Lowers HbA1c
by one per cent
Evidence base
For the NHS
by the NHS

Commissioning DESMOND

Commissioning World Class Structured Education for People with Diabetes

Commissioning diabetes care should be a strategic process involving a wide range of different people, including patients, carers and clinicians and taking into account the local vision for health and social care in the community.

Having a dedicated needs assessment of the local population is a fundamental starting point. (see NICE Health Needs Assessment: A Practical Guide)

This can help bring together key data to assist commissioners in relating good practice to their local population.

The Diabetes NSF Standard 3 highlights self-management as the cornerstone of diabetes care and the importance of structured patient education to facilitate this. In 2003, NICE recommended that all people with diabetes should be offered structured education (Guidance on the use of patient-education models for Diabetes) and the Department of Health and Diabetes UK Patient Education Working Group set out clear guidance for patient education programmes:

  • All programmes should be evidence based, with specific aims and objectives;
  • Programmes should have a structured, theory driven curriculum with effective supporting materials;
  • Programmes should be delivered by educators trained in education theory; and
  • Programmes should be quality assured, reviewed by independent assessors and with outcomes regularly audited.

DESMOND is the only programme that currently meets the standards identified by NICE and its implementation would fulfil CCGs / Health organisations obligations for structured education.

DESMOND is a structured, nationally recognised education programme for patients with Type 2 diabetes. Each 6 hour DESMOND course, presented by two health professionals, is mapped to an accredited curriculum and is delivered to 10 patients (patients may be accompanied by a friend, relative or carer).


A randomised controlled trial provided evidence that patients participating in DESMOND demonstrated greater understanding of diabetes and decreased depression scores compared with patients in the control group exposed to a spectrum of routine care. Furthermore, DESMOND appeared to elicit greater improvement in lifestyle measures (propensity to smoke and weight loss), as well as significantly greater improvement in risk scores for Coronary Heart Disease (Davies et al, 2008).

Delivering DESMOND

Each module is delivered by 2 trained DESMOND Educators . The modules can be delivered in 1 day or 2 half day formats. Adaptations can be made to ensure your local programme is culturally appropriate

Cost effectiveness

DESMOND is a cost effective treatment in the management of diabetes. The Wanless report (2002) asserts that every £1 spent on education saves £1.50 in the long-term.

For an accurate costing for the DESMOND newly diagnosed and Foundation programmes to be delivered in your health organisation please contact the National Office on desmondnationalprogramme@uhl-tr.nhs.uk