Implementation and Phase 1 evaluation outcomes of the
NHS
England National Diabetes Transition and Young Adult Pilot Programme (2022–2026)
Reza Zaidi, Fulya Mehta, Partha Kar, Jonathan Valabhji, Verity Hawkes, Lucy Holmes, Karen Kennedy, Sheena Dungey, Mo Jaffer Ismail Abstract
Aims
This programme was a 4‐year, centrally commissioned endeavour to gather evidence of strategies to implement a model service specification in 15 pilot sites and improve outcomes in 16‐ to 25‐year‐olds with diabetes.
Methods
Retrospective cohort study evaluating the quantitative and qualitative impact of implementing the model service specification on the study population. Phase 1 focused on changes and outcomes between 2022 and 2024.
Results
Services implemented changes to improve engagement, well‐being, care process measurements and clinical outcomes. 6564 individuals' data were analysed across sites. At the end of 2024, caseloads increased by 15% for type 1 diabetes (T1D) and 64% for type 2 diabetes (T2D). Young adult multidisciplinary team appointments offered ( 2022 : 5168, 2024 : 9013) and attended (67.5% in 2024 vs. 64.1% in 2022, p < 0.001) surged, and non‐attendance rates reduced (20.2% vs. 27.8%, p < 0.001). Measurements of HbA1c (73.2% vs. 69%, p < 0.01), blood pressure (69.1% vs. 57%, p < 0.0001), BMI (67.8% vs. 57%, p < 0.0001), psychological screening (43.8% vs. 14.7%, p < 0.0001) and uptake of hybrid closed loop systems increased. Median HbA1c reduced for the entire cohort (3 mmol/mol or 0.3%, p < 0.0001 for T1D, 4 mmol/mol or 0.4%, p = 0.2 for T2D). Treatment target achievement for HbA1c (T1D: 39.1%, p < 0.0001, T2D: 52.8%, p = 0.2) and blood pressure (T1D: 84.6%, p < 0.01, T2D: 74.1%, p = 0.3) increased. DKA admission rate (13.8 vs. 16.4, p < 0.05), hospital bed‐days (42.1 to 30.1, p < 0.0001) and length of stay (2.57 to 2.18) reduced, with financial savings of £10,000/100 young people. Improved well‐being was also reported.
Conclusion
Early evaluation of the programme has shown improved outcomes for young people.