NHS England tells CCGs to end postcode lottery over blood glucose monitoring

CCGs will be expected to make wearable sensors that allow continuous monitoring of blood glucose levels available to all eligible patients with type 1 diabetes from April next year, NHS England has said.

NHS England said the technology would give patients greater confidence to manage their diabetes (Photo: iStock.com/6okean)
NHS England said the technology would give patients greater confidence to manage their diabetes (Photo: iStock.com/6okean)

NHS England chief executive Simon Stevens said the move would end the postcode lottery, which has seen patients in some parts of the country denied access to the Freestyle Libre device.

Patients will be able to receive the sensor ‘on prescription from their local GP or diabetes team’ from April, NHS England said.

Currently around 3-5% of patients with type 1 diabetes in England have access to the monitoring system however, if current guidance was followed, this could rise to at least 20-25% of patients, NHS England said.

It highlighted guidance from the Regional Medicines Optimisation Committee, which sets out which patients should be prescribed Freestyle Libre (see box below).

Continuous glucose monitoring

The Freestyle Libre is the size of a £2 coin and sits on a patient’s arm, relaying glucose level readings to a smart phone or e-reader.

NHS England said that the technology would give patients greater confidence to manage their condition because they would be able to more easily notice when their sugar levels were starting to rise or fall and take action earlier.

Dr Partha Kar, NHS England associate national clinical director for diabetes, said: ‘This is an exciting and welcome step forward as the aim is to have uniform prescribing policy across the NHS, irrespective of where someone with type 1 diabetes lives. This will be based on previous national guidance issued – with the provision of updating it as further evidence accrues.’

Mr Stevens added: ‘As the NHS prepares to put digital health and technology at the heart of our long term plan for the future, NHS England is taking important action so that regardless of where you live, if you’re a patient with type 1 diabetes you can reap the benefits of this life improving technology.’

Who should receive Freestyle Libre?

The Regional Medicines Optimisation Committee (North) recommendeds that patients, aged four and above, meeting one or more of the following criteria should be prescribed the device:

  • Patients who undertake intensive monitoring at least eight times daily.
  • Those who meet the current NICE criteria for insulin pump therapy (HbA1c >8.5% (69.4mmol/mol) or disabling hypoglycemia as described in NICE TA151) where a successful trial of Freestyle Libre may avoid the need for pump therapy.
  • Those who have recently developed impaired awareness of hypoglycaemia.
  • Frequent admissions (>2 per year) with DKA or hypoglycaemia.
  • Those who require third parties to carry out monitoring and where conventional blood testing is not possible.

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