Westbank’s portfolio delivered nine projects, working with eight delivery partners. This included the Living Well Taking Control project, which supported people recently diagnosed with type 2 diabetes or with pre-diabetic conditions. GP practices across Exeter and North Devon referred patients with a higher than normal blood glucose level to the project. The project supported people to make lifestyle changes and was focused on early intervention as this is when diet, physical activity, and other lifestyle elements can have a positive effect. Participants initially attended the project on a weekly basis, gradually reducing their attendance to monthly and then three monthly intervals. The project addressed an important gap in local health provision, being the only pre-diabetes service in Devon.
The diabetes project was managed by an ex- GP Practice manager. This was a key strength of the delivery model as the manager utilised their in-house knowledge of the medical management systems used by GP Surgeries, (System One and Emis web), to develop an effective, secure and traceable referral system into the project. The system linked to additional information which demonstrated a reduction in GP appointments and/ or medication amongst participants. This approach was very successful, resulting in an effective referral pathway into the project, and evidencing positive outcomes for GP Practices referring into the project.
The Living Well Taking Control project was designed to improve participants’ health, by improving their diets and raising their physical activity levels. The project demonstrated good outcomes in relation to a number of key change indicators. For example, by the end of the grant 2,833 people with sedentary lifestyles and poor mobility reported becoming more active, compared to a target of 1,800 people, and 1,033 people with a BMI over 25 engaged with new and additional physical activities, or became more active in their daily lives, compared to a target of 830 people. Positive outcomes were also reported on the healthy eating theme, with 435 people with lifestyle related conditions having attended healthy eating activities, (compared to a target of 450 people) and 1,112 people having attended activities on growing food locally, healthy cooking and healthy lifestyles (compared to a target of 90 people).
According to the project lead, the Living Well Taking Control project generated very positive feedback, with some participants writing to their MPs, or commissioners to support the case for future funding. Extra sessions were introduced based on participant feedback, such as support whilst shopping.
The project was designed to generate robust evidence to support sustainability. The project complied with NICE guidance and a randomised control trial (RCT) was established to help demonstrate impact by exploring whether a community-based diabetes prevention programme delivered by the voluntary sector (the Living Well, Taking Control programme), was more effective than routine care from GP practices in modifying diabetes risk factors (weight, physical activity and blood sugar levels) amongst adults at risk of Type 2 diabetes at six months. The RCT was undertaken by the University of Exeter medical school and the University of Birmingham.
The portfolio also commissioned a Social Return on Investment report, which assessed nine services delivered through the portfolio, including the diabetes project. All the projects demonstrated a positive return on investment, ranging from a return of £1.36 to £12.00 for every £1 spent. The Social Return on Investment (SROI) for the Living Well Taking Control project included data from 248 participants and seven focus groups. The SROI found that for every £1 invested in the project, an estimated £5.80 of social return was generated over a three year period. An infographic summarising the key findings from the SROI can be found in Annex Two of the full report.
The results are very encouraging. Westbank has secured support from Public Health England and is informing the development of the roll out of the pre-diabetic programme nationally. Westbank has also secured support from NEW Devon CCG (Northern, Eastern and Western Devon Clinical Commissioning Group) to develop a Social Impact Bond for Devon. This will support the Devon-wide role out of the Living Well Taking Control Diabetes type 2 project.
