By Rachel Pugh
The NHS Diabetes Programme is launching a new online platform to provide adults with Type 2 diabetes the skills better to self-manage their condition by improving access to high quality online education.
National Clinical Director Diabetes and Obesity, Dr Jonathan Valabhji gave GPs at the RCGP Conference 2019 in Liverpool results of the NIHR-funded trials of five different versions of the online package, Healthy Living, which have taken place in nine health economies around England.
They showed that patients with Type 2 diabetes making use of the online courses and information achieved:
* Reduction of their HbA1c of 1.6mmol/mol after 6 months
* Weight loss of 4.5% per patient for those followed up after 6 months
* Reduction in distress in newly diagnosed patients.
The evaluation to date (1) also indicates that Healthy Living produces cost savings of £111 per patient in use of NHS services, compared with patients not using the platform, and nearly 70% of referrals to the site lead to registration, compared with the 7-8% of patients who take up face-to-face education packages.
Dr Valabhji told GPs at the RCGP Conference 2019 in Liverpool: “Supported self-management is key to preventing complications and improving health outcomes. This is the only gold-standard, randomised controlled trial, evidence-based digital intervention in the Type 2 diabetes space.”
Work is now in progress to review and examine the technical product and to test it with 5,000 users in 11 sites in NHS settings in April 2020 as well as to develop an implementation tool kit in order to roll it out nationally, free to all CCGs from 2020.
More than 3.2 million people in England have been diagnosed with diabetes - around 90% of them suffering from Type 2 - but around 11 million more are estimated to be living with their condition undiagnosed. Approximately 10% of England’s health expenditure (£11 billion a year) goes on diabetes, most of which represents costs to the NHS of dealing with preventable complications.
Structured education following diagnosis is recommended by NICE and incentivised though Quality Outcomes Framework (QOF), but despite high referral rates (78%) only 7-8% of patients take up face-to-face education sessions.
The advantages of the online platform are greater accessibility for people working and with family commitments, a more appealing experience for patients not attracted by face-to-face education and a highly scalable potential at low cost.
Work is now underway to review and test the product with users and to review referral pathways, as well as to develop an implementation tool kit for a launch in 2020.
Healthy Living is based on HeLP Diabetes - an online self-management support programme developed by University College London. Its content will include food, lifestyle, smoking cessation, psychological wellbeing and physical activity. Progress is also being made to streamline its functionality.
GP and the Vice-Chair of Luton CCG Dr Chirag Bakhai. who also acts as clinical advisor to the NHS Diabetes Programme, said: ‘Ideally, every single person with diabetes will soon have access to structured education in this form.”