Libre on NHS

[donnellysdogs]

Believe me, the hell of something happening...
Well we should be making sure people are encouraged to test..

I think my details about testing were on a form, not a website years ago.
Interesting whether it is legal or not.. the risk of death, jail (some diabetics involved in accidents have been prosecuted)... well ut seriously is not worth risking falling short at any time.

 

[ringi]

The legal requirement is cover by “dangerous driving”

A person is to be regarded as driving dangerously for the purposes of sections 1 and 2 of the Road Traffic Act 1988 if the way he/she drives falls far below what would be expected of a competent and careful driver, and it would be obvious to a competent and careful driver that driving in that way would be dangerous​

The DVLA advice about blood testing when using insulin, make it “obvious to a competent and careful driver” that BG must be tested every 2hr etc in an approved way. (Likewise with everything in the Highway Code.)

Also, doctors are required by the DVLA to tell them if anyone is driving and not keeping to the DVLA requirements to test BG.

They can also use “driving under the influence of drugs” as this covers all drugs the effects someone’s driving regardless of them being prescription medicates, and it is the driver who has to prove the drug did not affect the driving.

 

[donnellysdogs]

Aaah, yes definitely under the influence of drugs...

All people taking any prescribed painkillers or depression tablets etc should also check the rules for what meds are notifiable to DVLA... not just diabetics...

 

[becca59]

Oh well, here we go again.

Do you test bloods first and leave a 10 minute gap before the Libre test. If there is still more than 20% difference ring Abbot.

 

[Diabeticliberty]

Do you test bloods first and leave a 10 minute gap before the Libre test. If there is still more than 20% difference ring Abbot.

I've taken the 50/50 option. Can I phone a friend instead please?

 

[videoman]

Not in the Devon aera;
Thank you for your email regarding the Freestyle Libre device, which has been forwarded to us by our colleagues in the Western Locality. NEW Devon CCG is aware of this technology and that it has been added to the NHS Drug Tariff. The Drug tariff provides a mechanism to determine which drugs and devices will have the cost reimbursed to the pharmacy if they supply against a prescription.
It is up to the individual local NHS commissioning groups to determine if they wish to fund this innovation, taking into account its costs, benefits and other competing priorities for the funds made available to the CCG for the commissioning of health care services.
This inevitably means that difficult decisions need to be made. Unfortunately, some treatments that patients might wish to receive, and that healthcare professionals might wish to offer, cannot be funded or are offered only under certain circumstances. This approach is consistent with other NHS organisations who provide healthcare for their local communities.
We are aware that there is significant interest in this device, which we know will incur extra costs for the health system. As with any new device, it will be evaluated with regard to clinical evidence and cost effectiveness. The CCG has processes through which it takes decisions on the use of funds for new technologies. A decision on this technology will be made in early 2018, and the CCG is in communication with local diabetes specialists about this.
Prior to this decision being made locally, prescribing is not recommended by the CCG. Communication has been sent to GPs and diabetes consultants across Devon clarifying this position.

 

[SockFiddler]

(Hope my reply isn't too late)

Find out who the "local diabetes specialists" are and by what means theyve gathered their evidence - recent studies? Anecdotal? Consultation with patients? GPs? Your local Healthwatch should be able to help you with this and maybe even put you in touch with one of these "Local specialists".

Dont let your CCG fob you off with a generic press statement; everything they do must be publicly accountable, and, if needs be, you can trump their "local specialism" (in Devon...) with national expertise. Again, your local Healthwatch will know what, who and how.

Good luck!

 

[NoKindOfSusie]

How many f&$(ing words do they need to use to say "not a cat's chance in hell."

 

[LooperCat]

How many f&$(ing words do they need to use to say "not a cat's chance in hell."

I think there is more difficulty getting it on prescription in England. I’m reading about more and more people being prescribed it in Scotland, Northern Ireland and Wales (where I am). I’m lucky enough to have it prescribed, for three months on a trial basis. If I can bring my HbA1c down by a certain amount, I will be prescribed it long term. So fingers crossed.

I’ve found it to be pretty accurate, except for when my levels are changing fast, and then the 15 minute lag becomes more obvious. I’ll do a blood test then. But I’m quite happy to bolus from it. I do a blood reading before I drive though, and every couple of hours when I’m on the road. It’s a pain in the ar... finger, but I can’t be doing with risking my licence, so just have to suck it up.

 

[kev-w]

Try contacting your local radio station to investigate, it's local news item if your CCG isn't allowing the Libre and others are under a National health service,.

I'm told there's such a report by BBC Radio York on their breakfast show tomorrow morning, I'll post a link if so...

 

[Scott-C]

For anyone under NHS Lothian, Scotland, there was an announcement on 8 February.

http://www.edinburghdiabetes.com/cgms/

While it mentions approved for "restricted use", it then goes on to say they'll be setting up group education courses on using it and, "there are literally thousands of potentially eligible people whom we have to write to and we will have to set up many group education sessions."

The prescribing criteria don't mention anything about lack of hypo awareness etc. which has been seen elsewhere, and the mention of "literally thousands" and "group education sessions" kinda suggests a broader roll out, although maybe that's just wishful thinking.

I'm in that area, so, fingers crossed, will have to wait and see how it pans out.

PS: and with impeccable timing, just got an e-mail from a co-worker who says he's off to one of the training sessions tomorrow night, so I'l get an update from him Wednesday.

 

[ringi]

I expect that "group education courses" is key, as the people who most need to improve their A1C are not members of sites like this. The Libre could transform how well education works, with people not being allowed to keep the Libre if their A1C does not improve.

(Think of the XPertHealth diabetes course with everyone being able to share their results with each other, and given it presents LowCarb as one option......)

" lack of hypo awareness" really needs a CGM with alarms and that can be trusted to give correct readings at low BG levels, hence not the libre.

 

[slip]

Everyones moving to Lothian now.

 

[ringi]

If Lothian gets improved A1C results on a large scale, the criteria will be copied by the NHS in England....... But I expect the key is the quality of the education. At present, we have no evidence that the libre helps other than with the most motivated people like us....

The accountants at the top of the NHS knows how much diabetes costs, they just need the proof.....

 

[slip]

If Lothian gets improved A1C results on a large scale, the criteria will be copied by the NHS in England....... But I expect the key is the quality of the education. At present, we have no evidence that the libre helps other than with the most motivated people like us....

The accountants at the top of the NHS knows how much diabetes costs, they just need the proof.....

It'll be interesting to see.

The Lothian DSNs are going to be overloaded with all that info coming in from their patients.

 

[ringi]

It'll be interesting to see.
The Lothian DSNs are going to be overloaded with all that info coming in from their patients.

I consider libres to be a good investment in training of DSNs, once they have each seen a few people with Type2 proving the results of low carb meals, they may never be able to look at the EatWell plate in the same way......

 

[Scott-C]

Feedback from my work colleague on Wednesday after he's been to the course tomorrow should make it clearer. Actually our other T1 in the office has told me she's going to a training session too.

We don't know if they've been selected because of some underlying facts specific to them eg a1c, general control issues, but the wording of the announcement kinda suggests they're basically inviting every T1 in Lothian along in batches - I'm still waiting for my letter.

I wouldn't imagine they'd invite people along to a course just to tell them they're not going tp get it, but, like I say, I just don't know at the moment whether those who get letters have been chosen because of underlying issues or whether it's a more general roll out.

Should be clearer on Wednesday once I hear back from them.

 

[slip]

I consider libres to be a good investment in training of DSNs, once they have each seen a few people with Type2 proving the results of low carb meals, they may never be able to look at the EatWell plate in the same way......

Unfortunately I don't think they'll see that many T2s following this announcement because of the criteria, but I do agree with you.

 

[ringi]

Unfortunately I don't think they'll see that many T2s following this announcement because of the criteria, but I do agree with you.

It only takes a few people with T2 using 400 units of insulin a day, greatly reducing insulin usage to get the attention of medics....

It also gives a good opening, asking them to do a trail with T2 to see if the libre results in better control, by motiving lifestyle changes. It does, after all, show a drop in BG when you take a walk.....

 

[NoKindOfSusie]

The other thing is how suitable for me it really is.

I have a couple of ways I could fund it. But I have not been able to get anyone medical to sign off on it... and the amazingly super awesome people who are offering to help fund it want that to happen before we can actually do it. So I asked loads but it was always "well let's wait and see how we're doing shall we?"

(I love that "we" thing they do, like my **** body is going to make their toes fall off... I wish...)

But the point is, I get the feeling there are basically two groups of people who aren't allowed to have it people who are so awesome they don't need it, which is definitely not me, and people who are so **** it wouldn't help which I fear is very much me. But the thing is that between those groups is a really narrow band of people they will probably allow to have it, no matter how they fund it. I could probably just pay for it, even, but I have no idea what anyone's attitude to that would be.