Specialists blocking access to important diabetes technology

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Specialists in diabetes health teams are blocking access to diabetes technologies which could significantly improve people's lives. Dr Partha Kar, NHS England's National Specialty Advisor with a specific focus on type 1 diabetes and technology, has criticised the level variation of access to technology across the country. Speaking at a Westminster Health Forum on diabetes and technology, he said: "Pumps are a legal mandate. If you fit the criteria you should get it." Dr Kar is joint lead for diabetes for the NHS Getting it Right First Time (GRIFT) project. GRIFT is a programme that has been introduced to improve the quality of care within the NHS. Dr Kar has worked as significant bridge between the needs of people with diabetes and NHS management. Statistics from an ongoing audit of 91 NHS trusts show a substantial difference in access to diabetes technology across different trusts. Dr Emma Wilmot, a consultant diabetologist and founder of the Diabetes Technology Network UK, states: "We have some places where less than 5% of that population [patients with type 1 diabetes] are on a pump. We have some centres where more than 40% wear a pump. There is completely inequitable access to care, and we urgently need to address this." Dr Kar adds that some diabetes specialists are making a personal call on whether to make technology available to their patients: "Do we think the difference is down to clinical commissioning groups? No, categorically, it is down to local specialist teams. We've been to centres where the total number of people on pumps is zero because the local team doesn't believe that pumps are a good intervention. "That sort of difference needs to go. We're not talking about something very complicated; we are talking about something which is a proven intervention in type 1 diabetes care." Another key area of technology, in addition to pumps, is the availability of flash glucose monitoring (the Abbott FreeStyle Libre). Dr Kar has worked hard to break down barriers in the NHS that are preventing equality of access to the technology. Dr Kar notes that lack of adequate education on the use and benefits of technology is one of the barriers affecting access to technology. As a result, the GRIFT programme may introduce mandatory education for health staff on type 1 diabetes care to address the issue. He adds, "This has never been done, because there is an assumption that all specialists know about technology. What we are finding out, to our surprise, is that the answer is no [they don't]. That's the biggest barrier to access at the moment." Roman Hovorka, professor of metabolic technology at the University of Cambridge, spoke at the forum to point out that there are additional factors, such as "understaffing, continuous change, and a misunderstanding of technology", as to why specialist teams may be slow to make new technology available. The article appears in the BMJ.

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Diakat

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It’s clear to anyone reading the forum that there is a huge difference between locations on tech access.
 

Peter03

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I never realised so few type 1 diabetics in the UK are given pumps and cgm,s, it sounds very pour, here in France the percentages are a lot higher I suppose that is because they see the benifits of pumps and cgm for diabetics in France
 

MeiChanski

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I never realised so few type 1 diabetics in the UK are given pumps and cgm,s, it sounds very pour, here in France the percentages are a lot higher I suppose that is because they see the benifits of pumps and cgm for diabetics in France

Actually we have a different health care system compared to you and there is a lot of factors into why some areas of England lack funding and some aren’t. I wouldn’t jump the gun and say “it sounds very pour”, NHS have saved each and every person here and thank you we don’t have to pay for insulin like our fellow Americans in order to live.
There is a criteria here on who gets what and who doesn’t and there is a lot of debate whether there is more benefits than MDI. So NHS have to weigh out the benefits. Unfortunately the full kit is very expensive so we really have to persuade them to fund it. But with the future closed loop systems and non invasive testing, also more brands of CGMs with competitive prices, I am hopeful that the NHS will be more opened to more products, especially with better pricing as we all know Dexcom is expensive.
 
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It really is a travesty that so much money is squandered treating the devastating aftermath of the preposterous dietary advice typically given to those with type 2, when the funds could be better spent on technological quality of life improvements for those with type 1 :mad:

And don't even get me started on how relatively easy it would be to prevent millions of people even getting type 2 :banghead:
 
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Peter03

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I would not like to say the nhs is pour , it is just that here in France I was doing 10 finger prick tests a day costing the health system here 125 to 150 euros a month, so I am now and have been for over 2years using freestyle libre at a cost of 70 euros a month a big saving for the health sytem here and would have fought it would be the same for the NHS and of course technology means a healthy patient
 
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MeiChanski

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I would not like to say the nhs is pour , it is just that here in France I was doing 10 finger prick tests a day costing the health system here 125 to 150 euros a month, so I am now and have been for over 2years using freestyle libre at a cost of 70 euros a month a big saving for the health sytem here and would have fought it would be the same for the NHS and of course technology means a healthy patient

It is arguable, it all depends on individual case - freestyle libre is offered but under certain circumstances. Technology doesn’t always mean healthy patient, someone going through diabetes burnout or other issues could face problems on both MDI and on insulin pump. Technology makes our lives easier but it doesn’t eradicate our need to stop testing.