Case Study: Tackling the waiting list backlog for structured diabetes education in Kent and Medway

With diabetes accounting for 10% of the total NHS expenditure in England and Wales, and the number of patients diagnosed with diabetes rapidly increasing year-on-year, having access to diabetes education remains a priority for the NHS. With World Diabetes Day on the 14th of November 2021, it’s important that this message is highly recognised across the healthcare industry.

Prior to the COVID-19 pandemic, diabetes services in the UK took place predominantly face-to-face. As infections spread across the UK and lockdown began in March 2020, most face-to-face services were put on hold. Kent and Medway CCG recognised the impact this had on their patients referred for diabetes education services and wanted to find a solution to help reduce their waiting list and restore pre-COVID-19 levels.


In March 2021, Kent and Medway CCG recognised their waiting list for diabetes education for people living with Type 2 diabetes in their region was growing and worked in partnership with Spirit Health to roll out EMPOWER T2n.

EMPOWER T2n is an interactive, four-hour education programme, designed to help people understand what Type 2 diabetes is; the effect it has on their body; and how to make small, achievable changes to the food they eat and their everyday life. Spirit had already moved its QISMET accredited EMPOWER education programme to a video platform and was successfully delivering virtual courses across the UK.

The Spirit Health team contacted everyone on Kent and Medway’s existing waiting list who had been referred since April 2020, but had been unable to access their vital diabetes education. They were offered EMPOWER T2n Video as an alternative option whilst traditional face-to-face options were unavailable.

EMPOWER T2n trained educators delivered the patient education directly over MS Teams to online groups with between 6 and 12 people. The same course content as previously provided via face-to-face courses was delivered, but in the patient’s own home or a location of their choice.


Kent and Medway CCG was able to offer courses to its patients who needed structured diabetes education.

Since commencing support in April to July 2021:

Spirit has contacted all patients who were on the original waiting list of 862.
309 of these patients have attended a Spirit EMPOWER course to receive their education.
119 patients have confirmed they are waiting for face-to-face support.
Spirit has contacted all GP practices to let them know of their patients’ attendance and those declining to attend, advising of the relevant SNOMED codes.

Overall, 50% of the people on the waiting list either completed a structured diabetes programme or confirmed their intention to book onto a face-to-face programme (which Spirit are now helping by running the face to face sessions needed).

“Being able to resume diabetes education virtually has been so important to our patients’ health and wellbeing, especially while these patients remain at high risk of COVID-19. Working with Spirit to provide quick additional capacity of digital education services has been invaluable to the system, working at pace has meant we have been able to reduce our backlog within months rather than years. EMPOWER is now being considered as a permanent course offered across Kent and Medway” – Ian Butcher, Diabetes & CVD Transformation and Development Manager, NHS Kent & Medway CCG