From Incentive to Impact: Safe System-Wide SGLT2i Optimisation

NHS Sussex

Project summary

NHS Sussex implemented an accelerated incentive scheme in January 2026 to support general practices to switch eligible patients from other SGLT-2 inhibitors to generic dapagliflozin, in response to a national NHS England efficiency priority. As delivery and funding were determined locally by ICBs, this provided an opportunity to develop a clinically led, system-wide model of implementation.

A six-month scheme, with a premium payment for activity in the first three months, was designed to maximise early adoption and release prescribing savings. The programme aligned to the Sussex medicines optimisation strategy and was delivered through a clinically led model, with the clinical diabetes medicines optimisation lead pharmacist playing a key role in strengthening the programme to ensure it remained focused on patient safety and clinical credibility rather than cost-efficiency switching alone.

Clinical leadership ensured a clear focus on patient safety, evidence-based prescribing, and shared decision-making. Standardised searches, education, and patient communication tools enabled safe, consistent implementation at scale across primary care.

This approach has delivered a 32.4% switching rate (vs. 10.8% national and 17.6% regional) and generated over £2.5 million in estimated net annual savings to date, demonstrating high-value, safety-driven care delivered at scale.