Welcome! This is a very long webpage! It contains all the resources that Practice staff may need to identify and refer eligible patients to the NHS Type 2 Diabetes Path to Remission Programme. It is designed for people who have attended or listened to one of the training sessions (we have included links to videos).
We have embedded the eligibility criteria near the top of the page for easy access. All relevant documents e.g. Searches, Readiness Assessment Tool, Referral and Medications Adjustment forms etc. are also available individually on this page for easy access. Searches and Referral templates are available on your Practice systems.
Where relevant we have included links to videos e.g. referrer lunch and learn event.
Thank you very much and we look forward to your referrals.
If you are not from Birmingham and Solihull please see the bottom of this page for the correct referrers’ pages.
Table of contents
The NHS Type 2 Diabetes Path to Remission Programme
The NHS Low Calorie Diet Programme relaunched in Birmingham & Solihull on June 1st 2023, with two significant changes:
- New name: NHS Type 2 Diabetes Path to Remission Programme (T2DR) – in response to patient focus groups convened by Diabetes UK (formerly the NHS Low Calorie Diet)
- New format: Coached support over 12 months delivered one-to-one, either in-person or digitally according to patient choice.
The T2DR Programme continues to offer life-changing support for people who are living with Type 2 diabetes and above a healthy weight. The 12 month programme is designed to support people to improve their diabetes control, reduce diabetes-related medication and in some cases, put their Type 2 diabetes into remission. The three phases remain:
- Total Diet Replacement: 12 weeks, with all meals replaced by TDR products
- Food re-introduction: 6 weeks, gradual reintroduction of real food
- Weight maintenance: To 52 weeks, ongoing support to build and maintain healthy lifestyles.
The whole programme, including coaching and all total diet replacement products, is free for participants.
On average participants lose 10-15% of their starting weight in the first three months.
Referral support lunch and learn - February 2024
The slides from this event are downloadable below.
T2DR Healthcare professional FAQ
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 T2DR flowchart
GP practice staff can use this one-page flowchart as a quick reference guide for the NHS Type 2 DIabetes Path to Remission Programme service. You can download it to print 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…
Juliet, Birmingham & Solihull
Eligibility criteria
Inclusion criteria
- 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%)
Exclusion criteria
- 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.
Patient information
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).
Alternatively you can download an A4 PDF Patient Information Leaflet for local printing / attachment.
EMIS searches, invitation letter and referral forms
These should be on your clinical systems – see Sarah Beddow’s slides from the September ‘Lunch and learn’ at the top of this page for instructions.
If you still need to download them you can do so using these documents. You will need to download the Zip file, extract the documents and then follow the instructions to import the search.
SystmOne / TPP searches, invitation letter and referral forms
These should be on your clinical systems – see Sarah Beddow’s slides from the September ‘Lunch and learn’ at the top of this page for instructions.
If you still need to download them you can do so using these documents. You will need to download the Zip file, extract the documents and then follow the instructions to import the search.
Using accuRx to support referrals
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 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-bsol 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 Birmingham and Solihull 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 (see below).
Medications adjustments guidelines
Medical Guidance with examples and context: From NHS England with additional one-page summary
Participant journey
In Birmingham & Solihull the NHS Type 2 Diabetes Path to Remission Programme is now delivered to individuals (for anyone referred before 1/6/23 delivery is by virtual groups).
Your patients are now offered a choice of in-person or digital pathways, the former delivered in community or primary care venues, the latter with app access and both supported by trained Coaches.
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 20-30 minute sessions focus on the topics highlighted in this diagram over the 12 months and include monitoring of weight and blood glucose (and blood pressure for those on blood pressure medications at referral). Participants also receive a range of resources at different points.
SNOMED codes for NHS T2DR Programme
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.
Key contacts
Referrals
momenta.t2dr-bsol@nhs.net
PLEASE DO NOT SEND REFERRALS OR PID TO ANY OTHER EMAIL
Weekly Referrer lunchtime drop-in.
Plain text pls: Momenta host regular lunchtime 'drop-in' sessions which you can join for an overview of the service or to ask any specific questions. Follow this link and click the Contract-specific button.
Sarah Beddows
Birmingham & Solihull CCG
Project Officer Lead for NHS Type 2 Diabetes Path to Remission Programme, (formerly the NHS Low Calorie Diet Programme)
Email: sarah.beddows@nhs.net
Philomena Gales
Birmingham & Solihull CCG
Senior Integrations Officer
Email: p.gales@nhs.net
Nicky Gilbert
Momenta Newcastle
Contract Manager for NHS Type 2 Diabetes Path to Remission Programme
Email: nicky.gilbert@momentanewcastle.com
Tel: 0121 289 4805
Complaints contacts and procedures
Complaints should be addressed to the Provider (Momenta Newcastle) and/or the CCG and/or the Commissioner (NHS England) as appropriate.
– Momenta Newcastle (Provider): complaints@momentanewcastle.com
https://momentanewcastle.com/complaints
– NHS England: england.diabetestreatment@nhs.net
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: