The NHS Type 2 Diabetes Pathway to Remission (T2DR) Programme (formerly the NHS Low Calorie Diet Programme) is an innovative and free service for people who are overweight and living with type 2 diabetes. From the 1st February 2024 the programme will include both the existing 1:1 digital offer and a NEW (1:1) face-to-face offer.
[NOTE: Name change of NHS Low Calorie Diet Programme to T2DR]
The one year programme supports healthier lifestyles, weight loss, and remission of type 2 diabetes by combining specialist nutrition, behaviour change strategies and physical activity to support rapid weight loss and long-term lifestyle changes.
It works by offering 12 weeks of a low calorie diet (shakes and soups) followed by four weeks of gradual food reintroduction and eight months of weight maintenance, achieved through healthy eating, movement and online support.
The new two year contract is limited to 500 patients across West Yorkshire. For the programme to be successful, we need help from GP practices to support potential patients who fit the criteria and are motivated. To help tackle health inequalities across our area, the focus will be on improving access to patients from deprived and ethnic minority communities. If patients opt for the digital offer but do not have their own digital devices such as computers, laptops or smartphones, support to join the programme may be available. Please see the digital access pages on the Healthier Together website to find the nearest services that offer digital devices, or refer to your local social prescriber service who can find local support.
Packs designed for all general practice staff detailing how to identify eligible patients, adjust their medication, and refer them to this service along with other useful resources are available in the next section of this page.
Referral
New Xyla T2DR service user pathway and programme model
T2DR Eligibility criteria and referrer responsibilities
In our video, Dr Waqas Tahir, the Clinical Diabetes Lead for the West Yorkshire Health and Care Partnership explains how to fill in the referral form to the NHS Type 2 Diabetes Pathway to Remission Programme.
Deprescribing
In this video, Dr Marlon Morais, Medical Director for Xyla, explains safe deprescribing.
Examples of case studies around deprescribing:
Xyla T2DR_Deprescribing_case_studies.1.pptx
New Xyla T2DR adverse event protocols
Standard Operating Procedures (SOPs)/GP packs
The below SOPs/GP packs are aimed at general practices staff in West Yorkshire. The GP packs details how to identify eligible patients and refer them to the programme through local clinical systems. Please note CKW and Bradford are currently being updated with new branding.
NHS Type 2 Diabetes Pathway to Remission Programme GP pack - Calderdale, Kirklees and Wakefield
NHS Type 2 Diabetes Pathway to Remission Programme GP pack - Leeds
NHS Type 2 Diabetes Pathway to Remission Programme GP pack - Bradford and Craven
Quick SystmOne/Emis user guidance of referral form and clinical searches
NEW Calderdale, Kirklees and Wakefield (CKW) EMIS user guidance for T2DR referral
NEW Calderdale, Kirklees and Wakefield (CKW) SystmOne user guidance for T2DR referral
NEW Leeds EMIS and SystmOne user guidance for T2DR referral
NEW Bradford and Craven local T2DR ASSIST pathway guidance
NHS England guidance
NHS England guidance for GP practice and referrers
Patient leaflets
Please note that the Xyla website has been updated with Google Translate. The Xyla patient information leaflet in English can now be translated into different languages. One simply needs to copy the information and paste it under the desired language (for example, Urdu, Punjabi, Polish, Arabic, Bengali) in Google Translate.
Updating patient records
General practice will receive communication from the provider Xyla Services to the GP practice generic email address. The communication includes Letters to GP practice templates and SNOMED codes.
Practice will need to update patient records from communication received from the provider.
Template of invitation letter (example)
https://
Empower is a six-month pilot programme designed to provide enhanced psychological support to participants in the NHS Type 2 Diabetes Path to Remission Programme (T2DR). Running from 13 January to 30 June, Empower aims to help people overcome barriers to lifestyle changes and improve engagement with the T2DR programme.
More information:
Case study 1
Angela Forsey, a Diabetes Care Coordinator at Pennine GP Alliance, is both a healthcare professional and a patient who has recently participated in the NHS Type 2 Diabetes Path to Remission programme. Here is her story:
Pennine GP Alliance Diabetes Care Coordinator takes part in the NHS Type 2 Diabetes Programme
A Diabetes Care Coordinator’s Personal Journey on the NHS Type 2 Diabetes Path to Remission programme
Case Study 2
Anthony’s T2DR journey:
https://
Pilot on how to increase referrals at PCN/Practice level
T2DR Upper Calder Valley PCN pilot patient sessions:
Prevalence of type 2 diabetes is rising year on year in West Yorkshire. The NHS Path to Remission programme (T2DR) is an evidence based behaviour change intervention which supports diabetes remission. We have a responsibility to enable people eligible for T2DR to take it up. Uptake to T2DR is facilitated by providing information about the programme from trusted health and care professionals. Local delivery of information sessions provides opportunity for peer support and confidence building. In addition, sampling of the total diet replacement products which are taken as part of the intervention helps individuals understand what is involved. The report below describes one of the approaches used in West Yorkshire to increase T2DR update. The learning highlights how partnership working between primary care, commissioners, and providers to deliver tailored care and support for people with type 2 diabetes results in improved programme uptake and empowerment through more person-centred approaches.
Upper Calder Valley T2DR pilot patient information sessions evaluation
Primary Care Diabetes Society Upper Calder Valley T2DR patient session 'evaluation on a page'.
The Leeds Diabetes Remission Service Phase two evaluation
Example of referral conversation with HCP and Patient
Xyla T2DR introduction video for GP practice waiting room screens
Below are the recordings from the one-hour training events aimed at GPs, nurses, practice diabetes leads, medicine management colleagues, dieticians and anyone who does medication reviews:
Here is the slide deck used at each of the presentations.
Please note that NHS Type 2 Diabetes Path to Remission Programme (T2DR) is the new name for the former NHS Low Calorie Diet (LCD) programme.
NHS Type 2 Diabetes Path to Remission (T2DR) - Formerly NHS Low Calorie Diet Programme (LCD) - a short video resource explaining what the NHS T2DR is and how it works.
Review into diets for weight management in adults with type 2 diabetes
Xyla: What is the NHS Type 2 Diabetes Path to Remission Programme summarises the T2DR programme, and provides insights on who, why and how to join the programme.