No, the NHS isn’t mindlessly ‘giving free Fitbits to fat people’

By Kitty Knowles 14 November 2017
Image: Getty/kali9

Those in uproar over £1.2million spent tackling type 2 diabetes are failing to see the bigger picture.

“NHS to give free Fitbits,” writes The Sun this morning.

“Fitbit-style wristbands on the NHS for the obese,” read The Daily Mail.

Today much of the British media appears to be up in arms over a new £1.2m programme launching this month to help prevent type 2 diabetes.

Critics have been swift to question the investment – wouldn’t it be better spent on those with cancer asks Mark Littlewood, head of the Institute of Economic Affairs, before calling the move “frivolous” and “unnecessary”.

And yes, the idea of the NHS mindlessly giving out millions of pounds worth of Fitbits to our overweight population would be.

But that isn’t what’s happening.

So much more than Fitbits

What NHS England, Public Health England and Diabetes UK have actually announced is a six month trial of five innovative new healthcare businesses, each that can be tailored to diabetes prevention.

Just two of the five explicitly promote wearable trackers – companies called Buddi Nujjer and OurPath – and even these only offer wristbands as part of a wider experience.

Both are first and foremost digital platforms designed to support healthy diet, physical activity and good mental health.

The other three companies being trialled include Hitachi (which has developed an online portal to support self-assessment, management and online coaching), Livia Healthcare (a coaching-first platform built with an app for goals, tracking, video communication and peer support), and Oviva (a food-centric lifestyle intervention with an on-hand dietitian, videos and podcasts).

In short: this is not a case of throwing trashy tech at patients and praying for positive results.

As you can read here, the NHS knows that simply giving out Fitbit trackers doesn’t help people to lose weight.

That’s exactly why it is working with a series of specialist online healthcare businesses.

Business sense

It’s also worth pointing out that while £1.2m might sound like a lot, the whole testing programme costs just £240 a head (roughly) to trial – a drop in the ocean of NHS England’s £110 billion annual spend.

At the end of the six month testing period, only the most effective solution is set to be rolled out on the NHS – and even then, these businesses are not going to be needed for life. Oviva and Livia Healthcare, for example, are pitched as one-off year-long programmes.

In terms of budgeting, it’s also a trial that needs to happen given that current diabetes prevention techniques clearly aren’t working well enough.

Today 90% of diabetes is type 2, which is linked to obesity and is preventable. Yet diabetes is the fastest growing health threat of our times: since 1996, the number of people living with diabetes has more than doubled.

If nothing changes, it’s estimated that over five million people in the UK will have diabetes, and those five million will cost a lot more to treat, than a preventative system of care.

Could the study have been made cheaper by being smaller or with less users? Possibly. But really, paying a couple of hundred pounds a head for 5 carefully chosen partners to be tested by 5,000 users is hardly unreasonable. It’s smart.

Get over it

If you accept that type 2 diabetes is an expensive, increasingly prevalent disease, and that the new NHS trial businesses have been picked because they are likely to work, it might be worth asking where today’s pushback is coming from.

No one bats an eyelid when money is invested in preventing other lifestyle diseases – when quit smoking apps like NHS partner QuitGenius are adopted to help prevent lung cancer, say.

Could it be that as a society, we’d still rather blame people for being overweight than step in to help?

The many mental, physical, financial, social and educational barriers that lead to obesity are still too quickly brushed under the carpet in favour of the lame excuse – ‘they’re lazy’.

Some people who are outraged today are right: fat people shouldn’t get free Fitbits on the NHS – that would be a senseless waste of money when we already know so many end up unused in drawers.

That doesn’t mean our growing obese population don’t deserve digital help to live happy healthy lives.