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Showing posts from 2018

December Update - Rationwatch + strips/needles/lancets

So far, I've only been looking at Libre prescribing and the variance therein.  However, there is a lull in those proceedings at the moment, with announcements from the DVLA and NHS England keenly awaited around Christmas.  Until then, I will still be working on CCGs that are refusing to answer basic questions - Gloucester and the Warwickshire CCGs to name but two.   Rationwatch Yesterday, I attended Parliament as a guest of the JDRF to take part in the Medical Technology Group discussions.  Matt Hancock (Health Secretary) spoke at the event, which was attended by patients, patient groups, lobbyists and industry insiders.  The main purpose of the event was to launch  Ration Watch : I have filled in their response form and hope that it will be possible to influence some of their discussions.  If readers of this blog have anything to add, then there's a place to register via their homepage. Items which should not routinely be prescribed in primary care: an update an

Reflections on a monumental week

This week was big - it was big because of the announcement from NHS England that the Freestyle Libre device would be prescribed across the country according to a common policy without CCGs being able to make up their own rules NHS England Announcement .  Is it a victory?  I'm not so sure - it should never have got to this point.  I hope the policy-makers both regionally and nationally come to acknowledge the reasons behind the situation and resolve to make changes to ensure that something similar doesn't happen again.  That will be the lasting legacy created by Partha Kar, Emma Wilmot and many others seen and unseen. As mentioned elsewhere the starting point for the post-April 2019 prescribing is the  RMOC Guidance  .  This isn't the final criteria, but the assertion is that it will enable 20%-25% of T1s to get Libre on prescription - perhaps more, as suggested in this excellent blog piece by Tim Street . So, why not all T1s?  Is 25% much too low?  Some people have beco

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 l

Media Articles November 2018

It's been a whirlwind couple of weeks for Libre publicity and decisions.  I have been involved with or written a number of articles across numerous media outlets.  Below are the articles that I have been involved with. Stoke Sentinel Article  - a short review with some inaccuracies based on a piece I sent to the newspaper.  It did provoke a reaction from the CCG, so did the trick! Leicester Mercury Article  - virtually verbatim what I wrote - well presented and I think did justice to our campaign.  There are signs of progress in the Leicester CCGs. BMJ Article  - comprehensive review of the situation using the data that I've put together.  The only missing element I can see is an assertion that the data that's available to me only covers primary care prescribing - I anticipate some clinicians in the North East being a little upset by that as prescribing is predominantly via hospitals in that area - but there's no data in the public domain and they are not willing

October Progress - East of England Wanderers 0 - Lancashire Utd 1 - Birmingham/Solihull & Warwickshire still refusing to play ball!

In the world of Libre, progress is happening - often slowly, often deeply frustrating but punctuated by bright lights of hope, optimism and tales of persistence bringing results. Here are the highlights of the past month or so: The announcement of Libre 2 -  Announcement  - more below Policy for prescribing published in Blackburn, Blackpool, Chorley, E Lancs, Preston, Morecambe Bay, W Lancs and Fylde CCGs -  Policy  - more below A policy statement from Dartford, Medway, Canterbury, Thanet, S Kent Coast, Ashford, Hastings, Eastbourne, W Kent & Swale CCGs  Statement   This states that Libre prescribing will start in early 2019 following the RMOC guidance. Guidance published by East of England PAC which covers Beds, Luton, Cambridgeshire, Essex, W Essex, Mid Essex, NE Essex, Thurrock, Basildon, Castle Point, Southend, EN Herts, Hers Valley, S Norfolk, W Norfolk, Norwich, G Yarmouth, W Suffolk & Ipswich CCGs  Adult Policy ,  Paediatric Policy  - more below Policy released

Tweetchat - 12th September 2018

Yesterday evening I hosted the weekly webchat on Twitter taking over  @GbdocTChost .  The topic of discussion was "Libre - where we're at".  It was a frantic and fascinating hour of discussion involving members of the #gbdoc.  As host, I had little chance to voice my answers to the questions I raised, so thought it might be good to share some of my thoughts.  Of course they are just opinions and discussing them helps me to modify my thinking and learn.  I had seven questions prepared and miraculously managed to fit them into the time allocated (Tweetdeck scheduling of tweets was very handy!). Q1. What is your favourite piece of diabetes tech and how did you find out about it? I love Libre as you might have guessed, but  MiaoMiao  takes it to another level.  I now understand those that are passionate about the Dexcom.  Having those permanent active reminders, alarms and prompts changed everything about how I manage my condition and my motivation.  Libre made a differen

August Libre Update - Data, data and more data!

This month's update will be dealt with in two parts, both focusing on data; the first part summarising some data about the prescribing policies across England, the second my usual update on prescriptions fulfilled across the UK. Libre Prescribing Policies and Implementation in England There didn't seem to be an easy way to compile this.  I used the Diabetes UK Map  to link to the policies and then I cross-checked this with a Google search to see whether there was any more information.  I had to do this line by line for each of the 195 CCGs in England - quite a lengthy and tedious process.  However, I am pleased with the information arising from the data. Firstly, the headline figures - how many CCGs were funding Libre, how many had denied funding and who were still undecided?  There are differences of opinion about these figures as some CCGs have not been clear (Staffordshire CCGs), and some have agreed to fund, but are yet to actually fund due to implementation difficulti

Libre Policy Links

The England CCG Policies - as at 15/10/18 (and in the public domain!) RMOC Guidance BaNES and Wiltshire Barnet and North London Barnsley Bradford, Calderdale, Greater Huddersfield, North Kirklees, Wakefield  (new November '18) Brighton, Hove & High Weald Bristol Birmingham/Solihull and Sandwell Cambridge & Peterborough Canterbury and Coastal Coastal West Sussex Dorset Dudley East Berkshire East Cheshire, South Cheshire, Vale Royal East of England  (now superseded) East of England Adult September 2018 East of England Child September 2018 East Riding & Hull Erewash, Hardwick, North and South Derbyshire North and East Lincs APC Extract from mins Lancashire (Blackburn, Blackpool, Chorley, E Lancs, Preston, Morecambe Bay, W Lancs, Fylde) Lincolnshire (4 CCGs) Hackney Hambleton, Richmond and Whitby Harrogate Havering Herefordshire Kernow Leeds - minutes with mention of Libre Leeds Policy Leicestershire  (now superseded) Leicester  (released

July Update - CCGs Under Pressure!

The heat is unbearable in some parts, not only in the environment, but also hopefully the heat directed at the decision-makers in 'non-compliant' CCGs who are either refusing to accept that Libre is a revolutionary tool for many T1s or have agreed to fund, but then set crippling criteria. Latest Prescribing Data Progress in prescribing continues, with stabilisation in Scotland and a continuation of the steady rise in the other three countries of the UK.  The Wales May data should be out this week. As mentioned last month, the situation in Scotland is particularly promising and the excellent Edinburgh Centre for Endocrinology and the Scottish Health Technologies Group have published documents that should significantly help the Libre case.  These documents are based on the first six months of prescribing Libre. Healthcare Improvement Scotland Statement Flash Glucose Monitoring is associated with improved glycaemic control and quality of life in people with type 1 d