The App Will See You Now: How New NHS Apps Could Empty Hospitals as Patients Get Better Before They Have a Stroke or Lose a Leg
Long term medical conditions like Type 2 diabetes have become commonplace. People seem almost resigned to ‘the diabetes’ as an inevitable part of ageing. But this condition has a significant impact on individuals and society. Someone with diabetes quality of life will be poorer and they won’t live as long as a person without it - and the costs of looking after a diabetes patient are skyrocketing.
Diabetes alone affects three times as many people as all cancers combined. Public Health England estimates there are over three million people with the condition in this country, and an increase of at least two thirds to more than five million is predicted by 2025. The disease accounts for 10% (£11.6bn) of the annual NHS budget. And 80 per cent of that sum is attributed to treating largely avoidable complications that happen as patients are left to carry on making unhealthy choices.
What people don’t realise is that it doesn’t have to be this way. Science shows that diabetes is preventable, and even if someone has the condition, it can be reversed with relatively minor adjustments to lifestyle. So why aren’t we on top of this? Fewer than five in 100 people with Type 2 diabetes have received any form of structured education on how to manage their condition to prevent it getting worse. But the revolution is coming. Digital technologies are turning healthcare on its head, and soon people with diabetes will have access to care and support to live healthier lives whenever they need it.
Research carried out by me and my team at Newcastle University has shown conclusively that if most people who have been diagnosed with the condition make even small changes to the way they live their lives they can significantly reduce their risk of getting worse. And, what’s more, by managing their weight, sitting less or going for a walk, they can improve their chances of living healthier, happier lives. For instance, evidence from clinical trials published in the International Diabetes Federation Diabetes Atlas shows that if people with Type 2 diabetes reduce their blood sugar (HbA1c) by just 1% they are 14% less likely to have a stroke or heart attack, and 43% less likely to need a leg amputation. Oh, and they will look better, feel better and have more energy!
When the evidence is so clear it seems bizarre that in our digital age, when we can do so much at the swipe of a screen, we aren’t able to have the information and support we need to get better literally in the palms of our hands.
But isn’t the internet packed with information about illnesses, health and lifestyle? Yes, but effective healthcare is not just about a website and information - it needs to have a real clinical benefit for the user. That is where our research using controlled trials, science and experience of delivering healthcare to people with diabetes is critical. Giving people information is easy, but they need to know how to use it. That is where the world of behavioural science has opened up a new way of thinking.
Our team has set out to change diabetes care, enabling patients to manage the condition themselves. We do this by putting cutting edge behavioural science in their pocket, literally, through the use of mobile phone apps, the internet and the rich world of data. It’s available today, and that’s the point. Far too many people with diabetes (and other long term conditions) have had to wait for access to tools to help them.
Our research based on findings from the US Diabetes Prevention Programme has even pinpointed the type of patient who is most likely to improve after being referred to a self-management programme. This is a seismic shift in care for patients. In 2017 health service commissioners will finally have the go-ahead to invest to make evidence-based apps available on GP prescription. Trials kicking off in Manchester, Birmingham and London will see thousands of patients benefit from these interventions that will improve lives and save the NHS billions.
I know we can make a significant impact on this situation. I’ve seen how a little support can help people make small but very significant changes to their lives and that’s why I’m so excited that our Newcastle app - dubbed Changing Health - is now being prescribed by GPs in large parts of the country. We are about to give people the key to unlock their healthy future nationwide, and I can’t wait to see it happen.
Follow Professor Mike Trenell on Twitter: www.twitter.com/miketrenell