Recipient organisationNorthern Care Alliance NHS Foundation Trust
Funding£2.8M
PeriodApr 2017 — Mar 2023
In plain English
AI plain-English summary
The NHS Diabetes Prevention Programme is a nationwide effort to help people at high risk avoid developing type 2 diabetes, and this research will find out whether it actually works and is worth the money. Type 2 diabetes is a major driver of illness, healthcare costs, and early death in the UK. The NHS has invested heavily in a behavioural change programme—offering diet, exercise, and lifestyle support—to people identified as pre-diabetic. But running such a large programme across diverse local health systems makes it hard to know whether it is reaching the right people, being delivered as intended, and genuinely reducing diabetes rates. This evaluation fills that gap by combining patient data, interviews, cost modelling, and fidelity checks. If the programme proves effective and cost-effective, the NHS could confidently expand or refine it, potentially preventing thousands of cases of diabetes and reducing long-term demand on hospitals and GP services. If it falls short, the findings will show where to improve—whether in access, delivery, or follow-up. Either way, the results will shape how the NHS spends public money on prevention for years to come.
View original technical description
The NHS Diabetes Prevention Programme (NHS DPP) is an ambitious programme to deliver an evidence-based behavioural change intervention (‘the NHS DPP intervention’) to patients at risk of developing diabetes, to encourage behaviour change and reduce risk of diabetes. The size of the programme and the complexity of its implementation present significant challenges for any evaluation. The DIPLOMA research programme is a mixed methods study delivered by an experienced multidisciplinary team, which is designed to provide (a) feedback to NHS DPP stakeholders on the delivery and outcomes of the programme to support ongoing development and quality improvement (b) a rigorous longer-term assessment of the success of the NHS DPP in meeting the aim of reducing diabetes prevalence in a way that is cost-effective and sustainable. We have the necessary skills and experience to deliver this evaluation. Our expertise includes quasi-experimental evaluations of population health initiatives, use of routine datasets to support evaluation of policy, mixed methods evaluation of regional and national policy, design and evaluation of behaviour change interventions, implementation science expertise as well as experience of the evaluation of relevant local diabetes prevention schemes. The DIPLOMA research programme will have 8 work packages: Work package 1 Access and equity will use quantitative analysis of routine data to explore the characteristics of patients who enter the NHS DPP, and those who are eligible and do not enter. This analysis will be complemented by qualitative research on the process of accessing the NHS DPP, and the experience of patients and professionals. Work package 2 Implementation will explore the process of implementation of the NHS DPP in selected sites, exploring the local organisation of the programme, workforce, funding, and pathways. Work package 3 Service Delivery and Fidelity will analyse data on uptake and adherence to the NHS DPP intervention, combined with a detailed analysis of the degree to which providers adhere to the specification for the intervention. Work package 4 Outcomes will use data collected by the NHS DPP to assess effects on patient outcomes within the programme. Data will also be linked to data from Implementation and Service Delivery and Fidelity work packages to explore factors influencing outcomes and ‘active ingredients.’ Work package 5 Comparative Effectiveness will use quantitative analysis of routine data to explore whether the NHS DPP leads to a reduction in the prevalence of diabetes and other outcomes, using suitable comparators with and without access to the NHS DPP. Work package 6 Validation sample will use a survey to evaluate the risk of confounding and allow adjustment in other work packages. Work package 7 Comparative Long Term Cost Effectiveness will use data from other work packages and external sources to create an economic model to assess the longer-term benefits in terms of improvements in quality of life, mortality and reductions in long-term care use Work package 8 Programme management will include management of the programme, co-ordination of the research work packages, liaison with stakeholders and dissemination of findings to internal (NHS DPP) and external academic, service and patient audiences.
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