On the "people" point, what about those of us who are already educated and already have good control? For us, it should not be "education first, tools second" because we already have the education and knowledge. We know our diabetes better than anyone. If you can show that you understand your diabetes and are managing it well then CGM should be provided to help you to continue to do that. As we all know, T1D is hugely burdensome and - for most of us who care deeply about it - there is literally not an hour that goes by when it is not on our mind. If you can show you are self managing and CGM would help you do that more easily then, in my opinion, CGM should absolutely be provided by the NHS. Even if it is the case that "30% of people struggle", "over 50% don't even test daily" there is no reason that those of us who do invest our time and mental energy into this horrible condition shouldn't be given the tools to make it easier.
Lots of really interesting stuff, but this post, in my view, forms the core of the "pro" argument. In the meantime (and, please, don't roll your eyes and go "Ugh, T2 weighing in..."):
1. Throughout this thread people have been talking cost vs meters and their test strips (and finger pricking), which is a fallacy. CGM is designed to be used
alongside regular testing, While, arguably, it could be a help to responsibile self-managers when it comes to reducing complications, it's an immediate cost
increase.
2. The more the NHS buys of something, the better the deal they can get. This is why things are slow to change. CCGs band together to procure better deals from their suppliers. This is why, for example, people who have issues with incontinence haven't seen an improvement in their products for years and years - the CCG groups stick with the best deals.
Which sounds like potentially great news, but it means that, sure, entering the market and buying a supply of CGMs for patient use, a CCG group will get a great deal. But the chances are that product will not change, no matter the improvements made to other CGMs and the technology in general.
Which means, ultimately, people - as with continence products and so on - will be able to get CGMs through the NHS, but to get ones that suit your needs and are the best / easiest / most efficient available, they will still end up self-funding.
3. "Essential" means "cannot live without". Not "really helps and has changed my life after 30 years" (for example). Currently, the NHS does not fund medical cleansing kits for children with central lines and trachys who are not in hospital. I'd call that stuff fairly essential. In fact, the wealth of actually essential stuff that isn't funded would blow your minds. It does what it can.
I appreciate the benefits. I can see people who cannot imagine managing their diabetes without a CGM, and I salute you for it. And, yes, in children and the elderly, they are obviously beneficial. But that does not make them "essential".
4. "Cost-saving" in the NHS is also a fallacy. I worked on a project that ultimately ended bed-blocking in high-dependancy bed in my local children's hospital. It just required community services to co-ordinate and communicate more effectively, but ended up "saving" the hospital £2 million in its first year.
This wasn't money the hospital got back. It was just money it didn't have to spend. It's not like when we go grocery shopping and pay £1.50 instead of £3 for our cheese - they will not have that £1.50 as "extra".
The notion of "saving" the NHS money is media myth that proves popular with readers and viewers. In real life, you don't save, you just don't spend as much on that particular thing. The money still gets spent.
5. This issue will not be fought and won via people power and petitions, but with a strong business case requiring an overall look at potential savings (hospital admissions, complications, self-management etc) vs potential costs (the immediate outlay, education - and NHS staff training and awareness, The X Factor). If the first can be demonstrated to outweigh the second, CGM will be made available.
It might seem as if I'm being terribly negative, but I'm actually in support of this being available on the NHS. I'm pro anything that allows people to empower and manage themselves more effectively. But with that in mind, I agree with something
@Brunneria said very early on on this thread about education and better diet advice, and that links back to the post I quoted.
We can't have all the things we want all the time. And once we get what we want some of the time, we need to be ready to put it to good use.