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How to get an insulin pump on the NHS?

Discussion in 'Insulin Pump Forum' started by RollingJovi, Oct 29, 2017.

  1. RollingJovi

    RollingJovi Type 1 · Member

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    I’ve posted on here before that I suffer from mental health issues and I’m battling paranoid schizophrenia as well as type 1 diabetes. I’ve been under management of district nurses for my insulin dosages but have been taking back control slowly from the district nurses to maintain my own insulin doses more regularly and without input from district nurses.

    I understand unless I am completely self managed with my insulin I will find it hard to get funding for an insulin pump. But that day when I regain complete control is not far off and I will maintain myself better. My hba1c is 9.9% presently and I find the dawn phenomenon is adding to my control issues in the morning.

    I was just wondering how I would gain funding from the NHS in England to get a Medtronic MiniMed640G with CGM sensors too. Has anyone been able to get this on the NHS and how easy is it at all to get and have the CCG fund?

    I’m currently using a accu-chek aviva expert blood glucose machine. Any help and information on how to go about securing a possible yes to the pump/CGM would be most appreciated!!

    Many thanks
     
  2. claire1991

    claire1991 Type 1 · Well-Known Member

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  3. Seacrow

    Seacrow LADA · Active Member

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    I wondered about this since I have mental health issues. My dsn said pump, no problems. The cgm sensors are another thing entirely. If your local hospital has a consultant enthusiastic about cgm, then maybe.

    If the hospital doesn't want to use cgm, they can't be forced to. It goes like this:
    To get a pump, you have to show the probability of significant improvement in your bg management. To get the cgm sensors you have to show 'episodes of disabling hypoglycaemia'. But these 'episodes' can be seen as evidence that the pump has not improved your bg management. So it is now down to bureaucracy whether you get taken off the pump or put on cgm.

    My dsn says my local authority falls on the side of 'Heck no. Do you know how much that'd cost?' Worth checking into your local health authority's policies before asking your doctor.
     
  4. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    The dawn phenomenon in itself is likely all you need to get a pump if its effecting your daily BG management......I don't know what a mental illness would mean for you though....

    Would there be a risk that you could lose the ability to self manage in the future during a bad bout for example....?
     
  5. ringi

    ringi Type 2 · Well-Known Member

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    A cgm that uploads all the BG readings to "the cload", so that the district nurses etc could see them would be great for people with mental health issues, as the nurses will know when they need to take action.
     
  6. helensaramay

    helensaramay Type 1 · Well-Known Member

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    Have you spoken to your diabetes health care team about this?
    Although the interpretation of the pump criteria varies per area, it is always your team who you need to liaise with.

    It is probably useful to think about the criteria in the links @claire1991 provided above to set out your argument.
    Unfortunately, a pump is not a cure and is not a simplification of your diabetes control: it is less forgiving than injections when you get your carb counting wrong. In my area, for example, we are required to go on a DAFNE-type course to prove we understand this before qualifying. It is not the same everywhere so, as well as being prepared with your argument why your would benefit from a pump, it may be useful to be prepared with an explanation of how you cope with carb counting.

    Good luck (sorry to say, there does seem to be some luck involved)
     
  7. hopeful84

    hopeful84 · Member

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    Hi to All
    I am writing to You as I need a help and I hope You can help me or try to do it. I come from Poland and recently I have gone through the horrible events and I decided to do my best to help my mum .. I want to gain for my mum some insulin pump from NHS, it can be Paradigm 715 or Accu Chek Combo or something else if You can reccomend to me? To get it in Poland , You can buy it only privately but it is very very expensive so I started chewing it over how to get it from the other country? do You know if it's possible? I will be grateful for any help .

    Take care and be strong!
     
  8. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    Are you asking to get it on the NHS without actually living here.....?

    If so, no, that's not possible..... or moral even...

    You need to be a resident of the UK, and preferably a resident who has paid in to the system...although the paying in isn't required...
     
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  9. hopeful84

    hopeful84 · Member

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    Thanks novorapidboi26 for some help in understanding how does it work but I can't get over that You can get it from NHS and I have to buy it only privately ;/ we are all in EU so I think we should have the same rights which everyone has and I would buy it wherever I am, provided that my country is in EU? if You can, pls tell me which pump do You use? do You know if it's possible to control the glucose level via sms from any pump? I mean, I am not leaving with my mum but I'd like to know if everything is all right? e.g. I am home, 10km far from my mum and when the glucose level is increasing or dropping I would get the sms to act and help in form of calling?

    Thanks in advance!
    Best Regards
     
  10. hopeful84

    hopeful84 · Member

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    what else, I would like to know if I buy the mdi or accu check combo , do You have any service after the guaranteed lifetime ? what I know, in Poland , fixing the old pumps is uneconomic and they want we to buy it new once again..
    btw: sorry for my english, but I have still learned that ..
     
  11. hopeful84

    hopeful84 · Member

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    Thanks for some help in understanding how does it work but I can't get over that You can get it from NHS and I have to buy it only privately ;/ we are all in EU so I think we should have the same rights which everyone has and I would buy it wherever I am, provided that my country is in EU? if You can, pls tell me which pump do You use? do You know if it's possible to control the glucose level via sms from any pump? I mean, I am not leaving with my mum but I'd like to know if everything is all right? e.g. I am home, 10km far from my mum and when the glucose level is increasing or dropping I would get the sms to act and help in form of calling?

    Thanks in advance!
    Best Regards
     
  12. Diakat

    Diakat Type 1 · Well-Known Member

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    Not all UK diabetics get pumps. In spite of paying in...
     
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  13. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    In an ideal world we would all have access to the same technologies yes, however the NHS isn't a European service....its just provides for the United Kingdom.....

    I use the Medtronic Paradigm 754....currently I am not aware of any remotely controlled pumps, at least over the ranges you are talking about...

    An insulin pump is best operated by the pump user as its them who needs to be aware of all the different settings and be able to make short term changes if needs be...

    Is your mums diagnosis recent.....?

    What support is she getting...?

    Its sounds like you are taking the diagnosis quite hard, which isnt good, but gaining good control on injections is perfectly possible and actually best to try out first once the basics of carb counting and dose adjustment is established...
     
  14. hopeful84

    hopeful84 · Member

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    I have to admit You are right, but I can't understand the horrible world where you can count for no help. I can say You are lucky living in UK, having hope I will find some solution.. when it comes to my mum, she has diabetes type 1, she got it in youthful age, she has refund from our NFZ , your NHS for insulin and sth more, I don't know excatly what else, but it doesn't matter as I want to gain insulin pump from them but every reply convinces me that impossible :(
    My mum has to take blood with glucose meter every day and I wish to spare her that.. but the most problem in my opinion is that my papa passed away a month ago and my mum had sometimes tendency to hypoglycemia..
    Backing to old days, my father was caring for her and was close to her every day, even I have been lived many km far from them.. currently I come back to my mum every other day as I affraid of her, you know what's going on, I can't lost her! and do my best to make her and my life mentally easier ..
    Today I was talking with medtronic's rep and he told me about Guardian Connect to control and get information about glucose level via txt, in case suddenly decrease of it I would get txt about that and swiftly respond, but he also added that it can't be connected with insulin pump?
    Have You ever heard about it? or maybe You know the insulin pump which can be compatible with this?
     
  15. helensaramay

    helensaramay Type 1 · Well-Known Member

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    The NHS applicability is not based on Nationality or Europeaness or even how much money you have paid in British taxes. The NHS very clearly states “the NHS is a residence-based healthcare system.” So not even a British person living in Poland is entitled to a pump funded by the NHS.
     
  16. emmacheasty

    emmacheasty Type 1 · Member

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    Life events that cause emotional upheaval and stress which affects our blood sugars whether or not you are on a pump. The greiving process is a prime example of the most stressful life event.
    Your mum has been on injections for years and during this stressful sad time she needs more input from her specialists, picking up any trends when she is getting her hypos and then can adjust her insulin doses accordingly.

    Even if she had a pump it requires a team that understands how to manage people on a pump....an insulin pump in uneducated hands is very dangerous piece of kit and will almost guarantee a hospital admission.
    Does she even attend a diabetes clinic where they have patients with pumps?
    There is also the cost of the consumables for the pump....these are not cheap either.

    Please do not listen to the pump reps who's job it is to sell you a product....it is not a one stop fix it shop.... pumps are amazing bits of kit if you have the correct education prior to starting and support whilst using.

    Kindest Regards
     
  17. hopeful84

    hopeful84 · Member

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    Thank You to All for your replies, I didn't expect that whoever gives me some reply for my question, Thank You very much! but coming back to my problem, today morning I have got some info from my colleague that her friend from UK said the following: You can get the insulin pump from UK on one condition that: equalize diabetes?I don't know how to say, stabilised diabetes? lack of often hypoglycemia? they exclude anxiety disorder, depressive illness, no control of glucose level?
    Can You refer to that?

    Emmacheasty, thank You for nice words and understanding, I can say that my mum hasn't had the pumps in your hand yet and I am convinced she doesn't know how does it work and who would have it, so me and her are newbie in this, and I know the training course of that has to be carried out prior to using.

    Coming back to pumps rep, he told there is system under the name of Guardian Connect (Medtronic). Thanks to that I would get txt from this on my phone and track glucose level with my mum? what do You think about that? Following this thinking, it maybe better if I would buy only pump without cmg and buy the Guardian Connect to have much more control of live of my mum?
     
  18. hopeful84

    hopeful84 · Member

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    Can You also tell me how much is pump cost at You with cmg and without that? Our prices are teetering between 10 - 15 000 zł with cmg , it's about 3500 euro ,they cost about 2000 euro without cmg, thanks
     
  19. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    After a quick online search there is a thing called guardian connect, but I believe it is an app that can be used alongside Medtronics continuous glucose monitor (CGM)......so, that's a completely separate device from an insulin pump......so if your mum got a hold of one of them, you could monitor her levels.....you wouldn't be able to take any action on those levels, but you could for example raise the alarm if you were notified of a hypo event......

    Has your mum had any dose adjustment training? What insulin regime is she on? [multiple daily injections/basal/bolus or twice a day injections]

    Can you clarify what your colleague said about obtaining a pump from the NHS if you're not a resident of the UK? My interpretation is that they are saying you can get one if you have stable blood sugar control and rarely have hypos...well, thats the opposite scenario of the one where a pump would be considered here.......frequent hypo due to insulin sensitivity is usually a reason to get one...

    The best option for your mum is to gain control on the insulin injections, increase her knowledge of dose adjustment....
     
  20. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    I think my pump costs about £2500 minimum......and I would expect a CGM to cost something similar, maybe a little less......

    So its big money and that not including all the consumables you will need with those devices on a regular basis....
     
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