Lifestyle Intervention


Whenever you hear the word “intervention” you may automatically think of an ‘addiction intervention’’, or a ‘surgical intervention’, as these terms have almost become synonymous with the word. But how about a lifestyle intervention?

Currently, the NHS England spends around 10% of its budget on treating diabetes, with recent projections showing that the growing number of people with the condition could result in nearly 39,000 people suffering a heart attack and over 50,000 people suffering a stroke by 2035.

There is progress within the sector to redress the prevalence of type 2 diabetes (T2DM) in particular, through a prescription of- lifestyle changes.

There are plans proposed by the NHS to roll out a national Diabetes Prevention Programme (DPP) in the form of ‘lifestyle interventions’ to curb the demand the health service is under. The evidence shows that diabetes prevention programmes significantly reduce progression to T2DM compared to traditional care by ~26%.

The approach will involve GPs prescribing a liquid diet of just over 800 kilocalories a day for three months, then a period of follow-up support to ultimately help achieve remission of their Type 2 diabetes. NHS England’s chief executive, Simon Stevens, announced the program on 30th November. It will first be offered to 5000 patients before being rolled out nationally.

The announcement followed a series of recent studies that have overturned the widely held view that type 2 diabetes is incurable and must be managed with medication.


Large population-based studies in China, Finland and the USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). With these studies leading to the conclusion that even moderate reduction in weight and only half an hour of brisk walking each day reduces the incidence of diabetes by more than fifty percent.

The objectives for the DPP are:

  • To support more people at high risk of developing diabetes to receive lifestyle 
    interventions to help them lower that risk.
  • To slow down the increase in the incidence of type 2 diabetes compared with current predictions.
  • To reduce the incidence of heart disease, strokes, kidney, eye and foot problems (and associated 
    mortality) related to diabetes compared with current predictions.

The benefits include not only saving the NHS money by alleviating the demand diabetes puts on numerous services within the sector, but the money and resources will then be reallocated and reinvested into providing more essential frontline care.

Chris Askew, the Chief Executive of Diabetes UK states:
“Plans to double the size of the NHS Diabetes Prevention Programme is excellent news. The programme is already the largest of its kind globally and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy — we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.”

There are even plans for online versions of the DPP, involving wearable technologies and apps to help those at risk of Type 2 Diabetes better self-manage. These will also be provided to those who find it difficult to attend regular sessions due to work or family commitments.

The aim is to better integrate the available solutions and help patients feel more in control of their treatment. This will hopefully stop the chance of patients withdrawing from their therapy and in feeling more accomplished with short-term goals- by achieving a certain number of steps for instance. This move by the NHS brings us one step closer to achieving a patient-centric health service, a more integrated solution.

By Medicalchain’s Tim Robinson

Curiosity killed the…Trust?

Salford Royal NHS Foundation Trust

Trust is a valuable commodity and in the words of American business magnate, Warren Buffett — “It takes 20 years to build a reputation and five minutes to ruin it.” The greatest issue is not so much the fact that you have been lied to, but that it then becomes so much more difficult to trust.

Trust is especially valuable when it comes to our privacy, and what is more private than our most intimate data — our personal medical records. In May, Sir Alex Ferguson, Britain’s most successful football manager was admitted to Salford Royal hospital after suffering a brain haemorrhage. After emergency treatment and less than a month in the hospital, Sir Alex made a good recovery.

After an audit of the Trust’s computer systems however, it became evident that a number of staff members- Two doctors, a senior consultant, and two nurses allegedly gained unauthorised access to Sir Alex’s private data.

Doctor Chris Brookes, chief medical officer for the Northern Care Alliance NHS Group, which runs Salford Royal, said of the incident- “We can confirm that a number of staff who work at Salford Royal are currently subject to investigation in relation to an information governance breach… All of our patients have the right to expect that their information will be looked after securely and accessed appropriately. We take patient confidentiality extremely seriously.”

Human error is not the issue here, curiosity shouldn’t be a variable in the privacy of our data since ideally, this shouldn’t even be a possibility. The Information Commissioner’s Office (ICO) is the UK’s regulatory body charged with enforcing data protection legislation and bringing regulatory action against those found to have breached data laws. It regularly deals with health-related cases and states that within its figures for Q2 of 2018/19 alone, there were a total of 4,056 data security incident reports within the sector.

What can Hospital Trusts do to earn our trust? Doctor Chris Brookes, chief medical officer at the site responsible for Sir Alex’s breach also stated — “We take patient confidentiality extremely seriously and will take the appropriate action to ensure staff understand the seriousness of unauthorised access.” Does that mean staff were not previously aware of the seriousness of unauthorised access? Does that statement guarantee this won’t happen again?

If hospital sites and CMOs wish to redress the issue they should reconsider their solutions, since trust is built through actions, not words. Successful relationships, including doctor-patient relationships, are built on the foundation of trust. This isn’t automatically awarded to someone due to a title, but earned, and as each Doctor and healthcare professional represents the sector as a whole, their reputation affects the NHS’s reputation.

Advising someone not to be curious is not enough, we should have firm and robust measures to protect patient data. Around the world, companies are considering using blockchain technology to help with privacy and data safety as they have done for the financial sector. it is time to block unwarranted access so that we can rebuild some trust.

By Medicalchain’s Tim Robinson