Skip to main content

Pump funding - 2008

Not written in ages as I have had so many other things to do - kids, decorating, work etc. I still don't have a great deal of time, but felt industrious this evening whilst watching England fail at cricket, and wrote the following email to an American asking about the situation for UK diabetics:

"Not sure whether you got an answer to the pump question about UK. I think I have a fairly balanced view of it (not common here):

In the UK, we pay taxes which cover most of our medical needs (socialised medicine). Our companies often pay for private medical insurance, but these do not cover chronic conditions like diabetes. As there are limited funds, everyone generally gets the same treatment (in theory) and an organisation called NICE (National Institute for Clinical Excellence) decided what is the best treatment for each condition based on cost and clinical outcome. They have decided (this is a summary) based on the clinical evidence that a) Type 2 diabetics are never eligible for pumps, b) Type 1 diabetics are only eligible if they have severe unforseen hypos or very high a1c's that have not been controlled by all efforts a using mdi.

They (NICE) are currently reviewing the scientific evidence, but as it stands pumps are not widely available and therefore clinical expertise is not great in this area.

It is possible to self-fund a pump, but you also have to fund the clinical assistance (physician consultations) so it is prohibitively expensive. Alternatively health authorities (governance of regional health policy) can decide how they use their finite funds. Some have decided not to follow NICE guidelines, so pumps are available. I expect these policies to change in the nea future but further scientific evidence for the success of pumps needs to be proved and the price of them needs to come down.

Finally, to complete the picture, prescriptions (notes written by doctors (physicians) for medications are charged at £6, $12 a time, but diabetics that are on insulin have free prescriptions for any medication, whether it be related to diabetes or not. Diabetes is one of the very few ailments that falls under this exemption.

Hope you haven't been too bored with this description. Maybe I'll save it to try and help some one else to understand the situation. It is not as bad a situation as some people make it. Just talk to an American diabetic without adequate medical insurance to find out the shortfalls of that system!"

Maybe it is of interest to someone reading this blog....

Comments

Popular posts from this blog

Big Announcement - Libre Funding

NEWS RELEASE Embargoed 00:01 November 14 NHS TO PROVIDE LIFE CHANGING GLUCOSE MONITORS FOR TYPE 1 DIABETES PATIENTS Tens of thousands of people with Type 1 diabetes across the country will benefit from life changing glucose monitors on the NHS. To coincide with World Diabetes Day, Simon Stevens, Chief Executive of NHS England, is announcing action to end the current variation patients in some parts of the country are facing to access Freestyle Libre. The wearable sensor does away with the need for inconvenient and sometimes painful finger prick blood tests by relaying glucose levels to a smart phone or e-reader. NHS England will ensure the device, which is the size of a £2 coin and sits on the arm, is available on prescription for all patients who qualify for it in line with NHS clinical guidelines. From April 2019, these patients will be able to receive it on prescription from their local GP or diabetes team helping them to better manage their blood sugar levels. It comes as the NHS seeks t…

The CCG Project!

In order to find out the situation around the country for Libre prescribing now that the national policy has been published, I have made the decision to contact many of them to find out their plans.  I have arbitrarily chosen to contact all English CCGs that in December 2018 prescribed Libre via Primary Care to less than 5% of their population (and one specific request from a group member).  I had hoped this would be a small list, but there are 135 CCGs on the list.  I may have bitten off more than I can chew, but I'm committed to doing this and feeding back.  It worked before and hopefully this level of scrutiny will bring similar results.

Below is a screenshot of the base document I am sending to each of the CCGs - it has some fields that are merge fields, so don't worry about the brackets and codes in the document (I found a typo, which has now been corrected too)
The major piece of work with respect to this is finding the right person to contact.  However, I have some m…

NHS England Libre Policy

The NHS England policy for prescribing of Freestyle Libre has now been released.  There is a link to the document at the bottom of the page, but the key part of the policy can be viewed below.  Here is the Link to Policy