Knowledge and confidence are a potent mix. That much has been made clear this morning, as new research from the Health Foundation shows that if people with long-term conditions are better supported to manage them, a staggering 436,000 emergency hospital admissions and 690,000 A&E attendances could be avoided entirely.
The findings confirm the conclusion I reached with Professor Mike Trenell of Newcastle University in 2015: that when people know what to do and they feel they can do it, they can achieve incredible things. It was on that basis that we founded Changing Health, delivering behaviour change programmes for people with Type 2 diabetes.
Many people with Type 2 don’t know how to properly manage their condition. There’s a wealth of information to take in, with too much misinformation online, and GPs rarely have enough time to give their patients much further guidance than a stack of leaflets.
But if we could give everybody with Type 2 diabetes a comprehensive understanding of diet, exercise and how lifestyle impacts on the condition – and then empower them to act on that understanding – the implications for public health are enormous.
The Health Foundation report makes a number of recommendations on how to achieve this: primarily health coaching, peer support and greater access to apps. All have been shown to improve patients’ PAM (Patient Activation Measure) scores, which predict an individual’s engagement with their health and healthcare based on over 400 peer-reviewed studies.
Indeed, a trial of Changing Health’s programme in the North West London Collaboration of CCGs found that personalised support for diabetes, including lifestyle coaching and digital education, results in a 10-point PAM increase – enough to boost patients’ score by one level (out of a total four).
According to the Health Foundation, if we can give just the lowest ability patients (level 1) the knowledge and the confidence to manage long-term conditions as well as those at level 2, we could prevent 504,000 A&E attendances, and 333,000 emergency admissions per year. That equates to 5% of all emergency attendances, and 6% of all emergency admissions in England each year.
On an individual level, we see this science in action every week as more people with Type 2 diabetes put their condition into remission. Once people know how, for example, complex carbohydrates affect their blood sugars, and they’re given a motivational boost on a regular basis, they’re often able to cut out the bread and the pasta - and begin reducing their HbA1c. It’s simply a matter of providing that support in the first place.
Fortunately, we’re seeing increasing recognition among healthcare providers that, as the Health Foundation points out, there’s a very broad spectrum of ability and confidence among people to manage long term conditions, and different approaches are needed accordingly. At the same time, technology is enabling the delivery of more personalised support for such conditions, improving patients’ self-efficacy in managing them and, as a result, living happier, healthier lives.
For Type 2 diabetes the outlook does, then, look promising. But diagnoses are still rising, and the clock is ticking. We must act fast.
Janice had Type 2 diabetes. She was stuck in some unhealthy habits - drinking four cans of coca cola a day, eating three-person portions of pasta, binging on pringles - and she needed help to make a change. In January 2018 she was diagnosed with an Hba1c level of 89, indicating a severe lack of glycaemic control.
And make a change is what she did. It began when, soon after her diagnosis, her GP referred her onto Changing Health’s Transform programme for diabetes management. Transform combines a course of digital education on diabetes with personalised behaviour change support from a lifestyle coach, and aims to give users the psychological tools to sustain a positive health behaviours over the long term.
She got off to a flying start. Kirsten, her lifestyle coach, was impressed; Janice had already begun prepping her meals in advance, swapping carbs at lunch for a healthier alternative, and dancing each night to an exercise routine - and lost a kilo in a week as a result. While it’s important to start with small changes, Janice felt she could do more, so Kirsten worked with her to set a clear, achievable short-term goal for physical activity: three brisk, 10 minute walks per day on the way to work, at lunchtime and on the way home.
By March, Janice had accelerated her progress, decreasing her portion sizes, increasing her fluid intake, cutting out crisps, swapping white bread for wholemeal and potatoes for sweet potatoes.
“She wanted to know more about the carb and sugar content of fruits and vegetables,” Kirsten says. “So I gave her a document about GI of foods and a link to a website that could be useful too. I told her carrots are quite high in GI and sugar, but they’re still vegetables and better than other things you could be eating!”
“I was very honest with Kirsten,” says Janice. “She was equally honest back, and without being judging - she was supportive and positive. I wasn’t very active - partly because I was ill and partly because of the weather, and we spoke about my frustrations with that. We discussed mini exercises I could do during the day.”
May rolled around, and it was time for another visit to the GP. There was some excellent news: Janice had reduced her HbA1c to just 55 in four months. She was well on the way to reversing her condition for good.
“I kept making swaps - I like to go to concerts, so I swapped beer for sparkling water. I haven’t touched Coca Cola, no red meat, no processed foods - I’m eating lots of fish, veggies, grilled halloumi. My partner enjoys the new diet too. I’d led him astray to be honest, but he’s just brilliant - he supports me every day”
The last time Janice and Kirsten spoke, in July, things were looking even better. Janice had reduced her HbA1c to 42 - meaning she no longer had diabetes! She’d now lost a total 14.8kg on the programme, and dropped two dress sizes to boot.
“Janice has been amazing throughout her journey on the Changing Health programme,” Kirsten adds. “She recognises that the changes she’s made are long-term lifestyle changes, rather than a short-term fix. She deserves this fantastic news!"
Does Janice have any advice for others in her position? “Be honest. That’s the key, that’s the tough thing. When I’ve been low, I’ve rung up Kirsten and beat myself up, but she looks at the bigger picture. She’s brilliant. I’ll miss her.”
Debra was in shock. A routine visit to a new GP had come with some unexpected news. “To be honest,” the GP told her, “It’s your diabetes I’m worried about.”
She’d had no idea she had Type 2 diabetes, and she didn’t know how to manage the condition either. Conscious of the waiting room filling with other patients, the GP began reeling off a list of actions Debra should take to keep things under control. “He was giving me all this information so quickly,” Debra says. “There was just too much to take in at once.”
“But I thought, there’s no way I’m living with diabetes for the rest of my life. I’m going to make a change. He offered to get me on the Changing Health app, and I started straight away.”
The Changing Health programme combines digital education, which breaks down guidance on diet and diabetes into a single straightforward course, with one-to-one support from a behaviour change coach.
Carl Lumsden, one of the Changing Health coaches, was assigned to support Debra. “She sounded a bit overwhelmed by all the information her GP had given her,” he says. “I suggested she take it in easy steps, focus on making manageable changes to her diet, and don’t do too much at once. It’s the smallest battles that win the war!”
Little swaps, it turned out, can make a big difference. Beer for gin and slimline tonic, pasta for brown cauliflower rice, fruit for vegetables and protein. Combined with some of Carl’s most tried and tested motivational techniques - setting SMART short- and long-term goals, writing them on post-it notes to leave around the house, involving others in lifestyle changes - soon Debra was seeing real progress. By the time of her second coaching phone call, she had lost a total of 8kg.
At the same time, Debra’s understanding of diabetes, diet and weight loss had rapidly improved. “The app was so helpful - I learnt so much about how my carbs affect my blood sugar - slow release carbs, fast release carbs - all kinds of things I had no idea about before. And Carl had the answer to all my questions, telling me what to google; every time, I had more questions, and he always had the answer!”
Three months after she began the programme, Debra visited her GP again - and there was news this time around too. Her diabetes was in remission.
“I did it!” she says. “Now I feel 100% better. Now I’m walking to the bus stop every day, tracking my steps, fitting as many into my job as I can. I’m about to go on a self-catering holiday, and I’m going to cook all my meals fresh so I can keep up my diet.
“Before, I was down in the dumps, sometimes I just felt like I couldn’t be bothered – I’m so much more energetic now! So I’ll keep it up for the rest of my life. I was so determined to get better. To anyone considering starting the programme, I’d say don’t be embarrassed and just give it a go – if you’re like me, then there’s a lot to learn – but that help is there for you.”
With a record 12.7 million people at elevated risk of developing Type 2 diabetes in the UK, the need to help people change their lifestyles en masse has never been more acute.
Patients already diagnosed with Type 2 are typically very aware of the need to move more and eat more healthily, but struggle to translate their intention to change into sustained action. People with prediabetes, on the other hand, can be more difficult for healthcare professionals to engage with a behaviour change intervention.
Their perception of risk is generally lower; the lack of any physical symptoms leads some to question whether they actually have a health issue and whether changes are required at all.
According to one study, people with prediabetes consistently underestimate their probability of developing Type 2; 84% considered themselves at low, very low or negligible risk. Indeed, many people with prediabetes only find out about their condition when they visit a GP with an unrelated issue, rather than on a regular check-up for diabetes as the NHS recommends.
Others are hindered by outcome expectancies. They recognise the need to change, but feel any attempt will be hopeless and so accept that they will simply remain in their current habits and that developing the condition is an inevitability. As food is perceived as a necessity for life, low outcome expectations can be further compounded by feelings of frustration and deprivation when healthcare professionals advise making changes to a dietary intake.
But digital DPPs, often dubbed “Prevention 2.0”, are addressing these challenges. By making support available on a smartphone or tablet, anytime and anywhere, digital DPPs are reducing the “hassle factor”, leading to significantly higher uptake; one digital trial in London’s Waltham Forest, for example, saw a 500% increase in just 14 days.
When a user can work through a DPP in their own home, in their own time, completion rates are much higher too, improving on users’ understanding of how prediabetes affects their health and increasing users’ risk perception of more serious health issues in the future if they don’t act on their healthcare provider’s recommendations.
Trials in behavioural economics have shown that when a complex goal, such eating more healthily, is broken down into a series of easier actions (eg eating five a day), outcome expectancies can be significantly improved. On a digital DPP, participants can set their own clear, achievable short-term goals and can refer back to them on their phone at any time, boosting motivation to sustain a healthier lifestyle over the long term.
Instant, one-click referral systems also reduce wait times between referral and access to just minutes - as opposed to weeks or sometimes months for a face-to-face DPP - minimising drop-offs as people become demotivated over time without support.
Digital DPPs therefore show serious promise in improving access to support - among even the hardest to reach groups - and overcoming the psychological barriers to sustaining lifestyle changes for people with prediabetes. As the NHS scales access to such programmes across the UK, turning the tide on diabetes has never seemed more possible.
Author, Holly Hart, MSc, is a qualified Health Psychologist and one of Changing Health’s lifestyle coaches. This article is based on real life case studies, including two users who achieved Type 2 diabetes remission in 10 weeks between April to June, 2018.
People with Type 2 diabetes usually know they need to make a change, and they have the motivation to do so. But their self-efficacy - that is, their beliefs about their capabilities to succeed - is often low; they perceive significant barriers preventing them from sustaining a healthier lifestyle.
There are, however, some useful techniques to help people with diabetes overcome the barriers to change and translate their motivation into action. Here are a few recommendations from my experience supporting people to better manage their condition:
1) Letting people know that good food can be cheap
Many people think fresh, “healthy food” is more expensive (it doesn’t have to be!), while others may be hampered by a lack of social support - often key to success. Some may worry that eating as a family may require the entire family to change their diet, and some may have been disillusioned by a lack of success when trying to make lifestyle changes in the past.
2) Making education simple
People with diabetes report that one of their biggest barriers to making the changes they need to is a lack of access to education and information. Those who do receive guidance from their healthcare provider often tell us that there was too much to take in, too quickly, and they ended up with only a limited understanding of how their condition affects them. We tend to provide links to websites and tell people what to search for online instead, so they can learn at their own pace in their own time.
3) Showing that dieting doesn't mean no food
A common misconception we find among people with diabetes is the idea that following a diet means cutting out your favourite food and getting up at 4am for an exercise class. In fact, the simplest lifestyle changes are typically the key to successful management or even remission of diabetes. The inspirational success stories you get to hear as a coach are testament to this approach, and communicating to patients that their lifestyle changes don’t need to be radical can transform their outcome expectations.
Debra, a Changing Health user who recently achieved remission in 10 weeks, did so by making only “little swaps”, like pasta for cauliflower rice, so a healthier diet didn’t feel like a chore to maintain. It’s also important to avoid warning people with diabetes about what will happen if they don’t make a change; research has shown this doesn’t work.
Instead, we find that listing the benefits of a healthier lifestyle can be much more effective, particularly those which impact the most on everyday life: improved cognition and memory, better concentration, reduced tiredness and feeling less out of breath when walking the dog or taking the children to the park. focusing on past successes (identifying and emphasising previous, successful attempts to initiate lifestyle change) has been linked to optimal care consultations and better clinical outcomes.
Pairing this with discussions about how to overcome barriers that have occurred in the past, or might come up in the future, enables the patient to think more positively about making a change and this positivity is key.
4) Setting achievable goals from the outset
Healthcare providers can also support patients on their journey towards a healthier lifestyle by encouraging them to set clear short, medium and long-term goals. SMART goals - specific, measurable, achievable, realistic and timely - keep patients focussed every step of the way and have been proven to be effective in improving outcomes.
If patients write these goals down, the chances of success are even higher - up to 42%, according to new research. Changing Health coaches suggest users write down their progress so far on post-it notes and leave them in prominent places around the house, boosting their motivation to keep going when times are tough.
5) Personalising the approach to support
Every individual is at a different stage in their behaviour change journey and so it’s important to take their unique circumstances into account. Ultimately, it’s about re-framing the conversation to focus on their own possibilities of success, rather than the consequences of failure, at every point of contact.
The biggest lesson I’ve learnt, though, is that while people with diabetes don’t often realise that transforming their health can be a straightforward process - once they do, they’re bound to surprise you.
Watch Sheinaz, a GP Practice Manager who achieved diabetes remission with Changing Health, tell the story of her weight loss journey in NHS Digital’s short film here: https://bit.ly/2v67fvR
Meet Sheinaz. She’s a GP Practice Manager in Gateshead, Newcastle, and she was largely sceptical of the power of digital interventions to help people Type 2 diabetes change their lifestyle and better manage their condition. Until she tried one out for herself.
On 13 January 2018, Sheinaz was diagnosed with diabetes. Her GP told her that her HbA1c level, an indicator of blood glucose control, was at 52. That meant her condition was under control - but only just. It was enough to motivate Sheinaz to begin making some big lifestyle changes, and when her GP offered to refer onto the Changing Health programme to help her do so, she accepted - albeit with some reservations about whether it would be of much use.
The programme comprises a course of digital education on diabetes to improve participants’ understanding of how diet impacts on their condition, combined with one-to-one lifestyle change coaching from an expert in health psychology and behavioural science.
“I was devastated to hear the diagnosis, absolutely devastated” she says. “I just thought, ‘I have a healthy diet, I do all the things I could possibly do, what more can I do?’ Going to a group session wasn’t really sustainable for me, and the other option was having a health app.
“When you’re being monitored by your GP practice you’re only seen once a quarter, so I thought having the app available will help me to maintain that consciousness of the long term condition I have, and it’s an alternative that actually works better than seeing your GP”
As Sheinaz worked her way through the programme, her preconceptions of digital health apps changed entirely. She was moving more. She had more energy. With a few pointers from her lifestyle coach on the best changes to fit her own circumstances, soon she was cooking tasty, healthy meals every day, building positive habits into her daily routine rather than treating weight loss as a chore. “I increased my physical activity on a daily basis using the app, and having my own personal health coach really helped too.”
It was a complete change of mindset for Sheinaz - and it paid off. In just ten weeks she had lost 18lb, or a little over 8kg. Then came more good news.
“I spoke to my GP on the phone. He said ‘you don’t have diabetes’ - I said ‘yes I do, I was diagnosed ten weeks ago!’ - and he said ‘well your blood sugars are normal; you’ve reversed your diabetes.’”
Sheinaz was ecstactic. And six months on from the original diagnosis, she’s living a whole new life. “In myself I feel better, my memory’s much better… I’m sleeping really really well, bouncing with energy, and bouncing with confidence. I love the diet and I’ve got so much energy as a result, and I’m still losing up to half a pound per week but I never feel like I’m on a diet.
The Changing Health programme was designed to empower users not only to adopt healthier habits, but crucially, to keep them up - for good. That looks promising for Sheinaz. As of mid-July, she’s now lost a total of 24lb and dropped two dress sizes.
“I can still use the app and the coaching sessions for another six months, but I don’t really need them; it’s become a habit now. I’m being creative about cooking, and I’m eating less carbs, but you know what? I don’t miss them at all.”
Type 2 diabetes can be reversed for some. The treatment is a single, straightforward one, inexpensive to prescribe and often effective in a matter of months. It makes, in many cases, conventional, costly diabetes medications redundant. It’s supported self management for weight loss. Through sustained, positive lifestyle changes, weight loss results in greater glycaemic control and can achieve complete remission, negating the need for medication entirely.
There is clear evidence that lifestyle change support can play a key role in making this happen. The DiRECT randomised controlled trial, enabled by Diabetes UK and published in the Lancet in December 20171, gained huge attention in the UK national press – with good reason. It showed that with the aid of a weight management programme, a staggering 46% (68 participants) reversed their diabetes. That compares to just 4% (6 participants) in the control group.
What weight management programmes don’t always take into account, however, is that any lifestyle intervention must address the underlying psychological drivers of behaviour for optimal results. To give people with diabetes the greatest chances of success, at scale, it’s essential to understand that human behaviours are the product of both intentional and automatic actions that are deeply embedded in the social, material and cultural context we live in1.
What we do in our day-to-day lives can be influenced by a whole host of factors: research shows social influences, social role and intentions and goals are three of the most important2, while ethnicity, gender, socioeconomic status and educational attainment are key too. Each can influence how people will respond to particular behaviour change techniques and ultimately, determine whether they will sustain lifestyle changes over the longer term.
This personalised approach is highly effective, perhaps best illustrated by BBC1’s How to Stay Young in 2017. The documentary followed the journey of Tina C, a Changing Health user, who reversed her diabetes in just 12 weeks with the support of her lifestyle coach. A year on, she remains diabetes and medication free.
Personalised support for people with diabetes, facilitated by digital, clearly goes a long way towards improving patients’ glycaemic control. There’s good news on this front; the NHS sees the value of such interventions and is taking big steps towards adoption at scale.
A significant proportion of the c.£44m Diabetes Transformation Fund, for example, has been earmarked for digital interventions, with Changing Health named as one of the four recommended providers. The new allocation could provide access to the most effective lifestyle change programmes for tens of thousands of people, to the great benefit of patients without strain on NHS professionals already working at or near capacity.
There’s an unmistakable air of optimism on the front line too; GPs, diabetes specialist nurses and support staff are recognising the power of personalised support to achieve diabetes remission. That recognition doesn’t go unnoticed by the commissioners responsible for trialling new innovations. Slowly, but surely, change is coming.
In July 2017, Tina C, a Fire Prevention Officer from Northamptonshire, achieved something incredible. She had been diagnosed with Type 2 diabetes two years earlier and needed medications to keep her blood sugars in check day by day. She was feeling lost, was struggling to keep a check on her diet, and things were getting worse.
Then came the call from the BBC. A second series of the hit documentary How to Stay Young was on the cards, and Tina had been selected to participate. If she was up for it, she would embark on a strict, 12-week diet and exercise plan supervised by Changing Health’s Professor Mike Trenell, with the aim of reducing her “real body age”. She would undergo extensive testing at four, eight and twelve weeks to assess everything from her weight and blood glucose levels to quality of sleep and cognitive function.
Tina accepted. The diet took some serious willpower; calories were reduced to just 800 per day, with each meal logged in the Changing Health app alongside Tina’s daily physical activity levels for her lifestyle coach to feed back on. It was a dramatic shift from Tina’s normal habits, but she kept it up.
Fast-forward 12 challenging weeks, and there was big news. Watched by millions across the UK on BBC1, Professor Trenell gave Tina the results from her final round of tests. Had she walked in and there and then, Professor Trenell told her, he wouldn’t say she has diabetes. He’d say she had diabetes.
She was gobsmacked. She had taken control of her health and transformed her life. And a year on, she’s kept it up. “It’s been a difficult year with some big challenges,” she says. “Sometimes your mind gets unfocussed, you end up comfort eating – in April I lost my way. It was the first time I’d felt like that, and it disappointed me.
“But then, 6-8 weeks ago, something reclicked; I’ve gone back to being strict with myself, logging my foods and exercise in the Changing Health app and re-reading the learning content. It’s really important to have the facts, because when you do you realise you’re in control. I reminded myself that my health is something I can change. It is possible.”
Perhaps the most drastic change in Tina’s lifestyle over the past year has been her meal choices. “I used to just load up on carbs, thinking they would fill me up – not realising that carbs actually turn to sugar in your blood! Now I’m eating a lot of vegan meals and plant-based foods… and sugar-free baking has changed my life! I use a lot a cacao in my cake recipes; it’s just a matter of getting your taste buds used to it.
“The recipes in the Changing Health app have been really useful too. All kinds of foods I didn’t even know about have become staples… Chia seeds, for one, have become a massive part of my life. I have to think of unhealthy foods as evil. I’ll allow myself a treat on very special occasions, for example I baked a normal cake for a 40th birthday, and I’m going to have a slice!
“I make sure that on 6 days a week I’m brilliant, so on the 7th day I can have a glass of wine or something a little naughty! My strategy is to picture my own long-term health. I keep a couple of pics on my phone of how I was before, just to remind myself.”
There’s no doubt that Tina’s husband’s support has been invaluable too; together they’re quite the team. “He gave up six months of his life to lose weight with me and support me through completely changing my diet and starting a regular exercise routine and if he can do it, I can too. I was having a tough time in April, and without him, I would’ve self-destructed. But now I feel so much better. You just feel more positive when your diet is good and when I’m healthy I get through things. I feel really different in how organised I am – literally just ticking things off my to-do list all day!"
“We’ve got two businesses that I help out with; and we always look for different solutions to get the energy we need for a long day without eating sugar. Planning is very important. I’m back down to 1000 calories temporarily so this morning, for example, I had chia seeds and soya milk, for lunch it was chickpea falafels and a green salad, and this evening we’ll have chicken fajitas without the wraps."
“Having the Changing Health app on hand is like having a little buddy in my pocket. When my husband isn’t there, it’s a constant reminder: what have I eaten this week? It’s engaging, nice to look at and the content is easy to understand."
“Ultimately, the power’s in your hands to change your health. I still can’t get my head around how I made that difference and changed my life. It’s not expensive, it’s not a lot of work, it’s just you and your mindset. If somebody gave you that chance, if somebody told you could do it – why wouldn’t you?”
Watch Tina’s moving account of her experience reversing Type 2 diabetes at www.changinghealth.com/cs2
Diabetes Professional Care 2017 brought record numbers of delegates to London’s Olympia conference venue, with over 3,000 healthcare professionals involved in the prevention, treatment and management of diabetes attending to learn about the latest developments in this area of care.
This November’s event looks certain to be an even bigger hit, and Changing Health is for the first time to become an event sponsor as well as an exhibitor. The sponsorship is another major milestone for Changing Health in what will be the company’s most eventful 12 months to date.
Changing Health will be presenting new data to inspire healthcare providers and commissioners, showing how personalised support for behaviour change can be highly effective in diabetes prevention and management, helping patients lose weight, lower their HbA1c and significantly reduce complications. The data supports the need for a new, highly personalised approach to diabetes care outlined in the company’s first White Paper, published in May.
Now in its fourth year, DPC quickly became a key diary entry for those looking to find new perspectives on diabetes care, according to Event Director Toby Baker. “We were acutely aware at the time that there wasn’t an accessible forum which provided free, high-quality, relevant information education to all those who come into contact with people with diabetes and related conditions, not just the specialists.
“We wanted to bring together all these people under one roof to share knowledge and best-practice whilst also easing the strain on a cash strapped NHS who cannot afford to fund expensive passes to events base. Our 2017 event was our biggest and best yet and we were delighted to welcome over 3200 visitors across the two days.”
A diverse range of delegates are expected to attend, including diabetes specialist consultants and diabetologists, hospital doctors, consultants, GPs, diabetes specialist nurses, diabetes CCG leads and commissioners. For those interested in lifestyle change interventions for people with diabetes, DPC2018 will feature a Prevention & Obesity in Practice track, one of eight in total, with highlights including:
Diabetes Professional Care 2018 will held on 14-15 November at Olympia, London and is, as ever, free to attend for all diabetes healthcare professionals. To register your interest, visit https://www.diabetesprofessionalcare.com/
NHSE names Changing Health as recognised provider for Transformation Funding in Digital Diabetes Education and Supported Self Management
Tuesday, 5 June 2018:
NHS recently announced that Diabetes transformation funded sites are now able to use up to 25% of their 2018/19 structured education allocations for digital self-management applications.
Changing Health has been highlighted as a suitable provider for this funding after successfully passing the NHSE technical assessment and being accredited by the independent body, QISMET.
Chief Executive John Grumitt said: “this announcement, in addition to QISMET accreditation, reinforces the importance of applying a robust evidence base to digital solutions. Our enhanced service provides the NHS with the most cost effective digital education and self management application available coupling this with personalised behaviour change coaching support.
“We welcome NHS England’s encouragement of commissioners to use accredited digital solutions to improve access to education that gives people with diabetes the support they want and need to make sustained improvements to their lifestyle to lose weight and improve their diabetes management.”
The funding will run until March 2019, and could provide access to digital education for tens of thousands of people. WIth detailed guidance from NHS England now confirmed, NHS commissioners are encouraged to apply for funds immediately
Changing Health Chief Executive John Grumitt is available for interview.
Jonathan Gwillim: email@example.com
Changing Health provides behaviour change programmes through evidence based digital education and lifestyle coaching for people with Type 2 diabetes, pre-diabetes and weight management issues. It offers the best value for money per unit change in HbA1c in the UK, improves patient satisfaction and can be deployed at scale, making better use of scarce health resources.
Today around 7% of people with diabetes attend education programmes: almost none receive sustained support. We remove access barriers and use techniques proven to improve clinical outcomes which in turn reduce spend on avoidable complications that consume 10% of NHS budget. Visit www.changinghealth.com/nhs to learn more.
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