Digital works: how a new approach could save billions in Type 2 diabetes treatment

Changing Health discusses how to improve diabetes care at scale with DPC2017 speaker Tony Willis, Clinical Director for Diabetes at the North West London Collaboration of CCGs.

Type 2 diabetes prevention is climbing rapidly towards the top of the public health agenda as an estimated 4 million people now find themselves living with the condition. That figure is expected to rise to a record 4.9 million if current trends continue.

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This is a seriously alarming prospect for CCGs. Current NHS spending on diabetes care totals around £10 billion per year, with over 80% going towards treating avoidable complications. Without urgent reform, the direct and indirect costs associated with diabetes in the UK will likely reach £39.8 billion by 2035/36.

Prevention, of course, is the key: people with diabetes need the information and the resources to take control of their health. We know that, at least for some people, diabetes is reversible; it’s simply a matter of empowering them to take control.

“We know that, at least for some people, diabetes is reversible; it’s simply a matter of empowering them to take control.“

But current methods of delivering the information and resources to patients aren’t working. While more patients are being referred to structured education programmes, just 3% are choosing to take them up.

“Lots of the population are leading busy lives,” says Tony Willis, diabetes clinical lead for the North West London group of CCGs. “If you’re working, it can be difficult to find the time to attend structured education. Even using X-PERT Health [a strongly evidence-based education programme to support diabetes self-management], lots of patients still see it as a ‘course’ or an intellectual thing.”

There’s a clear, unmet need for a more effective solution to get more people engaged with education. And that solution is digital. It allows the provision of diabetes education en masse, with patients able to access the content wherever and whenever they like via their smartphone, tablet or PC.

The North West London CCGs have been piloting Changing Health, which translated X-PERT into a digital format and combines this content with personalised behavioural change coaching provided by phone, to assess how the adoption of digital can improve uptake. “We’ve seen a much higher response rate,” Tony says. “That’s among all demographics as well; we’ve onboarded a lot of older people, which is very positive. There’s a need for supported self-care – right now people have a lack of motivation. Digital behaviour change interventions can be very effective.”

“There’s a need for supported self-care – right now people have a lack of motivation.“

North West London is aiming for 30% of their area’s Type 2 diabetes population, amounting to 40-50,000 people, to be participating in diabetes education by 2021. Structured education courses cannot accommodate such a volume of people, and so Tony expects Changing Health and other digital behavioural change interventions to play an invaluable role in delivering the content at scale.

“Communication with GPs is key - they need to know how it helps them. Pilots require them to put some work in. My experience has been very positive, and we’re looking to scale up significantly pending outcomes data. I’d encourage others to do the same.”

Other pilots have also shown that higher digital uptake results in an immediate reduction in the number and volume of medications prescribed to people with diabetes, a reduction in unplanned hospital attendances and consequently, an average annual saving of £131,000 per year for a typical CCG.

This is the opportunity to transform diabetes for good. We can’t afford not to take it.

Meet author Mark Williams on our team page.