BHR Biosynex MoREM® gives real-life evidence - how a pharmacy-led national diabetes screening service would save NHS £50m each year
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BHR Biosynex MoREM® gives real-life evidence - how a pharmacy-led national diabetes screening service would save NHS £50m each year
BHR Biosynex is pleased to have worked with the Company Chemists’ Association (CCA) to produce a report that demonstrates how a community pharmacy diabetes screening service would save the NHS £50m in recurring costs each year.
The report ‘Increasing Access to Diabetes Screening and Prevention Through Community Pharmacy’ highlights the need to create a clear national patient pathway for diabetes detection and prevention and used BHR Biosynex’s MoREM® service as a real-life example of success.
The report highlights how an NHS-commissioned Type 2 diabetes screening service by community pharmacies across England would allow community pharmacies to deliver the following benefits each year:
- screen 1.5 million adults annually and identify 180,000 prediabetics;
- identify 45,000 undiagnosed diabetics and prevent them from developing serious complications that require specialised care;
- prevent almost 7,000 heart attacks and strokes and improve patients’ quality of life;
- prevent nearly 15,000 people developing severe-sight loss over the course of their lifetime; and
- reduce the financial toll that diabetes takes on the NHS by saving the NHS £50m in recurring costs each year.
Ramesh Patel, Managing Director of BHR BIOSYNEX said: “Currently one in four hospital beds are occupied by people with diabetes complications and offering targeted support could reduce the number of people who develop diabetes in the first place. Early diagnosis and action are key to tackling diabetes. Point-of-care testing, together with behavioural support helps to provide patients with a clear picture of their health[1].”
Donald MacDonald, a patient from the MoREM® Programme, said: "I would like to see all patients in my position and those with prediabetes have access to a nationwide screening programme. This would allow patients to be seen and treated quickly and regain control of their lives, just as I did through the MoREM® programme. I have been living with the condition for 12 years, however over the last year my control deteriorated. MoREM® allowed me to understand what my HbA1c was, and then gave me the toolkit to make changes to my diet and lifestyle through the GRO Health app. My HbA1c is below the prediabetes range for the first time since I was diagnosed”.
Type 2 Diabetes and its complications account for a tenth of the NHS annual budget[2]. By 2035/36 this is projected to grow to 17%[3]. Currently around 4 million people have been diagnosed with diabetes across the UK[4]. An additional 2 million people are at high risk of developing the condition[5]. Furthermore, diabetes creates an enormous economic toll on society - the loss of productivity and diabetes-related disability costs the UK over £20bn annually[6].
There are significant barriers to early detection and prevention. These include long waits to secure a GP appointment and patients having to travel long distances to see an appropriate healthcare professional, preventing them from receiving timely and appropriate care. As many as 25 million GP appointments every year are estimated to be dedicated to the management of Type 2 Diabetes, equivalent to an entire month’s worth of GP appointments[7].
These access issues are particularly prevalent in more deprived communities, where the economic burden of travelling long distances for a GP appointment or work commitments may deter people from seeking advice and care.
Following completion of the report, the CCA is now urging NHS England to:
- Commission a national diabetes screening service to identify and aid people either with, or at risk of, Type 2 Diabetes.
- Support and improve IT communications between pharmacies and GP surgeries so that test results can be shared seamlessly.
- Develop patient pathways to provide newly diagnosed diabetics with easily accessible treatment through community pharmacy.
Malcolm Harrison, Chief Executive Officer of the Company Chemists’ Association said: “With the burden of Type 2 Diabetes set to grow significantly, commissioning pharmacies to deliver a national diabetes screening service makes sense for patients, the NHS and the UK economy. A national Type 2 Diabetes screening service could not only free up as many as 25 million GP appointments a year but help reverse the blight of the disease which continues to disproportionately affect patients in areas of higher deprivation. This service would align closely to the objectives of the NHS and could be a step-change for the 4 million people with Type 2 Diabetes and 2 million people at high risk of developing it”.
Dr Manisha Kumar, Chief Medical Officer at Greater Manchester Integrated Care Partnership said: “Over a quarter of people living in Greater Manchester will develop diabetes in their lifetime. Type 2 diabetes has a significant impact on the health outcomes of sufferers everywhere as well as a preventable cost to the NHS and wider economy. That’s why Greater Manchester launched its ‘Tackling Diabetes Together’ strategy. New models of care supporting early identification of people with Diabetes including utilising the skills of Community Pharmacy is part of our neighbourhood delivery model and are keen to support how we could develop more opportunities to deliver these services in Community Pharmacy settings”.
Ends
NOTES TO EDITORS
Community pharmacy
There are 10,500 community pharmacies across England and services such as Pharmacy First[8], blood pressure screenings[9] and vaccinations[10] show that pharmacies regularly provide more consultations in deprived communities. A nationally commissioned Type 2 Diabetes screening service through community pharmacies would therefore increase access and detection amongst patients in areas of deprivation. This is especially important as people in deprived areas are more likely to be diabetic or pre-diabetic[11]. Patients are also already familiar with seeking care from their local pharmacy are also very likely to use a diabetes screening service if offered the opportunity.
MoREM®
Early detection offers an opportunity for earlier intervention. A behavioural support process called MoREM® (Motivating Remission) combines the HbA1c measurements together with the necessary support to enable behaviour changes. MoREM® combines lifestyle coaching with goal setting and ongoing support from trained pharmacy teams.
Results collected from initial small-scale trials, using MoREM® and glucose testing show promising results. All patients showed a reduction in their Hb1Ac readings, with an average reduction of 12% (6mmol/mol) over three months. Similarly, 96% of patients recorded a reduction in their waist measurements with an average of a 5cm reduction over three months. The combination of MoREM®-led behaviour change and glucose testing allowed 87.5% of Type 2 Diabetics in trial to achieve remission.
HbA1c
Haemoglobin is a protein component of the red blood cell and carries oxygen around the body. When haemoglobin joins with glucose, it becomes glycated to form glycated haemoglobin A (HbA1c or A1c). HbA1c gives a picture of a patient’s glucose levels over the previous 2-3 months and can indicate people with prediabetes or diabetes as follows:
- Normal – less than 42 mmol/mol (6%)
- Pre-diabetic – between 42 mmol/mol (6%) and 47 mmol/mol (6.5%)
- Diabetic – more than 48 mmol/mol (6.5% or over)
A1CNow+® Device
Pharmacy teams can provide patients with a lab-comparable HbA1c test using the simple and easy-to-use A1cNow+ point-of-care testing device, giving a quantitative result in 5 minutes from a single drop of blood.
- Small fingerstick blood sample (5µL).
- Requires no maintenance or calibration.
- Can be stored at room temperature for 4 months.
BACKGROUND
About BHR BIOSYNEX
Established in 1990 as BHR Pharmaceuticals Ltd and specialising in point-of-care diagnostics since 1994, BHR BIOSYNEX is a market leader in the provision of point-of-care testing (PoCT) solutions. It specialises in sourcing innovative and progressive technology from around the world and delivers these innovative products to customers in the UK.
BHR BIOSYNEX worked with the Company Chemists’ Association (CCA) to examine how community pharmacies could be commissioned to deliver a national Type 2 Diabetes screening service and the potential benefits to patients, the NHS and the wider economy. The report can be downloaded here: https://bhr.co.uk//wp-content/themes/bhr/doc/diabetes-screening-and-prevention.pdf
About The CCA
The Company Chemists’ Association (CCA) is the trade association for large pharmacy operators across England, Scotland, and Wales. The CCA membership includes ASDA, Boots, Morrisons, Pharmacy2U, Rowlands Pharmacy, Superdrug, Tesco, and Well.
[1] J. A. Hirst, A. J. Farmer and V. Williams, ‘How point-of-care HbA1c testing changes the behaviour of people with diabetes and clinicians – a qualitative study’, Diabetic Medicine, vol. 37, no. 6, pp. 1008-1015, 2020.
[2] NHS England, NHS Diabetes Prevention Programme (NHS DPP)
[3] N. Hex, R. MacDonald, J. Pocock, B. Uzdzinska, M. Taylor, M. Atkin, S. H. Wild, H. Beba and R. Jones, ‘Estimation of the direct health and indirect societal costs of diabetes in the UK using a cost of illness model’, Diabetic Medicine, vol. 00, no. e15326, 2024
[4] NICE, Diabetes – type 2: How common is it?
[5] NHS England, Record high two million people at risk of Type 2 Diabetes, 2020
[6] N. Hex, C. Bartlett, D. Wright, M. Taylor and D. Varley, ‘Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs’, Diabetic Medicine: a journal of the British Diabetic Association, vol. 29, no. 7, pp. 855-62, 2012
[7] D. Landau and S. Philis, ‘Medical Evolution, Measures to improve the interface between primary and secondary care’, Policy Exchange, 2023
[8] CCA, Pharmacy First – the first month, May 2024
[9] CCA, Championing cardiovascular health, March 2023
[10] CCA, The growing role of community pharmacy in Covid vaccination programmes, October 2023
[11] C. V, N. Unwin, P. Sherriff, R. Bilous and W. Kelly, ‘Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas’, Journal of Epidemiology & Community Health, vol. 54, pp. 173-177, 2000
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