Welcome! This is a long webpage as it includes all the resources that GP practice staff may need to identify and refer eligible patients to the NHS Type 2 Diabetes Path to Remission Programme (T2DR), formerly the NHS Low Calorie Diet Programme. It is designed for people who have referred previously or attended an education event or come to a weekly drop-in sessions – see below for details.
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 patient leaflets below.
If you have any questions or feedback please get in touch using the Contact information below.
Thank you very much and we look forward to your referrals.
If you are not from Nottingham and Nottinghamshire ICS please click on the link at the bottom of this page for the correct referrers’ pages.
Table of contents
The NHS Type 2 Diabetes Path to Remission Programme (T2DR) launched in Nottingham and Nottinghamshire in 2022. The service is provided by Momenta Newcastle, commissioned by NHS England and Nottingham and Nottinghamshire ICB.
The T2DR Programme offers support for people newly diagnosed 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. Coached support over 12 months is delivered one-to-one, either in-person or digitally according to patient choice
There are three phases:
- 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.
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.
Referral pathway options
This one-page summary flowchart should be used in conjunction with detailed guidance and documents below
Referrer education session slides and recording
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.
Searches, Referral and Medications Adjustment Form
Referrals can be made by completing the referral form and emailing it to Momenta at email@example.com The referral form is available on F12, ARDENS’s and SystemOne clinical systems. Details on each system are below.
From the Pathfinder click on either Diabetes or Lifestyle buttons (highlighted in yellow)
From either of these buttons you can either refer directly or click on the Type 2 Diabetes button which will open to the screen shot 4 below. On there can see all the guidance as well as the referral form
For SystmOne, please use the referral directory.
For Bassetlaw practices, please use the community section to locate the form. If you are an EMIS practice, you can locate this in the Diabetes folder.
If you have any queries regarding medication changes or completing the referral form please read the Medication adjustment guidelines below and then contact the Momenta support team if required at firstname.lastname@example.org
Potentially eligible people can be identified using the T2DR search.
Patient invitation templates
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-nn 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 Nottingham and Nottinghamshire 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.
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.
Medication adjustments guidelines
NHS England’s T2DR expert reference group has developed detailed deprescribing guidance for both medication impacting blood glucose and blood pressure.
The NHSE document is available here. It is a lengthy document so we recommend using the table of contents to navigate to relevant sections. Momenta have added summary pages at the back – these are for quick reference only and are not a substitute for reading the relevant pages of the full guidance.
The NHS Type 2 Diabetes Path to Remission Programme is delivered to individuals at community or primary care venues. Your patients will be offered a choice of in-person or digital pathways, 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 following topics 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.
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.
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): email@example.com
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: