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Find support, ask questions and share your experiences. Join the community »

T1's having strips limited?

Discussion in 'Diabetes Soapbox - Have Your Say' started by Dizzyangel75, Mar 19, 2014.

  1. Barrie Smith

    Barrie Smith Type 1 · Active Member

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    Over cheapo meters they did that to me 2 yrs ago ,51 yrs type 1 at the time , 2 days later did a test before dog walking 11.7 got 1/2 mile fell down 3 times with severe hypo badly stained knee ligament taking 3 months to recover .Ran tests against my one touch ultra which proved that meter and 2 others of different makes I was given were measuring more than 1/3rd higher , very dangerous particularly before driving .
    Went to PALS who put me through to the circuit Diabetic Sisters office who were aware of the problem and told me contact the CCG who after some argument told GP to reinstate strips for my old meter , So Be Very Very Carefull .
     
  2. ConradJ

    ConradJ Type 1 · Well-Known Member

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    If you do have this happen to you and you're on insulin, call your GP and ask him/her if they're going to restrict your insulin and change it to another type that you haven't used.

    When they answer 'No' to those two questions, point out to them the simple fact of life with diabetes: to administer your insulin correctly (and therefore not over or under medicate and end up in hospital - at an average of £300 per day), you NEED to know what you blood sugars are at LEAST FOUR TIMES per day - or 6-8 times per day if you're a pump user!

    If they try to argue the toss, ask them how they diagnose new diabetics: Do they give blood tests or do they just give a suspect a shot of insulin and see what happens next?

    My GP has barely dared to breathe over my prescriptions since running this past him.
     
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  3. Paul J

    Paul J Type 1 · Well-Known Member

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    My Surgery sent a letter to me asking me to have their meter and test strips
    I told them that I was happy with my current accu-chek Aviva and mobile, and that they worked well together especially with the software, as I could download the meters to my laptop from which they take data from, to monitor my condition, all of which is lost with their less accurate meter and strips.......they didn't argue and advised me to carry on! ........never heard another word
     
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  4. Davyb

    Davyb Type 2 · Active Member

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    There is only one reason for test strips being limited or being limited to a small set of meters....

    1. The NHS monies are controlled by CCGs (Clinical Commissioning Groups) and these are being controlled by PENNY PINCHING BEANCOUNTERS rather than CLINICIANS i.e. Accountants (but NOT Actuaries) rather than Doctors/Nurses/Patients (Actuaries live in the (usually life assurance)/ insurance world and work with actual data) rather than the beancounting accountants that work with guess-estimates (usually bad ones).
    Some CCGs are trying to limit use by T1's and T2's to specific meters such that the test strips cost £10 or less per prescription item.

    If your doctor changes your meter and prescription to comply with the bean counters, question their actions !!!

    The best cudgel to apply is usually that of DVLA Medical and testing for driving, otherwise the cost of failing to prevent expensive surgery.

    I have a spreadsheet - its a .numbers file (mac spreadsheet) from data in the Drug Tariff - "Appendix IXR - Chemical Reagents" The June 2014 edition (it is published 3 working days before 1st of the month) and it shows that 67 reagents can be prescribed on NHS prescriptions, 7 are for urine tests for glucose, ketones, and proteins, 2 for colorimetric testing of blood without a meter, (i.e. compare the reagents colour change after a specified reaction time against a colour chart), 2 reagents for blood ketone testing (using a BG meter, 3 meters can be used for both BG and Ketone tests) , 3 reagents for INR (blood thinning therapy - treated with warfarin etc), 1 for neuropathy, which leaves 53 BG meter reagents. This means a total of 62 out of 67 reagents are exclusively for diabetics.

    This data shows the cost the NHS pays per prescription item for SMBG (usually ~50 tests, i.e. 25, 50(2x25), 50, 51(3x17), 60(15x6), 100(2x50)) ranges from £4.50 to £31.90 or 14p to 33p per test. (The retail cost of the £31.90 prescription item (100 tests) is £27.99 for 50 tests, less the VAT exemption)
    • The cost of SMBG (Self Monitoring of Blood Glucose) is less than £70 per month.
    • The cost of a leg amputation in excess of £32,000 for a leg amputation in the first year
    • The cost of treatments for diabetic retinopathy can exceed £2,000.

    For the CCG beancounter types, go figure. Which is cheaper?

    - correct answer is SMBG at less than £70 per month

    Also take note that DVLA Medical requires an annual 3-stage assessment for all Class 2 drivers on insulin i.e. Lorry, Bus and Coach drivers, (and many local authorities require this of Taxi drivers also) BG testing results for 90 consecutive days to be seen by ones Diabetes Clinic (either Hospital or GP run-Satellite clinics) and an independent assessor appointed by DVLA (55 of these - all consultant Diabetologists/Endocrinologists, who have NOT been involved in your treatment, most are Hospital Diabetes Unit Clinical Leads) at least 2 tests per day, 7 days a week and every 2 hours at times relevant to driving, which means BG meters with at least 750 memories.

    They also expect this level of testing for car/motorcycle drivers on insulin (every 2 hours relevant to driving) and T2D Class 2 drivers on BG lowering oral medications. A professional driver is likely to be needing to do at least 30 tests per week.

    scores in trust of opinion
    1. Accountants = 1 star,
    2. Actuaries = 2 stars,
    3. Informed Patients = 3 Star,
    4. GPs = 3 to 4 stars, DSNs = 3 to 4 stars,
    5. Surgeons and Diabetologists/Endocrinologists 5 Stars
     
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  5. ConradJ

    ConradJ Type 1 · Well-Known Member

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    And there's the problem: the CCG Beancounter doesn't pay for leg amputations, retinopathy lasering, etc., etc. That comes out of secondary/specialist care budgets. So, the CCG Beancounter will go for option B AND C if it means saving 2p on option A.

    The DVLA regs are a good additional argument, but the key one is about change of medication - it's against guidelines to change a patient's medication without their prior knowledge or agreement. Blood testing IS an intrinsic part of insulin therapy because without the testing (and accurate and reliable results at that) you are prone to medication errors.

    If someone's GP gets really funny and insistent about it, their best response is to put their stance in writing to the GP, stating that in the event of a medication error occuring with their insulin they or their family will hold the GP clinically responsible for changing their medication system without their approval.

    There's barely a GP in the world who'd stand their ground on that point - and if they do, then they're not worth staying with.
     
  6. LAURENCE KING

    LAURENCE KING Type 2 · Newbie

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    I was sent a new meter with a letter to inform me to use instead of my USB one; which records blood sugar readings, I immediately got in touch with the pharmacy at surgery as the Diabetic Nurse was having me record my readings, as I was having problems with BG control. They allowed me to carry on using my meter.
     
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  7. Scardoc

    Scardoc · Well-Known Member

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    The real problem is that the UK is broke and needs to save pennies wherever possible and at a potentially high cost to the patients.

    The Government should, given the purchase power of the NHS, be able to drive down the cost of meters and strips and put an end to the profiteering.......perhaps not the current Government mind you!
     
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  8. ConradJ

    ConradJ Type 1 · Well-Known Member

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    I agree that we're broke - financially and albut intellectually, and that's part of the problem: too much short-termism in Whitehall has produced an NHS that spent too much time counting the wrong beans, discouraging GPs from prescribing sufficient strips, etc. so that £8bn of the £10bn spent annually on diabetes is on retrograde type 2 reactions and diabetes complications. I can't recall the exact amount, but BG strips cost the NHS around £150m a year - that's a mere 1.5% of the total budget on diabetes!

    And you're right about procurement: we know that thereare around 350k type 1's in the UK. So, if we allow each one to test 8 times per day, that's 2.8m strips per day, or 1.25billion per year.

    Now, if you opened this market to a three-year supply contract for say 5 different meters all designed to meet certain minimum standards (such as ease of use, analysis software, compatibility with pumps, etc.) which pharma-supply company in this world would not dream of pitching for a supply contract with a guarantee of demand?!?!?!?!?!?

    Instead, we have NHS England divided into 213 (as of March 2013) CCG's each with their own purchasing strategy. In the case of Bucks, where I live, there are two CCG's serving 24,000 diabetics, of which 200 are kids and another 1,000 adult type 1s. The type 2's are being dished out some piece of flimsy, inaccurate junk that's barely worth selling in 99p stores and yet, failure to manage type 2 diabetes carries the same risk of complications as for type 1s! So, yet again, short-term, narrow-focused thinking will lead us to ... more money being spent on foot amputations, retinopathy and cataract surgery, etc., etc., etc., and less money for proactive care and treatment for type 1s, etc.

    Madness, absolute madness...

    And Farage wants to get us out of Europe because THEY don't know how to manage things!!!
     
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  9. spirits

    spirits Type 2 · Well-Known Member

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    it seems like this is an ongoing never ending problem, no matter what diabetes type you are the meters and even strips are being stopped or limited, and no options no real reason for it no proper explanations,some are excuses that do not add up when you ask a question and the answers make no sense from gp etc. I think the way things are people are being forced either not to use them ever again or even have a chance to use them or they now think we do not need them at all any more, the way i see it is, there funds can not cope with the amount of diabetics growing sudden on the health list and it is climbing high,i think people are being forced to just fund there own even if they can not afford to. even though i already had a meter of my own, my gp said not to bother using it, we do not want you panicking over your sugar levels, it was not about panic for me, it was about keeping an eye on my sugar levels one to know what foods are affecting my sugars so i could stop eating the ones harming me plus to check for hypo and hyper,it has been a life saver for me,i would be more likely to panic if i did not use the meter did not know how my sugars was at what level and because i get no warnings for hypo i do not want to collapse some where and end up in a coma, i would rather use the meter to keep me alive and well, and i think you will agree for your health to what i am saying.
     
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