Written Evidence Submitted by Ms Sarah Welfare at Reed Wellbeing (FWM0141)

Health and Social Care Committee – Inquiry into Food and Weight Management

Evidence from Reed Wellbeing

Reed Wellbeing, a subsidiary of public services provider Reed in Partnership, delivers evidence-based health improvement services across England. Over 220,000 people have benefited from our healthy lifestyle and behaviour change services. Our services that include weight management elements include:

• Healthier You: the NHS Diabetes Prevention Programme. The community-based nine-month programme is informal, interactive and supportive. Reed Wellbeing delivers this programme in Chesire & Merseyside, Greater Manchester, Lancashire & South Cumbria, North East & North Cumbria, South Yorkshire, Stoke & Staffordshire and West Yorkshire.
• NHS England Type 2 Diabetes Path to Remission programme. The programme provides a specially formulated diet for three months followed by personal healthy lifestyle support for another nine months. Reed Wellbeing provides this programme for NHS England in Staffordshire and Stoke-on-Trent.
• We also have designed and developed Adult Weight Management programmes, Family Weight Management programmes as well as bespoke programmes for people with learning disabilities. These programmes are delivered in our healthy lifestyle services such as One You: Westminster, Kensington and Chelsea.

How well are weight management services functioning in the NHS and are they providing equitable access to treatment?

As a provider of weight management services Reed in Partnership is committed to delivering high quality and equitable services. We conduct regular quality audits including quality assurance with Health Coaches every six months. Our real-time service user feedback tool, Participant Voice, rates our NHS services 4.8 out of 5 (based on 24,500 items of feedback).

NHS weight management services operate using a tiered care model (from one to four). There are undoubtedly pressures on both tier two services, which offer community-based support and provide individuals with a 12-week programme of structured support, and tier three, where recent research[1] highlights significant gaps. Given the scale of need and inconsistencies in eligibility criteria by area, both would benefit from expansion and standardisation to reduce some of the geographical variations in access.

The services that Reed Wellbeing delivers are community-based, tier two services. These are over-subscribed but well-evidenced in their impact. For example, the NHS Diabetes Prevention Programme has been shown to reduce the risk of type 2 diabetes by nearly 40%[2].

There are a number of ways in which Reed Wellbeing has worked to increase equitable access on the tier two services that we deliver.

One is by providing a choice of channels, as well as tailoring delivery. Our Diabetes Prevention Programme delivery offers people referred by the GP as being at risk of developing Type 2 diabetes a choice of either face-to-face or digital app-based delivery options.  Tailored remote delivery is also offered to support particular groups of participants, e.g. Urdu speakers, sight or hearing-impaired participants and those at risk of gestational diabetes.

This approach has increased the number of people referred to the programme who go on to take up the offer of support, contributing to a reduction in the risk of developing potentially life-changing health conditions. Providing bespoke delivery of programmes, our Health Coaches are able to dynamically incorporate culturally relevant programme adaptations.

Another means of ensuring equitable access is by using digital tools to increase access to our services. Digital tools can also reduce the cost of accessing services by eliminating travel and increasing the length of time that services are available, for example for those on shifts. They can reduce geographic isolation and stigma/anxiety associated with in person services. Our Healthier You: NHS Diabetes Prevention Programme website utilises a UserWay accessibility widget to provide translation for people where English is a second or foreign language as well as a number of website adjustments catering to a range of needs such as, for example, people who have low vision, dyslexia and ADHD to those who are impacted by seizures and epilepsy.

Our work to improve access to our services has seen the introduction of the NiCE Proactive AI Agent to support our Contact Centre, which receives more than 300 referrals a day from GPs for our NHS Diabetes Prevention Programme alone. This intelligent AI innovation has seen: the wait time between GP referral and Reed Wellbeing patient engagement reduce by 55%, the time between referral received and first NDPP session attended reduced by 26%, increased sign-up rates and our team of expert advisers having more capacity to support individuals with more complex needs to join the service. There is a positive impact on health outcomes from converting people from referral to service, and increasing participant numbers enhances the experience for all attendees.

What changes might be needed to services, or additional support from Government, to ensure they are able to provide equitable access and take advantage of innovations in treatment?

• Over the coming years innovation and adaption will be key in weight management services. With the increasing use of weight-loss drugs, we strongly believe that this needs to be supported with wrap around holistic weight management and healthy lifestyle support (as recommended in NHS commissioning guidance[3]) in order to achieve sustainable positive health outcomes, alongside digital innovations that can widen both access and responsiveness for the individual.
• There is an evidenced need for targeted community programmes. For example, the Heal-D programme in the UK is a culturally tailored intervention supporting healthy eating and active lifestyles for African and Caribbean individuals living with type 2 diabetes. It demonstrates the value of culturally responsive, community-based approaches.
• National weight management guidance should be adapted to reflect ethnic and gender differences in risk – such as using appropriate BMI, waist circumference, and waist-to-height ratio thresholds. Dietary tools like the Eatwell Guide should be revised to include culturally relevant foods and meal patterns. Barriers such as limited cultural competence in services and lack of representation in policy design can be addressed through co-production with communities, improved workforce training, and inclusive policymaking processes.
• Inclusive and representative public messaging: Marketing materials for food and weight management policies must reflect the dietary habits of different cultural groups. This improves relevance, engagement, and trust in public health campaigns.
• The NHS could consider introducing a readiness to change scale for weight management services. Prior to accessing the services, a check on readiness to change at referral point could help determine how ready an individual is to engage with treatments and lifestyle changes. This would support the effective use of resources over the long term.