NHS to provide 'motivational coaches' in war on flab

NHS to provide 'motivational coaches' in war on flab

Overweight people will be given “motivational coaches” on the NHS in a radical attempt to halt Britain’s diabetes time bomb.

Up to five million people will be offered one-to-one and group sessions on weight loss, physical activity and diet, under the nationwide scheme starting next year.

Health officials said research has found targeted support can prevent one in four cases of Type 2 diabetes, among those identified as at high risk.

Under pilot schemes, GPs have been told to assess all patients over the age of 40, offering them tests for “pre-diabetes” if their weight or general health means they are likely to develop the disease.

New research suggests 5 million people in England now have blood sugar levels so high that they are on the cusp of the disease.

Such patients will be offered a nine month programme, including group or “one-to-one” sessions with health trainers.

Officials from Public Health England (PHE) said the schemes would offer “motivational coaching” and advice about how to live healthily, in a bid to help people shed the pounds.

Research found that those put on programmes which followed national guidance lost almost 7lbs more than those who did not receive help, over the course of a year.

Health officials said the programme, which will be rolled out across the whole of the country between next year and 2020, is estimated to save £3 for every £1 spent.

But they were unable to supply figures showing what the upfront costs of the courses will be.

The new estimates suggest 5 million people in England are at a “pre-diabetic” stage, in addition to more than 3 million with the condition.

The total amounts to almost one in five adults.

The head of the NHS has warned that without radical changes, diabetes could bankrupt the health service.

Britain is now the second fattest nation in Europe, with 25 per cent of adults classed as obese, compared to 15 per cent two decades earlier.

Type 2 diabetes – which is fuelled by obesity – costs the NHS £9bn a year, almost a tenth of its budget.

Duncan Selbie, chief executive of PHE, said: “We know how to lower the risk of developing Type 2 diabetes: lose weight, exercise and eat healthily, but it’s hard to do it alone.”

“PHE’s evidence review shows that supporting people along the way will help them protect their health and that’s what our prevention programme will do.”

Dr Andrew Lee, NHS Yorkshire and Humber diabetes lead, said: “We have found that it’s the motivational aspect that makes interventions work. This is about offering sustained support over a period of time; motivational coaching, by people with a health trainer background.”

In Bradford, one of the areas piloting the approach, more than 300 patients have been enrolled on an “intensive lifestyle change” programme with nine sessions over 12 months.

GPs involved in the scheme said patients were offered nine face-to-face sessions over 12 months, with telephone coaching in between, for those who were struggling.

Professor Jonathan Valabhji, national clinical director for diabetes and obesity, NHS England said: "In my work, I see a huge amount of suffering related to the consequences of our current lifestyles - diabetes is being pushed up by the fact our body weight is going up and up."

"It is causing blindness, kidney disease and other complications, and as well as the human suffering, the cost to the NHS is absolutely massive."

He said the research suggested that the chance of developing diabetes among those at high risk could be reduced by one quarter within 18 months, with the right changes to diet and lifestyle.

Roger Goss, from Patient Concern, said: “We have clearly got to try something because the growing costs of diabetes are horrific, it’s an avalanche heading towards us.”

“The question is will anyone take this advice,” he said. “It is a bit of a desperate measure and a lot of people may not react well to being told how to live their lives.”

Barbara Young, chief executive of Diabetes UK, said action was needed to prevent the rising number of people suffering from the condition, and from devastating complications, such as blindness and stroke.

“The NHS spends 10 per cent of its entire budget managing diabetes and unless we get better at preventing Type 2 diabetes this figure will rise to unsustainable levels,” she said.

The programme will be run jointly by NHS England, Public Health England and Diabetes UK, with schemes run by the health service, councils or contracted out to charities or private firms.

The new data shows that in some parts of the country, one in seven people are at high risk of diabetes.

In Brighton and Hove, 8.5 per cent of adults are pre-diabetic, compared with 14 per cent in Harrow, North London.

High rates are found in areas with large ethnic minority populations or older populations, which have a greater risk of Type 2 diabetes.

Under some of the pilot schemes, patients who are Asian, and Afro-Caribbean have been offered assessments from the age of 25 onwards.

The report comes as the National Institute for Health and Clinical Excellence published new NHS guidelines on managing diabetes in adults and children.

Its recommendations include same-day referrals of children and young people with suspected Type 1 diabetes to a specialist team to confirm diagnosis and provide immediate care.

By Laura Donnelly

The Telegraph, 26 August 2015

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