan Pettinger. Used under Flickr Creative Commons.