Public Health England and Diabetes UK, NHS England wishes to procure a Framework Agreement with up to 4 (four) providers who are able to provide, anywhere in England, between 10 000 and 100 000 behavioural interventions aimed at preventing or delaying the onset of Type 2 diabetes in people with non-diabtic hyperglycaemia (or pre-diabetes) over the 3 year term of the Framework Agreement. It is anticipated that between them, the providers will deliver up to 30 000 behavioural interventions in the first year of the Framework Agreement and will be able to upscale to deliver up to 60 000 behavioural interventions in year 2 and up to 100,000 behavioural interventions in year 3. The numbers of behavioural interventions may vary during the term of the Framework Agreement and these figures are estimates only, as precise quantities of likely purchases are unknown.

The primary aim of the NDPP is to reduce the incidence of Type 2 diabetes in the cohort referred onto the NDPP (i.e. those with non-diabetic hyperglycaemia). The secondary aims are:

(i) to reduce blood glucose parameters (Hba1c or Fasting Plasma Glucose) in participants at 12 months and beyond;

(ii) to reduce weight of participants at 12 months and beyond, and

(iii) to maximise programme completion rates by those referred onto the programme. A tertiary aim of the programme is to establish sound data collection mechanisms to ensure that programme effectiveness to reduce the long term microvascular and cardiovascular complications of Type 2 diabetes, as well as to reduce the associated higher mortality risk, can be assessed.

The behavioural interventions should include a focus on diabetes risk, weight loss, physical activity and diet and explicit use of behavioural theory and strategies. The focus is on individuals who are on the threshold of developing diabetes and non-diabetic hyperglycaemia is defined as having an HbA1c 42 — 47 mmol/mol (6.0 — 6.4 %) or a fasting plasma glucose (FPG) of 5.5 — 6.9 mmol/mol. Only individuals aged 18 years or over will be eligible for the behavioural intervention and the primary routes of referral will be by a General Practitioner or via the NHS Health Check and a blood test must have been completed prior to referral. Successful providers may be able to seek potential service users using a direct to consumer approach. Further details will be set out in the Invitation to Tender (ITT). NHS England will seek to identify Clinical Commissioning Groups and Local Authorities with which it might enter into separate arrangements in relation to referrals. It is anticipated that Clinical Commissioning Groups and/ or Local Authorities will be involved in awarding contracts under the Framework Agreement and the contracts may be awarded by way of a direct call off or following a reopening of competition. Interested providers must be able to deliver the behavioural interventions anywhere in England and the ability to mobilise quickly may be assessed at tender stage. Further details will be set out in the ITT.

The results of the behavioural interventions will be evaluated to inform any potential changes to the specification during the term of the Framework Agreement. NHS England therefore reserves the right to make non material amendments to the specification during the term of the Framework Agreement to improve the behavioural interventions, however NHS England may also carry out further procurement processes in relation to the NDPP. Providers may deliver aspects of the behavioural interventions through innovative means (such as, but not limited to, via the internet or a mobile phone application) however the core requirement in the specification will be that the behavioural interventions will be delivered face to face because evidence from previous diabetes prevention programmes sets out that face to face services are more likely to lead to a successful outcome for the service user. Where innovative means are used for the delivery of the behavioural interventions, they would have to be the subject of an evaluation and the data on outcomes would have to be shared with, and the relevant provider would have to work with, the relevant evaluation team in relation to that evaluation.

During the first year of the Framework Agreement, it is anticipated that providers would be paid on a per intervention basis. NHS England reserves the right to vary the Framework Agreement during its term so that the payment mechanism is amended to reflect a payment by results (often referred to as outcomes based) mechanism. Further details will be set out in the ITT.