Welcome! This is a long webpage as it includes all the resources that Practice staff may need to identify and refer eligible patients to the NHS Type 2 Diabetes Path to Remission Programme, formerly the NHS Low Calorie Diet Programme. It is designed for people who have attended or listened to one of the education sessions (including links to videos).
This website is for referring health care professionals only – please do NOT forward to patients. The patient information page is here – or you can print / order patient leaflets below.
Where relevant we have included links to videos e.g. an Education session
If you have any questions or feedback please contact the NENC lead at the generic Clinical Networks Long Term Conditions inbox
See below for how to refer patients.
Note: Please DO NOT send referral or patient identifiable information to these emails
Thank you very much and we look forward to your referrals.
If you are not from North East and North Cumbria please see alternative links at the bottom of this page.
Table of contents
Education session for referrers - September 2023
The presentations are available here
Medications adjustments guidelines
Medical Guidance with examples and context from NHS England. This is a comprehensive guide developed by the NHSE&I Expert Advisory Group including clinicians and lead researchers.
We have added an indicative one page overview of NHSE Medical Guidance – and references to relevant sections in the main document – and appended it to the slides.
Identifying interested patients
GP practices can choose from three approaches to identifying eligible patients prior to a referral appointment.
In all cases, interested and eligible patients should attend a referral appointment to discuss the programme and any adjustments they should make to their medications on the first day of taking TDR products. The GP practice must then send a completed Referral and Medications Adjustment form to Momenta.
As a guide, 15 minutes should suffice for a patient record review, patient discussion and completing and emailing the referral and medications adjustment form. Although the appointment can be with different healthcare professionals the medications adjustments must be signed off by an appropriate prescriber and clinical responsibility for the patient remains with the GP practice.
See below for supporting information and resources.
Momenta host weekly lunchtime ‘drop-in’ sessions which you can join for an overview of the service or to ask any specific questions.
GP practice service flowchart
GP practices can use this flowchart as a single page quick reference flowchart for the service. You can download it here.
Participant case studies
Some participants have shared their stories – you might find their experiences help you explain the programme to your patients – or they might just make you smile…
- Aged between 18-65 inclusive
- Diagnosed with Type 2 diabetes within last 6 years
- BMI of >=27kg/m² (adjusted to >=25kg/m² in people of BAME origin)
- Attended monitoring and diabetes review in last 12 months, incl. retinal screening and commit to continue annual reviews, even if achieve remission. (If newly diagnosed no need to wait for retinal screening before making offer of referral).
- HbA1c within 12 months, with values as follows:
- If on diabetes medication, HbA1c >=43 mmol/mol (6.1%)
- If not on diabetes medication, HbA1c >=48 mmol/mol (6.5%)
- In all cases, HbA1c must be <=87 mmol/mol (10.1%)
- Current insulin user
- Currently breastfeeding
- Pregnant or planning to become pregnant within the next 6 months
- Heart attack or stroke in last 6 months; severe heart failure (New York Heart Association grade 3 or 4); severe renal impairment (most recent eGFR <30mls/min/1.73m2); active liver disease (not including NAFLD); active substance use disorder; active eating disorder (including binge eating); porphyria; or known proliferative retinopathy that has not been treated (not excluding individuals who are newly diagnosed and have not yet had the opportunity for retinal screening).
- Had bariatric surgery
- Health professional assessment that patient is unable to understand or meet the demands and/or monitoring requirements of the NHS Programme; or for whom the programme is not appropriate clinically (consulting with relevant Specialist teams if required); or for whom safe and robust medications adjustment is not practical in a primary care setting.
You can send patients to this landing page for more information about the service – this is helpful to do when inviting patients by text (or email).
Momenta sends all GP practices a pack of A4 posters and trifold patient leaflets – ask your Practice Manager for details.
You can download PDF versions of the A4 Patient Information Leaflet and Patient Information Poster for local printing / distribution. We have also attached the trifold leaflet so you can see what we can send you in hard copy.
GP Practices can also order additional packs of patient information leaflets and / or posters from Momenta: firstname.lastname@example.org
As noted above, the most time-efficient way to raise awareness amongst your patient population is to do a search, followed by shortlisting and sending a text or letter with further information and next steps (as many practices do for the NHS Diabetes Prevention Programme, Healthier You).
Summary steps include:
- Run Register search (see above) to generate ‘longlist’
- Conduct manual screen against non-searchable eligibility criteria
- Send a bulk text message using AccuRx/iPlato/mJog templates
This will signpost them to a service landing page where they can find out more about the programme, eligibility criteria and assess their readiness before getting in touch with you to arrange a referral and medications adjustment appointment.
Suggested wording for text invitation – please amend as you like:
A <Practicename> screening has identified that you may be eligible for the NHS Type 2 Diabetes Path to Remission Programme, also known as the NHS ‘soups and shakes diet’. This one-year programme helps you to lose weight, improve your blood sugar levels and reduce medication. For details see https://momentanewcastle.com/t2dr-nenc The programme and all products are FREE.
When you have read it, if you are interested in taking part please call the practice on <Practicenumber> and ask for an appointment to discuss a referral.
As there are a limited number of places available across the North East and North Cumbria please get in touch quickly.
Notes to GP practice:
– Most platforms automatically start the message with “Dear [patient name]”
– We recommend you ‘sign off’ with the name of an individual e.g. well-known doctor or other HCP to the text as this will improve the response rate over a generic practice sign-off
– It is best to either alert reception staff before sending the message or provide a specific response option e.g. email or phone/text number.
– Some practices also attach the patient information leaflet.
– Some practices follow-up with a second text and/or phone call to non-responders, depending on resource.
EMIS searches and Referral & Medications Adjustment Form
You can download this EMIS search to obtain a ‘longlist’ of potentially eligible patients with and without mobile phone numbers.
We suggest you screen out patients you believe are ineligible or otherwise inappropriate manually before contacting them directly by text and/or letter.
You can also download a one-page summary of how to import the search and which searches to run (typically the top two) when you open them i.e. :
– $LCD patient list no mobile (Run this and call/letter)
– $LCD patient list with mobile (Run this and text)
You will need to download the document below then then ‘unzip’ or extract it before using.
We suggest running the search (as per notes above and instructions). If it returns fewer patients than you expect please contact us as there may be other coding-related avenues to explore.
Finally, we extend our thanks to Scott Greenwood and colleagues at NECS and Joel Wilson at Symphony Healthcare Services for developing the searches and referral and Medication Adjustment Form as well as colleagues across many practices who have helped refine it.
SystmOne searches and Referral & Medications Adjustment Form
You can download a one pager on accessing the Type 2 Diabetes Path to Remission / Low Calorie Diet searches and documents (invitation letter and referral form) in SystmOne.
The SystmOne searches and Referral and Medication Adjustment Form (RAMAF) are located on the CDRC Folder – see downloadable document for details. The searches include searches for ‘longlists’ of potentially eligible patients:
– With mobile numbers (so they can be sent invitations by text or letter)
– Without mobile phone numbers (so they can be sent invitations by letters)
– (Patients who are less engaged with their diabetes care but may still be eligible if they re-engage)
You can either contact these ‘longlists’ directly by text and letter respectively and rely on them to ‘self-filter’ or you can choose to screen out patients you believe are ineligible or otherwise inappropriate manually before contacting them.
You can download the Referral and Medications Adjustment Form directly here but you will need to ‘unzip’ or extract it from the folder below to use it.
See next section for patient outreach.
Patient readiness (self-)assessment
You can use this standalone patient readiness (self-)assessment to either give to your patient to complete on their own or guide them through it. The patient landing page has a copy embedded. Alternatively you can download this document (for printing / emailing) and also view one-page instructions for healthcare professionals. Please note this has been developed by Momenta’s Clinical Director, a health and clinical psychologist, specifically to support decision-making but it is not an externally validated tool.
In NENC the NHS Type 2 Diabetes Path to Remission Programme is delivered in-person to groups of up to 15 people at community venues. It is a complex three-phase behavioural intervention over 12 months:
- Phase 1 Reboot: Total Diet Replacement (12 weeks)
- Phase 2 Rebalance: Food Reintroduction (6 weeks)
- Phase 3 Retune: Weight Maintenance (until 12 months).
The 75 minute sessions focus on the following topics over the 12 months and include 15 minutes for weight, blood glucose and blood pressure monitoring. Participants also receive a rage of resources at different points.
Complaints contacts and procedures
Referring from a different area?
Momenta also provides the NHS Type 2 Diabetes Path to Remission Programme in other areas, each with their own referral forms, local contacts and minor differences. Please follow the links below for Referrer information from other areas: