REFERRAL PATHWAYS CORNWALL DPP: Primary care referral (well-established) supported by 'Healthy Cornwall' public health website and ICB website.

REFERRAL PATHWAYS CORNWALL T2DR: GP referral; lunch-and-learn Teams meetings open to all GP practices with evening practice clinical meeting follow-up.

REFERRAL PATHWAYS CORNWALL BSOP: Mandated for all new eligible patients prescribed tirzepatide for weight loss in primary care. Lunch-and-learns at scheme start; touchpoint meetings with provider; non-referring practices contacted to remind of patient engagement value. INCENTIVE: Currently incentivising primary care to review diabetes annual checks exception lists.

REFERRAL PATHWAYS DEVON: Implementing a Single Point of Access (SPOA) as gateway to weight management/lifestyle support - triages all referrals against criteria (BMI >40; >35 with comorbidity; >30 with diabetes/hypertension; >27 with recent T2D within 6 years). SPOA supports onward referral via eRS to DPP/T2DR/BSOP or liaises with patient's GP.

STAKEHOLDERS CORNWALL: 55 GP practices; 16 Integrated Neighbourhood Teams across 3 ICAs (West Cornwall, Central, North & East); Kernow Health CIC (training, 'Diabetes and You' structured education, long-term clinical facilitators); WorkWell project coaches; integrated community diabetes specialist nursing team; LMC and LPC; voluntary care sector partners; expert reference group of people with lived experience; public health team.

STAKEHOLDERS DEVON: General practice; ICBs; prescribing/medicines optimisation; community and mental health providers; LA public health; VCSE; diabetes and obesity specialist services.

REDUCING PRIMARY CARE BURDEN: Standard Ardens templates on EMIS and SystmOne with pre-populated forms; standard text/QR-code templates for eligible patients; provider follows up referrals without further primary care involvement; simple flow chart for weight loss referrals; integration with NHS apps; lunch-and-learns, posters/leaflets/FAQs; timely outcome summaries back into GP record.

F2F LOCATIONS: Geographically accessible, especially in health inequality populations; existing community assets (community centres, leisure facilities, primary care estates); informed by population health data, travel patterns and deprivation; flexibility to complement digital delivery.

RURALITY: 40% of Cornwall residents live in settlements under 3,000; only 5 towns with 20-30k population. Many areas lack digital connectivity.

KEY LANGUAGES CORNWALL: Only 1.8% of population have a main language other than English (none exceeding 0.5%) - largely Eastern European (Polish, Romanian, Lithuanian).

KEY LANGUAGES DEVON: Over 90% of residents report English as main language; small non-English population. ETHNICITY: Cornwall 96.81% white (vs 81.05% England average); Gypsy/Traveller 0.13% (slightly above England average).

DEPRIVATION CORNWALL: ~58,500 people (10.2%) live in 20% most deprived in England (2025 IoD); 3 areas in most deprived 5% nationally - West Cornwall (Penzance/Treneere; Camborne/Pengegon) and Bodmin (Kinsman Estate, Monument Way).

DEPRIVATION DEVON: Spread across deciles - 5% in most deprived decile, 7% in 2nd, 10% in 3rd; 4% in least deprived. Unpaid care increasing; poorer than average outcomes for some mental health and wellbeing measures.

INCLUSION HEALTH: Public health 'Inclusion Cornwall' supports digital access; CHAMPs team (people with LD and/or autistic people) developed by Healthy Cornwall - supports better access to health services, easy-read information and signage, training for staff, and the 'healthy me' course. Provider expected to link with CHAMPs team for DPP access.

POPULATION HEALTH MANAGEMENT: Cornwall BI team has PHM tool covering population segmentation, LTC/risk factor prevalence and health inequalities - supports targeting and PCN/INT comparison.