To receive an update on diabetes prevention. (25 mins)
Julie Hotchkiss, Interim Consultant in Public Health and Jenny Wilson, Diabetes Prevention Programme Coordinator, West Berkshire Council, provided an update on diabetes prevention.
During the discussion of this item the following points were made:
· Julie Hotchkiss explained the difference between Type 1 and Type 2 diabetes. In England there were currently 3.8million people with Type 2 diabetes with a round 200,000 new diagnoses each year.
· Obesity was fuelling a rise in Type Diabetes. Members were advised that if trends persisted 1 in 3 people would be obese by 2034 and 1 in 10 would develop Type 2 diabetes.
· Members were informed that an individual’s ethnicity could have an impact on their Type 2 diabetes risk. For example, the South Asian population living in the UK were up to six times more likely to develop Type 2 diabetes than that of the white population.
· Members were informed of the Public Health England programme, Healthier You, an NHS Diabetes Prevention Programme. Weight loss, healthier eating and exercise could help to reverse the diabetic trend. On average participants lost half a stone.
· Julie Hotchkiss highlighted some of the reasons why many people were becoming fatter.
· Jenny Wilson explained that the Healthier You Programme was a joint ambition of the NHS Five Year Programme and Public Health’s Evidence into Action. It identified those at high risk of Type 2 diabetes and referred them to a behaviour change programme. 100,000 places would be made available across the country by 2020. In 2016 Berkshire had been identified as a ‘Wave 1’ site.
· The long term aims of the programme were: to reduce the incidence of Type 2 diabetes; to reduce the incidence of complications associated with diabetes (heart, stroke, kidney, eye and foot problems); and over the longer term, to reduce health inequalities associated with incidence of diabetes.
· Step 1 of the programme was to identify eligible patients. Patients had to be over 18, registered with a GP in Berkshire and have a HbA1c between 42-47 mmol/mol (6.0%-6.4%) or Fasting Plasma Glucose between 5.5-6.9 mmols/l within the last 12 months. Patients could not be pregnant, housebound or have had a previous diabetes diagnosis.
· Step 2 was to invite patients to join the programme. GP practices were paid £1.50 per invitation letter sent.
· Patients were required to make a commitment to a 9 month 4 stage programme.
· Jenny Wilson outlined the different stages of the programme.
· Members noted information regarding the number of referrals by practice. All GP practices in Wokingham had engaged except Loddon Vale. Jenny Wilson explained that there had been less referrals in May and June as the provider had changed in May and this had been a period of transition.
· Jenny Wilson highlighted progress made to date both nationally and locally. There had been 4092 referrals across Berkshire and 1900 Initial Assessments had taken place. Of this there had been 1750 referrals in Berkshire West with 956 Initial Assessments. 422 referrals had been made in Wokingham and 218 Initial Assessments had been carried out. The mean weight change at 6 months in Berkshire West was -2.5kg.
· In response to questions from Councillor Richards, Julie Hotchkiss commented that Type 2 diabetes could be reversed if a strict lifestyle change was maintained. Whilst thinner people could have Type 2 diabetes it was more often associated with those who had higher body fat levels. Public Health England did not have a population wide diabetes screening programme in place and focused more on raising awareness of symptoms.
· Diabetes UK had an online tool which people could use to assess their own diabetes risk.
· Councillor Jones asked which of the group sessions people tended to prefer. Jenny Wilson indicated that this varied. When patients first joined the programme they were asked when they would like to attend sessions. There were currently no evening or weekend sessions. Jenny Wilson stated that she was currently working on the reprocurement of the service and contract specification. The provision of sessions outside of working hours for those who wanted them would be built into this.
· Councillor Jones went on to ask how many people dropped out over the seven sessions and for what reason. He was informed that the reason people dropped out varied but it was quite a long programme. Evidence suggested that 9 months was required to see a real difference. Numbers attending decreased over time.
· Councillor Jones asked how the programme differed from the X-PERT Diabetes programme and was informed that whilst they had similar content they were delivered in different ways. The recommissioned service would have more around digital involvement to make it easier for patients who found it difficult to attend sessions.
· Councillor Loyes asked if there was a waiting list for the Healthier You programme. Jenny Wilson stated that there was a small waiting list but that it was reducing quickly.
· Councillor Croy asked why a number of GP practices were no longer delivering NHS Health Checks. Julie Hotchkiss indicated that the delivery of the NHS Health Check programme was the responsibility of Public Health. Five GP practices continued to provide NHS Health Checks. In addition it had been written into the contract of the new leisure provider, Places Leisure, that they could also deliver some NHS Health Checks. Members were assured that the leisure provider would have the relevant health service software to enable this.
· Councillor Haines asked about what was being done to help diabetics who also had a long term condition which made managing their diabetes more difficult. Julie Hotchkiss stated that there was the Sports and Leisure GP Referral Scheme and the long term conditions gym but that this issue could be looked at in more detail at a local level.
1) the update on diabetes prevention be noted;
2) Julie Hotchkiss and Jenny Wilson be thanked for their presentation.