GP wants to save money .... what do you reckon to this idea?

Alzibiff

Well-Known Member
Messages
76
Type of diabetes
Type 1
Treatment type
Pump
As a T1 since April 1967 I have seen many changes in BG monitoring and tried a fair few different meters. I have also been using an insulin pump for the past 6 years or so and changed to the Omnipod from the Medtronic Veo a year ago. In addition, I have been self funding the Freestyle Libre for a few months and find it to be an excellent - and reasonably accurate - alternative to finger pricking for BG monitoring.

My Medtronic Veo used a Bayer meter which transmitted its readings to the pump enabling my consultant to download full data relating to insulin use and BG values at my regular check ups.The Omnipod uses a similar system in that it is controlled by a handset which doubles up as a BG meter. All fine and dandy, everything in the garden is rosie..... and then I received a letter from the practice manager at my GP's practice.

The 'one size fits all' letter tells me that they are going to swap my meter to one which is super accurate and that I need to attend a training event in a couple of weeks. After that, they will stop prescribing my current test strips and switch to those compatible with the new meter.

Clearly, this is an attempt to save money - the training is being provided by the manufacturer of the new meter and its test strips and the meters will no doubt cost the practice nothing. Also of no doubt is that all of the manufacturers profit will come from increased sales of the test strips and the GP will save money by prescribing cheaper test strips. Gain for the patient? Don't think that there is one in my case.

My idea? First off, I don't want to switch and I have called to let the practice know that I will not be taking them up on this new meter offer but if they insist, I intend to ask for their response to a different money saving idea: whether they will contribute to a privately funded use of the Freestyle Libre system or Dexcom CGM in return for a very much reduced use of test strips - maybe one box every 6 months rather than the four boxes a month I have had prescribed for many years. In short, I would like the practice to subsidise - not pay 100% - my use of a BG testing system which will be better for me and better for the NHS in the long run. (I did a lot of letter writing a few years ago to no avail when I tried to convince my CCG that they should pay to give me a continuous glucose monitoring system alongside my Medtronic pump).

I need to add here that I do not agree in principle to funding my own healthcare given that I paid tax to the government all of my working life which should have funded my healthcare via the NHS, so this idea is a reluctant one but one which makes sense to me if I am prepared to spend some of my hard earned pension in this way.

Alan
 
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noblehead

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Hi Alan,

You need to make it quite clear to your gp practice that your pump also doubles up as a bg meter, although you can manually input your bg readings into the PDM I don't think you should be made to do that, if you have any problems then ask your DSN or Consultant to email your Dr's and I'm sure they'll see sense,
 

CarbsRok

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Messages
4,688
Type of diabetes
Type 1
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Insulin
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I intend to ask for their response to a different money saving idea: whether they will contribute to a privately funded use of the Freestyle Libre system or Dexcom CGM in return for a very much reduced use of test strips - maybe one box every 6 months rather than the four boxes a month I have had prescribed for many years. In short, I would like the practice to subsidise - not pay 100% - my use of a BG testing system which will be better for me and better for the NHS in the long run.

Slight problem if you drive, the DVLA will not accept CGM and or libre readings.
 

donnellysdogs

Master
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13,233
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Your GP shpuld accept that you are different and keep you as you are. Mine did easy.
 

tomfalc

Member
Messages
23
Type of diabetes
Type 1
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Pump
My GP tried this a few years ago, but accepted that as a pump user I was a special case.
 

Cap'n M

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Verified HCP
Messages
67
Type of diabetes
Type 1.5
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I think it quite reasonable for our CCGs, LHBs and GPs to promote the use of testing strips provided by the manufacturers at the best prices. We all know how cash strapped the NHS is and we are ALL responsible for ensuring that we get good value for our tax payers money.
When it came to updating my old Accu-Check Compact, I acquired a freebee Bayer Contour Next USB via this website. It was nice to use, up to date BUT the strips would cost the NHS £15.04 per 50.
My Lambeth GP supported Nipro TRUEyou, which is a new advanced device whose strips are provided to the NHS at £9.92 per 50. They gave me a free device, provided by Nipro, of course. I'm sure that if Nipro tried pushing their prices up to £16 they would soon be dumped by the Lambeth CCG.
As regards Alzibiff's posting, I'm not conversant with insulin pumps and clearly, GPs and CCGs need to be flexible with managing the minority who need such systems.
 

Britishbob

Well-Known Member
Messages
46
Type of diabetes
Family member
Treatment type
I do not have diabetes
As a T1 since April 1967 I have seen many changes in BG monitoring and tried a fair few different meters. I have also been using an insulin pump for the past 6 years or so and changed to the Omnipod from the Medtronic Veo a year ago. In addition, I have been self funding the Freestyle Libre for a few months and find it to be an excellent - and reasonably accurate - alternative to finger pricking for BG monitoring.

My Medtronic Veo used a Bayer meter which transmitted its readings to the pump enabling my consultant to download full data relating to insulin use and BG values at my regular check ups.The Omnipod uses a similar system in that it is controlled by a handset which doubles up as a BG meter. All fine and dandy, everything in the garden is rosie..... and then I received a letter from the practice manager at my GP's practice.

The 'one size fits all' letter tells me that they are going to swap my meter to one which is super accurate and that I need to attend a training event in a couple of weeks. After that, they will stop prescribing my current test strips and switch to those compatible with the new meter.

Clearly, this is an attempt to save money - the training is being provided by the manufacturer of the new meter and its test strips and the meters will no doubt cost the practice nothing. Also of no doubt is that all of the manufacturers profit will come from increased sales of the test strips and the GP will save money by prescribing cheaper test strips. Gain for the patient? Don't think that there is one in my case.

My idea? First off, I don't want to switch and I have called to let the practice know that I will not be taking them up on this new meter offer but if they insist, I intend to ask for their response to a different money saving idea: whether they will contribute to a privately funded use of the Freestyle Libre system or Dexcom CGM in return for a very much reduced use of test strips - maybe one box every 6 months rather than the four boxes a month I have had prescribed for many years. In short, I would like the practice to subsidise - not pay 100% - my use of a BG testing system which will be better for me and better for the NHS in the long run. (I did a lot of letter writing a few years ago to no avail when I tried to convince my CCG that they should pay to give me a continuous glucose monitoring system alongside my Medtronic pump).

I need to add here that I do not agree in principle to funding my own healthcare given that I paid tax to the government all of my working life which should have funded my healthcare via the NHS, so this idea is a reluctant one but one which makes sense to me if I am prepared to spend some of my hard earned pension in this way.

Alan
As a Type 1 patient, I believe you are able to choose your meter and particularly have one that is able to measure Ketones - check NICE guidelines and quote this to the practice.
The biggest saving to the NHS is by keeping patients out of hospital - not using cheap strips.
May want to ask the practice staff how using cheap strips will highlight any highs and lows of your glucose levels throughout the day - then show them a report from the Libre - be prepared to pick them up off the floor and explain how it shows all glucose levels over 24 hours. Not just a few times a day as they currently want to pay for.