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Lobbying for Test Strips on Prescription...

P

payitforward

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I visited my GP practice for a first visit since diagnosis recently (one visit with the practice nurse previously) and saw someone other than my regular GP.

His opening gambit after asking why I was there, and I said to review my diabetes care, was to say he was not a diabetes expert.

It quickly became apparent that even from my limited experience of my condition, I have gained considerably more knowledge than he had. He asked me a few questions but remained ominously quite in terms of more in depth questioning of my answers or may be it was that he was in total accord!

What was interesting was when I asked re: a presecription for the testing strips for the blood monitor supplied to me be the practise nurse. Basically, they don't prescribe these.

When highlighted the NICE guidelines on the subject of effective monitoring and patients being proactive in their treatment... he responded that it was felt that type 2 needed less intensive monitoring and that the Hb1A2C was demed sufficient. I offered the view that this was a little like trying to visualise an entire painting by Seurat, who painted with dots, by looking at one dor on the canvas. He said that practise policy was not an area he had any authority in and suggested Iwrite to the practise manager, cc the local PCT.

What are the views of others here? And, does anyone have a suggested wording for such a letter?
 
Hi.

Unfortunately it is all down to cost - that and the fact that many HCP's dont stick to guidelines as you found.
There are about 1600 posts on here all with some reference to test strips and why people don't get them. Do a search and take a look.
You are going to be your own lobbyist. Write to the Practice Manager, see your usual GP. confront them with your evidence and FACTS. You may get lucky - then again, not.
Lifes a beach ! (sp)

Ken :D

Oh, BTW. Do you know what sort of readings you get at the moment. I see you are on diet only. that could be another reason why - he say No !
 
CatherineCherub has posted some excellent advice in this post.

And could I refer you to this post?

It is arrant nonsense that an annual or bi-annual check of a value that represents the last three months control is sufficient to demonstrate how well controlled an individual is.

George
 
They are now saying that T2s don't need to bee well controlled, because it costs too much
 
I'm not saying that I agree with the author but doesn't the report you refer to make reference to a specific subset of the type 2 community Hana?

This link provides a summary of the report, including links to the studies referred to in the report.

I quite like the ADA/AHA/AACs response to the VADT study referred to, which is robustly repeated here, that says:

the evidence obtained from ACCORD, ADVANCE, and VADT does not suggest the need for major changes in glycaemic control targets but, rather, additional clarification of the language that has consistently stressed individualisation.
Click to expand...

This document asserts that:

While blood glucose control is important in type 2 diabetes, UKPDS showed that tight control of blood PRESSURE was more effective in preventing diabetes-related endpoints and deaths (1). MeReC states that “Cardiovascular disease is the leading cause of morbidity and mortality in patients with type 2 diabetes, and managing cardiovascular risk factors is at least as important as managing blood glucose.”
Click to expand...

The MeReC decision aid for type 2 patients can be found here

In my opinion Lehman's report does not justify denying prescribed test strips to type 2s - but, as a lay-person with an interest, what do I know? :)

George
 
It's utter madness and a false economy. Diagnosis of T2 is sometimes made following presentation of one or more complications, the management of which often ends up being a lot more expensive than a few paltry test strips, aside from the quality of life issues. Successful management of the condition requires good glycaemic control, so you kind of need to know what your blood numbers are, and a good deal more than 4 times a year!

There's another avenue that might be worth exploring. The NHS Exceptional Funding Panel meet to consider applications from individuals to fund treatments that are not normally covered by your local PCT. The only difficulty being that you'd normally require the support of a medical professional to make such an application, so this might be your usual GP?
 
My wife has been a diabetic for about 14 years now and since she got a glucose test meter so long ago that I can't remember, the tests strips have been put on prescription for her and will be for as long as is needed. Usually test her once a day but there have been times when it needs to be higher than this and sometimes do it every 2 to 3 days.

Hal
 
All diabetics should get their own copy of the NICE guidlines and underline the relevant sections. If you need test strips just tell your GP that you regularly get hypos and need to drive. I get near hypos on a regular basis as I am very active and I would never dream of leaving a session at the Gym without testing my Blood sugar. If you are on Glyclazide or similar you should be in position to test your blood sugar as suggested in the NICE guidlines. My advice to ALL diabetics is to learn as much as you can about your desease as only you can really provide the best treatment. My personal treatment and that of members of my family has in the past been third rate primarily because too many GPs do not know enough. Now I know enough about the condition that I determine what medication I am on and when I have my blood tests. LEARN about your condition and SAVE your life. HbA1c 7.7 (GP looking after me, HbA1c 6.4 (With self care). Generally Diabetes Care in Britain is very weak (Government Statistics). Do your research and you will be horified.

When you have a blood test always ask the value of your HbA1c. Never just accept the reply, "It is fine Mrs Smith". If it is more than 7.0% then ask for action.
 
Well said, wpaisley.
I agree with you entirely.
The problem is that PCT's and HCP's use the NICE Guidelines to do as they please. they stick to them when it suits, then ignore them when it doesn't ( i.e. costs) then they say, " Well they are only Guidelines. " You just cannot win. :?

Ken. :D
 
As Diabetics we should COMPLAIN, COMPLAIN, COMPLAIN. It really does work. I complain to the PCT about my GP. I stand up in PCT meeting and complain. Alan Johnson and the NHS say that I have a right to competent treatment at my GPs surgery but I have yet to receive it. I have been a patient at my GP for over 26 years. I have always trusted them but it is only as a diabetic that I discovered what poor service I was getting. It was TEST STRIPS which demonstrated the poor service. TEST STRIPS allow you to determine in part what type of service you are receiving. I might give the impression that I am anti doctor. I live in Norfolk. The standard of Cardiac care 150%. THe standard of Diabetic care 20%. Going to the Gym now as I feel my Blood Pressure going up and up.
 
OMG. I don't want to be responsible for a Cardiac Arrest. Go and lie down :shock:

I have been an advocate such as you describe for years. Cannot understand why people are so timid in challenging something they do not believe is right. they seem to be in awe and fear of a GP/ Nurse etc. Makes my blood boil too - now where is my tablet..... :D

Ken
 
I had my first post diagnosis (T2) visit to the diabetes nurse today.

She gave me a blood sugar monitor and prescriptions for needles and test papers. I am to e mail the surgery for further prescriptions as and when needed.

I am to test once a day, but vary the times so that a pattern of my blood sugars emerges.

I am hoping that I can control it by diet - first reading at surgery - 2 hours after lunch was 6.9 - and two hours later, before tea, it was 4.2.

I can also go on a course if I choose (I think I will) to learn more - and in particular it will allow me to meet other newbies. She also gave me dietary advice - and was quite happy when I said I would like to follow the low glycemic load route - but without all the fat that is technically allowed. She emphasised that I should have a little snack if mealtimes were to be far apart.

She was very encouraging, and told me to ensure I had a little treat from time to time - so I had the last piece of choc covered orange peel after tea (stuffed green pepper using quinoa).

I felt that she was very helpful, and that I had had all that I need just now.

I think the idea of testing once a day is good because it will prevent that desparate obessession that I know I have felt with weighing myself too often.

She was also reassuring as to why I hadn't lots weight despite my having shrunk somewhat - due to muscle build up because I have also been exercising.

She told me to contact her at any time if I had any worries or questions - and it is good that there is someone so helpful to turn to if necessary.

The surgery is in NE Essex.
 
Hi All,
I have been diagnosed for over a year now and have managed to have good control on a very low carb diet. My GP has insisted I keep testing so I don't become complacent and has never questioned my requests for more testing strips. Seems like I am one of the lucky ones, it's a shame they all aren't so helpful! It seems true some doctors have no idea about diabetes, one even told me it was ok to eat sugery foods as long as I ate it with carbs!! :roll:
 
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