Test Strips - Complaint Response from the Dept of Health

Bluenosesol

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Folks,

I recently made an official complaint to the DOH about my local PCT adopting a policy of non precription for T2's who are not on insulin. The response is below. Pay particular attention to the words I have highlighted in red....

Dear Mr Dawson,

Thank you for your email of 1 February about the provision of blood glucose testing strips to people with diabetes. I have been asked to reply.

The Department of Health is aware that self-testing of blood glucose is an important part of the self-management of diabetes.

The guidelines from the National Institute for Health and Clinical Excellence (NICE) on the management of Type 2 diabetes set out circumstances in which self-testing can be useful, and in these situations it can support people in managing their glucose levels and avoiding hypoglycaemia.

The NICE guidelines are also clear, however, that self-monitoring of blood glucose is helpful only as part of an overall package of support for self-care, and it is vital that the results of self-monitoring are fully understood. This means that decisions about self-monitoring should be made on a patient-by-patient basis, and healthcare professionals should work with people with diabetes to make joint decisions about the value of self-monitoring of blood glucose and prescribe accordingly. Any Primary Care Trust (PCT) that is automatically discouraging the prescription of blood glucose testing strips is not acting in accordance with NICE’s advice.If you have concerns about your treatment in particular then you should discuss them with your GP. You can also contact the Patient Advice and Liaison Service (PALS) for the Solihull Care Trust on 0800 783 2894. This line can provide information and advice about NHS services.
I hope this reply is helpful.

Yours sincerely,


Daniel Cavill
Customer Service Centre
Department of Health
 
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Bluenosesol

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Ray,

on the positive side, it is a repost to GP's like mine who have a policy to blanket refuse strips based on their prefered criteria,
on the negative side, the GP can "lose" any justification simply by objecting that testing is not in our best interests as it can be counter productive and cause depression and anxiety :(

Steve
 

Sid Bonkers

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I would read that as saying that there is no justification for any PCT to make blanket 'no test strips for T2' policies.

Brilliant Steve, good work sir
clap.gif
 

hanadr

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My PCT gets round this one by allowing 2 YES 2 packs per year to non-insulin users.
I've had one this year, because I was on antibiotics for an infection.
It suits them to claim that there is no advanage to T2s Not using insulin, in self testing. I wonder how many patients they have on the 5% sofa on minimal medication. I know one, who uses Gliclazide. Which I won't because of the weight loss problem.
Hana
 

noblehead

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Well done Steve!

I wonder if when type 2 patients discuss this issue with their gp, and their request for test strips is refused, what would the doctors response be when you tell him/her the following:

'As I have put across to you the importance to me in having test strips to help monitor and control my diabetes effectively, and without the possibility of future complications. There by, your refusal to issue these on prescription to help me to self-manage my condition, I can hold you personally responsible for any problems that I may incur in the future due to unstable diabetes control'. Make sure that you tell them that you will be putting this in writing, keeping copies for yourself and your family.

I am sure that many other intellectual members that are type 2 can put across a more worthy example than the one I have wrote here, perhaps you could all get together and write a letter together with words to that effect, where by other type 2's who are refused test strips can use this to argue their case.

Just a thought I had, but may be worth considering.

Regards

Nigel
 
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phoenix

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This document may be worth reading if you are looking for valid, arguments to use with doctors.
It is the Guideline on self monitoring of blood glucose in type 2 diabetes from the IDF study group on self monitoring .

**Link removed by moderator as incorrect**

Edit: found an even more recent and more valuable one an NHS one, Date completed: 21st December, 2009

http://www.diabetes.nhs.uk/tools_and_resources/reports_and_guidance/
There are lots of caveats but how about.
Individuals with non-insulin treated diabetes
who are motivated by SMBG activity and use
the information to maximise the effect of
lifestyle and medication should be encouraged
to continue to monitor.
second edit... I think this is the same report as Nigel mentions below,
 
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Bluenosesol

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Nigel,

it's all in there!!...

The problem is that any GP's who do not wish to prescribe will always "doctor" the argument in their favour. I would like to see something more specific, whereby the GP is OBLIGED to prescribe where an indivdual can prove beyond doubt that his/her achievements surpass the norm for that GP practice!!. We typically achieve significant weight loss, HBA1C of 5.X and show a high degree of self management and responsible engagement.
Salient points from the article :-

Individuals with non-insulin treated diabetes who are motivated by SMBG activity and use the information to maximise the effect of lifestyle and medication should be encouraged to continue to monitor.
"They identify that some people with Type 2 diabetes do derive benefit from SMBG, as it can support self-management, and impact on empowerment and motivation. SMBG should be made available to those who find it useful and have been provided with education in its use.
"The report also reflects the potentially damaging effect of the arbitrary removal of SMBG from individuals who view it as a key part of diabetes self management.


Steve
 

borderter

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Test strips and meters

When shortly the GPs get the power and the budget for strips and meters do you think that they will do a deal with one meter/strip firm and then we will all lose the choice ,lets face it strips are well overpriced for scripts so I can see this happening,what do you all think? :?:
 

johnc_uk

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Interesting that I should get a letter from my Diabetic Nurse today...

'All diabetic patients are being offered a new blood glucose meter.

The True Result Twist monitor is easy to use and small. It fits easily'... etc etc

Now I get a feeling in my water that I will be offered test stips for that machine and not for my Contour. Are the practice getting a 'benefit' providing (was going to say promoting) these particular monitors?

:?
 

Patch

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That looks like the ideal meter for people that are on the go all the time. Compact, and clips onto the top of your test strip pot.

But you're right - it will be BAD NEWS if GP's start imposing those meters on all diabetics... (And I suspect there is a finacial incentive to do so...)
 

cugila

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Pretty rubbish meter IMO John. Probably one of the cheapest and most useless around. It has only a 99-test memory with date and time, but there is no data management system or download capability which is what most well controlled Diabetics want.

I would tell them to stick it where the sun don't shine....... :wink:
 
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noblehead

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Re: Test strips and meters

Not sure really but can see where your coming from, whatever they do I'll be the first to shout should they dictate which meter I use to test!

Nigel
 

Patch

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Sometimes it's not convenient to carry your primary meter with you everywhere you go. This one would fit in your pocket - you'd hardly know it was there.

stick it where the sun don't shine.......

Stick it wherever you want - my personal preference would be my pocket (much more comfortable). But each to his own, I suppose. :lol:
 

bowell

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Question
What do you all think will happen when GPs control the purse strings :?:

Test strips or no strips ?
Will surgery only supply one make of test strips or meter ?

Refuse to take on diabetics or limit the numbers due to costs ?

No more referrals to Hospital diabetic unit or consultant
just because surgery has a practice nurse that deals with diabetics at lower cost ?

Only the lowest cost drugs prescribed

Something for the pot

Bob
 

Bluenosesol

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I have just purchased my 5th meter. They all do the job. The reason I have so many, is that meters are very cheap (I just bought a Contour which included 25 strips for less than £8!! - got fed up of trying to win one!!) and the more meters I have, the easier it is to find cheap strips on ebay!!

All the Best - Steve
 
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jansilverwood

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I live in Castleford (Location removed).I was diagnosed in May 2010. I am at present controlling my diabetes with diet but my doctor wants me to go on tablets as my 3 monthly blood sugars are 7.5. I have never been given a blood monitor and it is our PCT's policy not to give monitors or strips for any type 2 diabetic unless they are on insulin.
The extent of my support so far has been a one day DESMOND course and a blood test every three months. I can't get any information about the medications and how they work yet I am being pressured to go on metformin and statins. It seems to be a "one size fits all" approach and I am having to fight to be included in managing my own health.

Is my PCT in contravention of NICE guidlines?
 
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Hiya Jan
Im type 2 on 2x 80mg Gliclazide a day, I live in Featherstone so also come under (Location removed) , I too have been told that I do not need a monitor contrarary to what the Diabetes nurse said at my DESMOND course, especially as I perform safety critical duties as part of my work. According to (HCP name removed)(the Diabetes nurse) its all because of cost, what is n't nowadays :roll: :roll: , it just seems they will give any excuse not to prescribe monitors or strips (It makes you depressed etc etc), surely we diabetics should be issued with all the equipment we need to help us control our illness. When all said and done you would not expect anyone with a broken leg not to have access to crutches!. :!: :!: