Type 2 diabetes affects 5.9 million people in the UK, with 1.3 million of those effected living without a diagnosis. [1] The cost to the NHS is significant, with diabetes-related care estimated at approximately £10 billion each year.[2]

In response to growing pressures on the healthcare system, the Government’s recently published 10 Year Plan places a strong emphasis on prevention over crisis management. This shift is essential to ensuring the long-term sustainability of NHS services.

As the prevalence of type 2 diabetes continues to rise, prevention efforts are evolving to meet the scale and complexity of the challenge. Xyla, part of Acacium Group, is the UK’s largest provider of the NHS Diabetes Prevention Programme. Since 2016, more than 850,000 people have been referred to the programme, achieving outcomes that exceed national averages.

This experience has generated valuable insights into the role of early intervention and lifestyle change in diabetes care and prevention. The following learnings highlight how targeted, inclusive and flexible approaches can improve access and outcomes across diverse communities.

From national delivery to local impact

The evolution of diabetes prevention services has been shaped by a shift towards more community focused, digitally enabled models. This transition reflects a broader trend in healthcare, moving from centralised delivery to approaches that are more responsive to local needs and individual circumstances.

As part of its clinician-led approach to preventative health, Xyla identified key barriers within the existing delivery model of the NHS Diabetes Prevention Programme. In response, the team proposed a pilot to NHS England aimed at creating a more equitable and accessible service. The initiative focused on reaching individuals who were previously underserved, including those living in rural or deprived areas, people from different age groups and individuals with mobility challenges.

The pilot introduced online group-based sessions delivered via Microsoft Teams, offering a flexible alternative to traditional face-to-face formats. Over the nine-month period, 70% of participants reached their first milestone, compared to 65% in the original model. Crucially, these were individuals who had been unable or unwilling to engage with the standard service. More than 1,000 people at risk of developing type 2 diabetes took part in the pilot, receiving support they may not have otherwise accessed.

Rethinking support for people on medication pathways

As new medications like tirzepatide (Mounjaro®) become more widely prescribed, there is a growing need to ensure that pharmacological interventions are supported by behavioural and lifestyle change.

Expanding its diabetes prevention services the Healthier You: Behavioural Support for Obesity Prescribing programmeis designed to help participants build healthy habits that extend beyond medication use. It combines coaching, nutrition, physical activity and psychological support. This approach reflects a broader principle that medication alone is not a silver bullet. Long term outcomes depend on how well individuals are supported to make meaningful changes in their daily lives.

Scaling with sensitivity to context

Delivering prevention services at scale requires more than infrastructure. It demands adaptability. Across urban, rural and coastal communities, delivery models must be tailored to reflect local demographics, health inequalities and access barriers. Working with 15 Integrated Care Boards across England, Xyla’s services are designed with flexibility in mind, combining digital and in person options to meet people where they are.

Aligning with system wide goals

The NHS Long Term Plan sets out a clear vision to prioritise prevention, reduce health inequalities and embrace digital transformation. With over 12 million people in the UK at risk of developing type 2 diabetes, expanding the reach of preventative services is clinically and economically critical. Diabetes related care currently accounts for around 10% of the NHS budget.[3]

Innovations in service design, whether through digital pilots, integrated medication support or community-based delivery, improve the lives of individuals and build a more sustainable and equitable healthcare system. If you’d like to help people reduce their risk of diabetes, manage or even put their condition into remission, Xyla’s diabetes programmes can make all the difference to their success. Get in touch with their team for more information.

[1] https://www.diabetes.org.uk/about-us/about-the-charity/our-strategy/statistics#:~:text=Our%20data%20shows%20that%20almost,by%20185%2C034%20from%202022%2D23.

[2] https://www.england.nhs.uk/2022/03/nhs-prevention-programme-cuts-chances-of-type-2-diabetes-for-thousands/#:~:text=Evidence%20has%20shown%20that%20the,to%20prevent%20type%202%20diabetes.

[3]https://publications.parliament.uk/pa/cm201213/cmselect/cmpubacc/289/289we02.htm#:~:text=1.3%20Diabetes%20is%20expensive,costs%20are%20due%20to%20hospitalisation.