Brown, Tamara

Clare, Ken

Drew, Kevin

Ells, Louisa

Homer, Catherine

Jones, Susan

Logue, Jen

Radley, Duncan

Watson, Patricia

Sheffield Hallam University Research Archive

An evaluation of the NHS Low Calorie  Diet Programme — Early LearningElls LJ ¹ Homer C ²  Radley D ¹ Drew K ¹ Brown T ¹  Marwood J ¹ Logue J ³ Watson P ⁴ Jones S ⁴ Clare K ¹ ¹ Leeds Beckett University ² Sheffield Hallam University ³ Lancaster University ⁴ Teesside UniversityAimTo deliver a coproduced, comprehensive qualitative and  economic evaluation of the NHS Low Calorie Diet pilot  across broad and diverse populations. Funding and  acknowledgementsConflicts of interest: none Funding: This study has been funded  by NIHR HS&DR ref: NIHR132075Acknowledgments: Acknowledgments: The authors would like to acknowledge: all members of the research team; the Re:Mission Patient and Public Involvement Team; members of the study steering and oversight groups; the NHS England Programme Team and Low Calorie Diet Advisory Group (expert reference group).BackgroundThe NHS Long Term Plan made a commitment to test a Low Calorie Diet (LCD) (achieved via a Total Diet Replacement (TDR) programme) for people living with, or at risk of, obesity and type 2 diabetes. Ten pilot sites were initially recruited to test the NHS LCD programme, delivered using one of three different delivery models: one to one, group or digital. As NHS England are collecting  and analysing quantitative process and clinical impact data, an additional qualitative and economic evaluation was required.MethodsA comprehensive mixed method evaluation, underpinned by an informed realist approach to determine what works, for whom, in what context, and why, delivered through a series of five interlinked work packages. This paper reports emerging findings from WP2 service delivery and fidelity which includes: documentary review; session observations (WP2.2); focus groups with providers (WP2.3); semi-structured interviews with health care professionals (WP2.4); and WP3 patient experience and inequalities to include: longitudinal patient surveys (WP3.1), interviews and visually represented patient journeys using adapted photovoice (WP3.2). FindingsData collection is underway, the  findings presented here are emerging.Motivators and BarriersWP3.1 The vast majority of survey respondents were motivated to lose weight and manage their diabetes. WP2.2, WP 2.3 Referral staff and providers thought that patient motivation was key to a successful referral which results in uptake to the programme.Programme Content and DeliveryWP2.2, WP3.1, WP3.2 Identified a need for more support, with emotional eating. Client led WhatsApp groups can provide an effective means of peer support.WP3.1 Service users reported that the TDR stage helps with planning and organisation of food intake. A wider selection of products with a variety  of flavours and textures, to suit different palates would be welcomed by service users on the programme with some providers. Where service users order  the TDR products at the beginning of the 12 weeks, storage and deciding the correct flavours of soups and shakes can present challenges, service users who ordered every four weeks found greater control and choice over preferences.   InequalitiesWP2.2 The degree of cultural adaptation is variable across providers, greater consistency would be welcomed. Some providers have developed resources to support at the different phases of the programme during cultural festivals.WP2.2 The level of assumed client health literacy doesn’t always align with health literacy levels observed. WP 2.4 Health care professional referral staff felt more information about the programme in other languages would reduce possible barriers to engagement with the programmes.Marketing and Communications WP3.1 Most service users found out  about the programme through their  health care professional.WP2.4 Health care professional referrers discussed an interest in the outcomes for patients they refer and would value more frequent updates on patient progress.WP2.4 Health care professional referrers suggested that the referral process  is reinforced where information  materials are available to share with eligible patients. Eligibility and Referral ProcessWP 3.1 28% of survey respondents re-ported to have never lost more than 5kg in weight during any time in their life prior to taking part in the programmeWP3.1 90% of survey participants were informed by their health care professional that they would be on TDR and around 80% felt their health care professional explained the LCD programme well. WP2.4 A time delay between referral and patient receiving the first contact from the service provider was reported by some health care professional referral staff. This was linked to providers waiting for sufficient numbers for groups to start.ConclusionThe evaluation findings are providing  real time insights to inform ongoing service development and future pro-curement activity. 

Re:Mission - an evaluation of the NHS low calorie diet programme - early learning

https://shura.shu.ac.uk/31472/1/Remission%20UK%20ASO%20Sept%2022%20Poster%20Final.pdf

Re:Mission - an evaluation of the NHS low calorie diet programme - early learning

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Sheffield Hallam University Research Archive