Table 1

 Costs of the DESMOND intervention

Category and details of costLevel cost incurredCost based on the trial of the DESMOND intervention6Cost in the “real world”
Cost (£)BasisCost (£)Basis
Delivery of the DESMOND intervention
EducatorsDESMOND course531Two educators per course for two days per course, at £128 per day479One educator per course for one day per course, at top of band 6 (£39 701 per year including costs)
RefreshmentsPatient4Average of £3 per patient for a one day course or £1.50 if course split over two days; scaled up to include cost of guests (assumed ratio of patients to guests=5:3)1Estimate (less than during trial as no lunch provided in “real world”)
HandbookPatient125
Disposable course materials (for example, flipcharts, worksheets)DESMOND course68
Course materials (for example, food, models)Primary care trust*6300Included in £675 starter pack from DESMOND central office
Non-perishable “food models”Primary care trustCovered within “sundries” cost below18
Leaflets and postage (for example, letter confirming date, letter to practice)Patient22
VenueDESMOND courseNot applicableIncluded within £400 sundry payment to primary care trust25Estimate based on feedback from primary care trusts; can vary by a large amount depending on local circumstances
SundriesPrimary care trust400None assumed research cost0Itemised above
Training costs
Courses to train educatorsTrial*30 224†Training daysIncluded in fees (see “Programme fees from DESMOND central office” below)
Sundry course resourcesTrial*9Included in fees (see “Programme fees from DESMOND central office” below)
Quality assurance of educators
Educator time and travelNot applicable0Quality assurance done while courses runningIncluded in fees (see “Programme fees from DESMOND central office” below)
Quality assurers’ time and travel‡Educator*181Two educators were assessed at each visit; total 11 visitsIncluded in fees (see “Programme fees from DESMOND central office” below)
Programme fees from DESMOND central office
Training three educators (year one)Primary care trust*Not applicable2385£360 each for three educators per primary care trust per year
Quality assurers’ fees and travel (years two and three)Primary care trust*Not applicable1001
Annual fee for accreditation (year two onwards)Primary care trust*Not applicable300£50 per educator per year
Starter packPrimary care trust*Not applicable675
Programme fee§ Primary care trust*Not applicable49430.015p per patient in primary care trust per year
Coordination and indirect costs incurred by primary care trusts
Coordination time (for example, booking patients on course, sending letters, booking rooms)DESMOND course127Expected to do five courses in trial593.5 hours per course at Band 4 (£20 821 per year including costs)
Within trial central office costs (delivery only)
Element to annuitise (for example, arranging training)Trial*7420.5 days per month for 15 monthsNot applicable
Element relating to trial periodTrial742Not applicable

DESMOND, diabetes education and self management for ongoing and newly diagnosed.

Educators’ travel costs were deemed to be negligible because these costs would not be claimed if the course was held locally or no further than the distance to workplace.

*The benefits of these resources accrue over several years. We conservatively spread out such costs over a period of three years.

†£30<thin>224 was the cost of training 26 educators on two courses. The courses took two days and were necessarily residential to allow participation of educators from all over the country. This outlay contributed £69 towards the cost per patient of delivering the DESMOND course during the trial (including overheads).

‡For the trial, this cost was averaged across 13 primary care trusts because not all trusts received a quality assurance visit.

§Dependent on size of primary care trust. Total calculated from average primary care trust size.