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Moving from USA to UK...what to expect from NHS

S

skrautheim

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We will be moving from the US to the UK for two years beginning in early 2012. We have a ten year old boy with Type I. He was diagnosed when he was 2 1/2, so we are experienced at dealing with the diabetes.

My question, though, is what to expect from NHS when we arrive. Currently, we receive insulin, strips, and pump supplies every three months. He sees an endocrinologist once every three months and his primary care pediatrician once a year for a "well child" visit (preventive care & vaccinations). All these are covered within our normal deductible & co-pay limits.

My biggest concern is how hard it will be find an endocrinologist and how many visits NHS allows. My next concern is test strips & supplies. We have a brand new Animas pump, so does NHS pick up the tab for pump supplies? and do I have any brand choice on my test strips? In the States, private insurance typically has tiered pricing (my cost is lower for picking preferred brands, but you can pick most any brand you want if you are willing to pay a higher price). Are there any costs to me - compulsory or optional services - within NHS?

Thanks for your help.

Stephen
 
My understanding of the rules is that you would not be entitled to free treatment in the first year.

As I understand it the NHS will pay for pump consumables if you meet NICE guidelines (unable to get adequate control with MDI - I don't know how they would be applied to someone already using an insulin pump).
Brand choice may depend on your trust - the're people here saying that they had to switch to a particular meter because it was cheaper for the trust, and those (like myself) who can get virtually anything on prescription.
 
If you are coming to the UK and you are employed in or study in the UK ( with valid student visa/work permit) you will be entitled to NHS primary and secondary care. The regs are those linked by the last post.
I'll leave the rest of the post to others since I don't live in the UK now. The question on insulin pumps is one I very much would like the answer to as I have one and may need to return to live in the UK.
 
Basically, everyone in Uk registers with a GP (General Practicioner, sometimes called family doctor; if juts doctor is mentioned, people usually mean GP). Those who need specialist care eg a child with type 1 diabetes, will be refered by GP to a hospital clinic approprate to their needs eg not all hospital diabetes clinics / consultants (usual term for any specialist physician, who leads / co-ordinates a team of other doctors, specialist nurses, dieticians etc) deal with both adults and children, and not all deal with pumps. GPs issue prescriptions for all consumables, usually monthly, but having type 1 diabetes and being a child are both qualifying reasons for free prescriptions ie nothing to pay atthe chemist when you collect your items. However, GPs do hold budgets and may restrict items if consider excessive. I'm not sure how they would deal with someone on a pump who doesn't meet NICE guidelines - assuming you're moving to England - rules are wider for free prescriptions in Wales & Scotland, but tighter for pumps, and they have their own methods of deciding who is elligible for a pump.
 
I think that it depends where in the UK you will be. In Scotland, the NHS is devolved, meaning all running and decisions come from the Scottish Parliament, so any rules will be different, depending where you are moving too.
 
Thanks for the replies so far.

To clarify, We will be moving to England (Derbyshire), I will have a work visa, I will be paying UK taxes, and my understanding from the company is that I am eligible for NHS from day 1. Still fuzzy on the details, but I have a second layer of insurance, but I think that is for when i travel abroad away from the UK.

I am trying to get a better understanding, because I may be able to negotiate a standard of care package with the company for the type I diabetes. (i.e, have the company pay for pump supplies if they are not available through NHS).
 
Why not contact the British Embassy in the US and see if they can give you any information? They may be able to give you the name of the Primary Care Trust that covers the place you'll be living. Then you could Google it and see if you can get in direct contact with them before you come over, find out what the set-up is.

Or how about your employers' Human Resources people? Can they help you?

Viv 8)
 
I don't know the answers to your questions but I would imagine that if your child is already on a pump then the pump consumables would be paid for and they wouldn't expect your child to be taken off the pump and put back onto MDI, that would seem very unreasonable indeed and traumatic for a child who is used to managing their diabetes using a pump.

You will need to register with a GP (family doctor) who will refer you to a diabetes specialist clinic in the area. If you are not happy with the clinic you are referred to you have "patient choice" and have the right to request referral to a different NHS clinic. At the diabetes clinic you will have a team of consultant and diabetic nurse to look after your child's diabetes, a dietician is often involved when needed too. We get an appointment for every 3 to 4 months if our HbA1c's are good, I think if they're not good then your appointments may be more often. The consultant will write to your GP giving them a list of medicines and supplies that you need on repeat prescription, these will be for test strips, insulin, glucogel/hypostop gel, lancets, ketone strips, basically anything not directly related to pump consumables. You will need to request a repeat prescription from your GP as and when needed. The strips have always been for whichever test meter I'm using and haven't had any trouble with them saying that I can only be prescribed for one type of meter. I've never had trouble being prescribed enough consumables, we use as much as we need to and try not to be excessive and wasteful.

Assuming they are happy to continue with the pump, I really can't see why not, then you will also be put in touch with the pump company and from them you will receive consumables for 3 months at a time. We use an Animas pump and they their helpline here is very good, always receive the consumables within a couple of days of ordering. My only concern with your Animas pump is that when we were choosing the pump the latest model (Ping) at the time wasn't available here in the UK. You say your pump is brand new so I worry that perhaps it's a model not yet released in the UK which might then pose a problem. You will want to make sure that the pump you use is in the UK and consumables are available for it. Perhaps visit the Animas UK website and ask some questions. The cost to us through the NHS for all the diabetes related consumables and appointments etc is nothing.
 
ps. also wanted to add that my father is here in the UK on a work/temporary resident visa. He qualifies for all NHS treatment just like any other UK citizen would, however as he is an adult he has to pay the standard prescription fee but for children prescriptions are free.
 
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