Skip to main content

Herts Valley

Response from Meds Management:

Dear Mr Cahm,

Thank you for your letter dated 21st March 2019.

Following publication of NHS England’s guidance on funding arrangements for Flash Glucose Monitors (issued 7 March 2019) https://www.england.nhs.uk/publication/flash-glucose-monitoring-national-arrangements-for-funding-of-relevant-diabetes-patients/ there are ongoing local discussions. Nationally it is expected that starting these products will be done for the selected groups via the patient’s existing diabetes specialist with continuation by their GP.  Before prescribing can take place we need to agree how to prioritise patients for starting treatment and how education and training for patients is offered.

Progress is being made and further discussions will take place at the Hertfordshire Medicines Management Committee (HMMC) meeting on 4 April 2019. Currently, FreeStyle Libre® is not advised for prescribing in primary care; we will continue to follow existing HMMC guidance, where FreeStyle Libre® is recommended for restricted use as an option in specific groups of patients with supplies coming from hospitals only. The local recommendation documents are available at: https://hertsvalleysccg.nhs.uk/clinicians/medicines-guidance/topic/1049/Endocrine_system/541

Updates on this guidance are expected in April/May 2019 and will be circulated to GPs and via our website, which you can access at the following link: http://hertsvalleysccg.nhs.uk/.

I hope that this helps.

UPDATE

Further to this, I asked when the meeting was and the outcome:

Thank you for your further email dated 12 April 2019.

Following the HMMC meeting held on 4 April 2019, we await final approval of the funding decision for FreeStyle Libre®. In line with accepted governance processes for local prescribing decisions, revised guidance will require ratification by two local committees. We also need to agree how to prioritise patients for starting treatment and how education and training for patients is offered. Herts Valleys CCG intend to finalise this process as a priority, and although we cannot give you a specific date, we aim to complete this within the first quarter of 2019-20.

As you are aware, in the interim we are following our existing guidance and funding arrangements, available on the Herts Valleys CCG website at https://hertsvalleysccg.nhs.uk/clinicians/medicines-guidance/topic/1049/Endocrine_system/541. As such, primary care prescribing is not recommended; FreeStyle Libre® is to be initiated, managed and supplied by a hospital Trust consultant led specialist diabetes team only.


I hope this helps, but should you require further information please do get in touch.

Update 2 - 24/05 (end of June? Why?)

I appreciate your concerns regarding the availability of FreeStyle Libre® and a decision from Herts Valleys CCG on the implementation of NHS England’s funding recommendations. Following publication of NHS England’s guidance (issued 7 March 2019) https://www.england.nhs.uk/publication/flash-glucose-monitoring-national-arrangements-for-funding-of-relevant-diabetes-patients/, Herts Valleys CCG are urgently reviewing and updating their current guidance in light of the national arrangements. Herts Valleys CCG intends to complete this process as a priority, by the end of June 2019.

Our current guidance and funding arrangements in line with the East of England Priorities Advisory Committee (PAC) remain in place and are available on the Herts Valleys CCG website.
I can confirm that once a ratified decision has been reached in relation to the new guidance, this will be published on our website and will inform GPs and patients alike on the process to follow in assessing new patients’ eligibility for prescribing.

Comments

Alan said…
Copy of email I sent the Chief Exec:

I am a Type 1 diabetic living in Radlett, Hertfordshire under the care of West Herts Hospital, who greatly benefits from my use of Freestyle Libre.

To recap:

> In September 2017 NICE published a medtech innovation briefing (MIB) on FreeStyle Libre for glucose monitoring which is available at https://www.nice.org.uk/advice/mib110

> In October 2017 NHS England’s Regional Medicines Optimisation Committee (RMOC) (North) reviewed the use of Freestyle Libre and issued the following advice to Area Prescribing Committees:
https://www.sps.nhs.uk/articles/regional-medicines-optimisation-committee-freestyle-libre-position-statement

> In November 2017 the Department of Health and Social Care authorised the flash glucose monitoring system Freestyle Libre to be made available on Part IX of the Drug Tariff.

> In early 2019 the NHS Long Term Plan was published and announced that "the NHS will ensure that, in line with clinical guidelines, patients with type 1 diabetes benefit from life changing flash glucose monitors from April 2019, ending the variation patients in some parts of the country are facing"

> On 7th March 2019 a guidance document was published which set out the criteria for flash glucose monitoring and the maximum amounts CCGs will be reimbursed for the ongoing costs of flash glucose sensors.

> The DVLA has also recently announced that they accept readings from devices such as the Freestyle Libre to support driving for Type 1 diabetics.

That’s all good news for me as a Type 1 diabetic who is self-funding the Freestyle Libre. I find it an essential tool to help my diabetes management: this is the only tool that I have access to which shows the trend of my blood glucose levels across the day helping me decide how much insulin to inject before food as well as any adjustments needed at other times of the day. It is having a positive impact on my health. The alternative is to test over ten times per day - before food and then at hourly intervals afterwards to measure my post-prandial levels (a particular problem for me). In the short term it gives me early warning of potential adverse events (hyper or hypo glycemic episodes). In the long term it helps me keep my levels low and hopefully reach my target Hba1C and avoid long term and expensive complications of this disease.

The problem is, that despite government statements I still cannot get Freestyle Libre on prescription. My consultant at West Herts agrees that I would benefit from it and meet the criteria and yet says that the CCG is still not approving its prescription across the area because the necessary information has not been uploaded to Blueteq, Your delay is costing me £100 per month and saving you expenditure on the lancets and testing strips that I use much less than before.

Could you please provide immediate approval for funding of Freestyle Libre for me.

Best regards
27 June 2019 at 20:06
Post a Comment

Popular posts from this blog

First Post

This is my first post on a blog. Not sure whether it will be the last, but we'll see. I'm not sure I'm keen on sharing too much via a blog. I think work is out of bounds and not sure I want to share too much family stuff, but maybe I'll use it to record certain events. Most probably I will use it to record my experiences with diabetes. I was diagnosed yesterday with Type 1 (insulin dependent) diabetes. I am terrified (probably phobic, although I think it is an overused term) of needles, and know little about diabetes. Evidently my blood glucose was 37mmol/l when a normal reading is less than 10mmol/l. I guess the writing was on the wall. I have lost weight and had great thirst even though I ate lots of stuff and drank almost throughout the day. It is going to be an interesting few weeks finding out about the condition and dealing with the inevitable hardships that may follow. I even managed to eat Weetabix this morning without sugar for the first time in my life! I'...
2 comments
Read more

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....
9 comments
Read more

Abbott dX Virtual 2020

Having missed the preceding event in 2019 (in Lisbon) through my man meets horse moment, I was greatly looking forward to ‘attending’ this year’s event, albeit from my spare room rather than the rather more appealing Portuguese capital…but at least the quality of tea on offer was top-notch! Each year since 2015, Abbott have run an event for bloggers and influencers (and me!) bringing together representatives from all over Europe.   This year there were over forty representatives from fifteen European countries, including eight people from the UK.   The programme was split over Friday evening and Saturday morning with a variety of speakers and discussion sessions.   The sessions were run on the Remo platform ( https://remo.co/ ), an application I didn’t know of previously, but certainly something that has great potential.   I’ll go through its functionality at the end of my review. At this point I need to stress that I haven’t been asked to blog about this event a...
Post a Comment
Read more