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Blood testing strips, type 1's and the NHS

Discussion in 'Type 1 Diabetes' started by Matt J, Jul 10, 2015.

  1. Matt J

    Matt J Type 1 · Well-Known Member

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    Hello all

    No, it's not the start of a joke and it certainly isn't funny. Are there any guidelines on how many test strips can be prescribed to type 1's or is it down to your local CCG/practice?
     
  2. ann34+

    ann34+ Type 1 · Well-Known Member

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    Hi, Matt J, you are correct, the situation appears to be a bit different in different areas. - i myself have had one lesser problem, and three serious problems. twice happened on moving. - last was few months in, at my new practice. The first two situations resulted in my moving practices. one of these was not resolved (pre 2013), the next was, but left things seriously untenable, despite Hospital letters from my consultant and also DSN, the the last was resolved quickly but stressfully. There is an an advocacy pack to help,https://www.diabetes.org.uk/Documents/Reports/access-test-strips-report-0813.pdf - may be more recent stuff now. Above references a 2013 Government guidance letter re Type one and strips, the below ref mentions the postcode lottery - https://www.diabetes.org.uk/Documents/Reports/access-test-strips-report-0813.pdf , not sure of the date. In my own experience few GPs in some areas of the uk understand Type one at all, and some practices seem to have become just businesses- one of mine was run from the USA. it was frightening finding this out when i moved areas, as it was unexpected. Hope things sort out - a lot of effort may be needed, just googled my CCG and they do regular guidance re type of strip and prices, allowed in area, and for whom, dont want to go on to see if numbers there, as stressful. next review due mid july here - makes me feel ill, really, as if strip use is some sort of indulgence. In the early 1990s my teaching hospital, when a practice account manager first queried things, wrote sharply that testing had a good chance of prevention of much more expensive care later - the price of one laser treatment was given - no more was heard from the accounts manager . But not sure finance managers are so worried re costs 30 years on now.....
     
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    #2 ann34+, Jul 10, 2015 at 8:34 PM
    Last edited by a moderator: Jul 10, 2015
  3. Fayefaye1429

    Fayefaye1429 Type 1 · Well-Known Member

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    It's generally us how much budget is in the area and surgery. I have to have 3 and a half a week which I find it's different doctors that make different comments usually because of pressure they are getting. If it helps they are usually 25 pound a box and I get told often I cost them a lot of money. To be honest I just ignore it but really a locus doctor would be more accommodating usually because they don't have to think about budget hope that helps
     
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  4. mrspuddleduck

    mrspuddleduck · Guest

    I get 100 test strips a month from GP. That's approx 3 tests a day and 7 extras! But as I'm honeymooning and unstable the hospital tells me I should test about 8 times a day! Now I know I'm not good at maths........ :banghead::banghead::banghead:. Sue xxx
     
  5. Matt J

    Matt J Type 1 · Well-Known Member

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    It's all starting to annoy me. I had my meter changed without consultation about 2.5 years ago from an Accuchek Mobile to the Wavesense Jazz - looked and felt and presumably was, cheap. I then managed to get them over time to increase my strips to 3 boxes a month i.e. 150 strips (5 tests a day). I recently saw my DN and was given a new meter however my Doc has only prescribed 1 box of strips - 50 strips, saying it is an edict from the CCG. So on my current approx. 5 tests a day the box will last 10 days!

    I have a lot of respect for both my DN and Doc and am not blaming them at all for this. I'm assuming if I just keep ordering every week or so I'll still get them? However, what about the extra costs to the surgery, doctor, pharmacy etc from processing 3 prescriptions rather than 1. I've also got the inconvenience of having to go to the surgery and pharmacy on a more regular basis.

    I got T1 through no fault of my own and have been managing it for nearly 30 years. I don't smoke or drink, I eat a healthy diet, exercise a lot - my BMI is 19.3. and my control is good. Yet, I have to jump through hoops to get a few BG testing strips.

    Whilst in the pharmacy waiting for my prescription after a day at work the local junkies roll up to go behind the curtain for their methadone. They've chosen to put **** into their bodies and the NHS is giving them a free fix. Yet it seems I'm being restricted on having a few test strips. Doesn't seem fair to me.
     
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  6. Fayefaye1429

    Fayefaye1429 Type 1 · Well-Known Member

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    Hi Matt I can understand a lot. Are you a pumper? I just ask because it should automatically increase to run along the Ccg and nice guidelines. My old doctors refused so I went to my clinic explained the situation and my nurse faxed over a letter explaining my lifestyle. That seemed to get them to stop them refusing. Maybe talk to your nurse about your challenge they have awesome weight in these things. Also I had to get my consultant to write to my gps for a referral for feet as it took 6 months to get them to mKe a referral
     
  7. Matt J

    Matt J Type 1 · Well-Known Member

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    Hi Faye

    No, not using a pump. Just penning it with NovoRapid and Levemir. I haven't attended a hospital clinic for years and just see my DN (and Doctor who although a GP has an interest in diabetes) at the surgery. As I mentioned I have a lot of respect for both my DN and Doctor. The foot clinic is also held at the surgery and obviously the retinopathy screening is at a local optician. I'm hoping over time I'll be able to get them to increase it, it's just the extra hassle and uncertainty at the current time I could have done without.

    Personally I would have been more than happy not to have set foot inside a doctors surgery in my life. Unfortunately, despite looking after myself before and since - T1 got in the way. I fully understand the budget is not a bottomless pit and savings apparently need to be made. It just doesn't seem fair how this is done.
     
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  8. Fayefaye1429

    Fayefaye1429 Type 1 · Well-Known Member

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    Hi sue I think it's a box needed every 7 days if there is 50 in the box that leaves 4 strips over for the seventh day. In theory that means would need 4/5 boxes a month. That would leave you with quite a few left over but better than none. Hope my maths works there lol 5 boxes=£ 125.00 hope that helps
     
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  9. Fayefaye1429

    Fayefaye1429 Type 1 · Well-Known Member

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    Hey Matt I agree completely it's not fair when they help us. I was completely health before diagnose and I did 5 sports which i can't do as well now as my body gives up.

    Would you consider seeing some one at the hospital? I only ask because the surgery can't open as many doors as the hospital can to the Ccg budget and you may get more pathways. I can gear you gp and. Nurse are good it just might be worth thinking about and giving yourself more options
     
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  10. Matt J

    Matt J Type 1 · Well-Known Member

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    Yes I have thought about seeing someone at the hospital clinic. I guess I would need a referral from the GP? My past experience of hospital clinics is that they are a bit more up to speed with the latest developments in T1 management and technology.

    I remember when I went on the first Novopen about 28 years ago and there was the crazy situation of the insulin pen cartridges available on prescription but the pen needles were not - they needed to be bought. When I attended my hospital clinic in Sheffield the nurse used to give me a big bag of pen needles to keep me going! :) The BDA (now Diabetes UK) at the time started a campaign to get pen needles put on prescription and it finally happened after a few years.
     
  11. Nicola M

    Nicola M Type 1 · Well-Known Member

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    I get 200 which lasts for around a month and a bit. Although occasionally I have ran out but my doctors are good about things and will prescribe more strips urgently if and when they are needed.
     
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  12. donnellysdogs

    donnellysdogs Type 1 · Master

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    As a T1 you are missing out just going to a GP.
    I bet if you looked up your GP on the GMC website that he wouldn't actually express anything in tegards to diabetes. Generally in a Practice of say 10000 patients any GP out of the 5 may be allocated diabetics to oversee. Our Practice just allocates GPs to oversee asthmatics. Or diabetics.. The GPs do not specifically have an interest.

    I went to a Diabetic conference last night when a GP actually said that DSN's are more knowledgeable because of the courses they are sent on.

    This is your health.. A diabetic consultant specialises day in day out etc and you stand more chance of getting a more informed level of care by asking to referred to a hospital.

    I had a GP in Wales that was supposedly the Diabetic' GP but thought 1 strip a day for a T1 was enough....now 300 a month.
     
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  13. Fayefaye1429

    Fayefaye1429 Type 1 · Well-Known Member

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    Hey Matt yeh you would need a referral from the go. Maybe you can approach it just by saying you were thinking and getting as much support for yourself at the moment would be useful and thought it might help to access more from the hospital? The gp will be limited with resources so it's been awesome perhaps till now and you may need just a pinch more from somewhere else for your situation now?
    If it helps I use a nurse, gp and my diabetic team. Diabetic team for pump, more specialist things like sport, nurse for bits in my body such as blood pressure and gp for my other body needs and medication. I think of it as
    Needing different departments in a store for different parts of me and I guess one place may only be able to give me so much but how awesome that there are other departments! I have no idea if I am making sense now lol but I do wish you the best
     
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  14. noblehead

    noblehead Type 1 · Guru
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    @Matt J, in February 2013 all gp surgeries were sent a letter from the Dept of Health warning that test strips should not be restricted to type 1 patients, in the summary they said the following:

    It is essential that people with Type 1 diabetes are prescribed sufficient SBGM testing strips for their clinical needs.

    https://www.gov.uk/government/uploa.../Safe-care-of-people-with-type-1-diabetes.pdf

    Print off the letter above and remind your Dr of its contents, good luck.
     
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  15. mrspuddleduck

    mrspuddleduck · Guest

    Thank you @noblehead. I'm going to try that too. Sue xxxx
     
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  16. masonbason63

    masonbason63 Type 1 · Well-Known Member

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    I actually get prescribed 200 sticks a month and I buy 50-100 myself occasionally.

    I’d like to know what is the actual cost to my surgery is for 200 compared To 2 freestyle Libre Sensors which also last a month.

    As I’m figuring if I bought 200 sticks it’s over a £100 whereas 2 Sensors is £80 from a local chemist.

    This has probably been asked before but I’ve had a trouble.

    Any help would be awesome
     
  17. evilclive

    evilclive Type 1 · Well-Known Member

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    T1? There shouldn't be any question regarding prescription of sensor strips - you shouldn't need to buy any ever.
     
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  18. Circuspony

    Circuspony Type 1 · Well-Known Member

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    You could just track down the diabetes department in your local hospital, give them a ring and mention you haven't seen a consultant for x years.....
     
  19. tim2000s

    tim2000s Type 1 · Expert
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    There are clear guidelines from NICE in the following place: https://www.nice.org.uk/guidance/ng...d-glucose-and-target-levels#how-often-to-test

    Saying at least four times per day. In addition, NG-17 says:

    Support adults with type 1 diabetes to test at least 4 times a day, and up to 10 times a day if any of the following apply:

    • the desired target for blood glucose control, measured by HbA1c level (see recommendation 1.6.6), is not achieved

    • the frequency of hypoglycaemic episodes increases

    • there is a legal requirement to do so (such as before driving, in line with the Driver and Vehicle Licensing Agency [DVLA] At a glance guide to the current medical standards of fitness to drive)

    • during periods of illness

    • before, during and after sport

    • when planning pregnancy, during pregnancy and while breastfeeding (see the NICE guideline on diabetes in pregnancy)

    • if there is a need to know blood glucose levels more than 4 times a day for other reasons (for example, impaired awareness of hypoglycaemia, high‑risk activities). [new 2015]
    1.6.12Enable additional blood glucose testing (more than 10 times a day) for adults with type 1 diabetes if this is necessary because of the person's lifestyle (for example, driving for a long period of time, undertaking high‑risk activity or occupation, travel) or if the person has impaired awareness of hypoglycaemia. [new 2015]

    The reality then is that you should expect to be allowed up to 10 a day, and then anything beyond that may be more of a fight.
     
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  20. kev-w

    kev-w Type 1 · Well-Known Member

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    I was using between 8 and 10 a day, all on prescription, I had hassles on occasion, receptionist, pharmacists assisantnetc telling me I'm using too many, but the gp accepted the NICE guidelines @tim2000s links to so the scripts kept getting signed.

    Testing is the key to T1D control in my opinion.
     
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