NHS legally obliged to give you test strips?

[BarryLey]

Hi everyone. I am a type 1 who tries to do everything right. Good diet/excercise etc. I keep my levels around 4.2-5.8. But to do this I need to test around 7 times a day. This was no problem in Australia where I was diagnosed, but today my diabetes nurse told me I couldn't have that many strips. She says I only need to test once every 3 days. ONCE! If that was all I could test my levels would be all over the place and I would get very ill very quickly. Does anyone know if the NHS are obligated to give me the strips I need? I have a meeting with my GP tomorrow...

 

[Froobes]

That doesn't sound right at all! Perhaps they're thinking you're a Type 2? Although even then I would have thought a Type 2 would need to test more than once every 3 days!

 

[BarryLey]

That's what I thought. But how can a DB nurse not know the difference? Is there some sort of legal obligation? I mean can I demand them?

 

[Froobes]

I'm no expert don't get me wrong, I think Cugila would probably be the best person to ask as he seems to be pretty clued up but I would have thought you should be able to demand a certain amount. It does seem rather contrary of the NHS to refuse test strips, in order to avoid complications (which inevitably will cost more in the long run) we all need to have as tight control as possible. That can't happen without regular testing. I would definitely look in to it more. You're doing the right thing by getting an appointment with the GP, though.

 

[BarryLey]

Sure, in the long run I would cost less money. But right now (in this adminsitration's budget) it is slightly more expensive to give me the strips. I will only cost money when I get ill, in another adminstration's budget. So they don't care about what happens in 10 or 20 years really...

That's why I need to know if I can insist :?

 

[sugarless sue]

She says I only need to test once every 3 days.

That is criminal ! :shock: How are you supposed to control your levels testing once in three days ? How are you supposed to drive safely and avoid hypos. You also need to be able to test before and after exercise . This nurse does not know what she is talking about ! This again is the cost of test strips rearing its ugly head within the NHS. Puttiong Patients and others at risk

This is YOUR health and YOUR Diabetes. The frequency of testing should be agreed between the person with Diabetes and their Diabetes care team. SMBG should be regarded as an integral part of treatment for ALL with Type 1 Diabetes.

The majority of people with type 1 Diabetes should monitor their BG levels at least 2-4 times Daily depending on their treatment, lifestyle and individual needs.

Don't be dictated to ! Stand your ground and tell this Doctor what YOU need to maintain YOUR health.

 

[Froobes]

Well said Sue!

 

[BarryLey]

Thanks for the support. But if I demand and he says no, is there some legislation I can quote? Or some regulatory body that will help me? (I am afraid that if I speak to the PCT I will get somebody who does not understand DB and will say "do as the doctor says...")

 

[sugarless sue]

These are the guidelines from CG15 NICE Guidelines. Use these at the doctor's !

RECOMMENDATIONS
R18 Self-monitoring of blood glucose levels should be used as part of an integrated package
that includes appropriate insulin regimens and education to help choice and
achievement of optimal diabetes outcomes.

R19 Self-monitoring skills should be taught close to the time of diagnosis and initiation
of insulin therapy.

R20 Self-monitoring results should be interpreted in the light of clinically significant life
events.

R21 Self-monitoring should be performed using meters and strips chosen by adults with
Type 1 diabetes to suit their needs, and usually with low blood requirements, fast
analysis times and integral memories.

R22 Structured assessment of self-monitoring skills, the quality and use made of the results
obtained and the equipment used should be made annually. Self-monitoring skills
should be reviewed as part of annual review or, more frequently, according to need and
reinforced where appropriate.

R23 Adults with Type 1 diabetes should be advised that the optimal frequency of
self-monitoring will depend on:
● the characteristics of their blood glucose control

Education programmes and self-care
● the insulin treatment regimen
● personal preference in using the results to achieve the desired lifestyle.

R24 Adults with Type 1 diabetes should be advised that the optimal targets for short-term
glycaemic control are:

● a pre-prandial blood glucose level of 4.0–7.0 mmol/l and
● a post-prandial blood glucose level of less than 9.0 mmol/l.
Note: These values are different to those given in the recommendations for children and
young people with Type 1 diabetes because of clinical differences between these two age
groups.

R25 Monitoring using sites other than the finger tips (often the forearm, using meters that
require small volumes of blood and devices to obtain those small volumes) cannot be
recommended as a routine alternative to conventional self-blood glucose monitoring.

 

[cugila]

I am not sure if there is a legal obligation on this so will be doing some digging. NICE guidelines are vague about the whole thing. We are looking at this in depth. There is definitely a moral obligation and also a duty of care. This seems to be lacking here. :shock:

As my pal Sue said, have a full and frank discussion with your GP. The thought that a Type 1 only tests once every 3 days is ludicrous. Beggars belief ! Is this the policy of the practice or just somebody who doesn't know what they are talking about. It is criminal. You need to test much more often especially if you drive.

Fight tooth and nail, complain to the Doctor, Practice Manager, the local PCT, your MP, everybody. :twisted:

 

[BarryLey]

Thanks guys. I will certainly make my case with the GP. If he doesn't understand/refuses to help, I will speak to the practise manager. But if I have to go to the PCT, who should I speak to? I mean if they don't understand DB type 1, won't they just take the GPs word for it?

 

[BarryLey]

Sue thanks for the guidelines. They should be helpful

 

[sugarless sue]

Also have a read of this from Diabetes UK, Barry, maybe give you more ammunition.

http://www.diabetes.org.uk/Documents/Ho ... 202010.pdf

 

[cugila]

From an NHS website........information for Type 1 Patients.

Monitoring your own blood glucose levels
An important part of your treatment will be making sure your blood glucose level is as normal and stable as possible.

You will be able to manage this using insulin treatment and by eating a healthy diet, but you'll also have to regularly check your blood glucose levels to make sure they are not too high or too low.

Exercise, illness, stress, drinking alcohol, taking other medicines and (for women) changes to hormone levels during the menstrual cycle can all affect your blood glucose levels.

In most cases, you'll need to check your blood glucose levels at home using a simple finger prick blood test. You may need to do this up to four or more times a day, depending on the type of insulin treatment you are taking. Your diabetes care team will talk to you about your ideal blood glucose level

http://www.cks.nhs.uk/patient_informati ... /treatment

If you are a Driver you need to test to comply with DVLA conditions regarding your D/Licence. If you don't....it can be revoked !! Tell them all this, print it off if needs be.

Blood glucose should be checked before driving (even on short journeys), and tested every 2 hours on long journeys. If the blood glucose level is 5.0 mmol/L or less, the person should eat a snack before driving. Alcohol should be avoided.

From the DVLA.......

As for complaint to the PCT......complain to the Head Honcho......they are not all penpushers BTW !

This is one of those times where I wish we could name and shame........

 

[HLW]

That's terrible. Can you see another GP, so you can get enough test strips right away?

 

[JUSTFOCUS]

Hi type 2 here
my DN was on the phone to me this morning and told me that if i want to keep testing I had a right to do so with the correct amount of strips and if anyone were to interfere they would have to answer to her
I test 4 times /day .Don't let them tell you .You are afterall are(The client 8) )
hope i helped
JF. :wink:

 

[smidge]

I spoke to someone at PALS (Patient Advice and Liaison Service) when nurse at my surgery was refusing to prescribe test strips. They sent me all the guidelines from the Trust in this area and I was able to take that to the GP to discuss the situation - he prescribed immediately. Now I'm on insulin, the DSN at the hospital wants me to test 7 times a day. My prescription is up for review in April, so I'm just hoping there won't be any arguments about it!

Keep insisting!

Smidge

 

[Sue o2]

Hi,
I'm T2 and test 7 times a day sometimes more if i go too low, my doctor is 100% behind me as she knows i need to be in control of my diabetes,
Sue

 

[sugar2]

Barry,

If you drive, you are obliged to test before you get behind the wheel. I have been asked to reduce my testing before...but from 10 to 4 test strips daily. I talked to them about driving, and also being on teh pump, and they were hapy to fill my strip prescriptions.

The testing before driving thing is hotly debated elsehwere...and I don't think it is "law" but you have to agree to do this when you sign up for your driving licence...so if it is not law, it is very very close to one.

 

[Sid Bonkers]

The DVLA say you should test before you get behind the wheel of a car but they don't say who has to pay for all those strips. The NHS doesn't buy you a car and neither are they legally bound to prescribe you test strips to use before you drive.

That said when I was on insulin and my GP's practice refused me the number of strips I was using I mentioned the DVLA requirement and got my prescription filled with no problem. It is very much up to the particular doctor you have as to whether you will get all the strips you require.