The longstanding issue of testing and NHS

Sorry to hear this happening to you but no doubt further folks will concur as well as me.
First, I recall my GP saying the good news about being a registered DM is free prescriptions from now on... :roll: so you should be entitled to free strips etc.
I was puzzled too about their line on self test. My GP seemed reluctant but OKs my regular twin packs of strips no quibbles. But nursey was less keen only compromising on a self fasting test once a week. Sort of discouraged me from getting 'too analytical'. I am still confused but self test till they run out.
This lack of a consistent policy is not helping much.
ATB 8)

As far as I am concerned I wouldn't admonish you for anything you do regarding testing.....it is entirely your choice. I choose tight control which means I am always in control of my Bg levels.

As for the real reason that you are refused strips and not encouraged as a type 2 to test is the cost of the strips to the NHS. Plain and simple that's what it boils down to ! No other reason.

As for not encouraging testing there is a school of thought that it is bad for us as we will get paranoid about it and also that we don't understand what all the numbers mean !!! Now for some that may be true, however there are many of us, particularly on this Forum who don't get paranoid even when testing frequently as I do and DO understand what the numbers mean and get much better control of their Diabetes by doing so. In effect that in itself is saving the NHS money.....that argument seems to fall on deaf ears though.

As for the eat carbs advice given out by the NHS all they need to do is change the wording so that people are advised to cut down on those carbs as they are the things that can raise Bg levels if eaten to excess. Carbs convert to Glucose so why on earth wouId a Diabetic who has difficulty metabolising the stuff be told to eat more !! :?

I can eat carbs but I moderate the amount that I eat to around 20-30g per main meal which gives me a total over the day of about 80-90g. Some eat more, others eat less as they can't tolerate that level, I use strict portion control, weighing individual foods and that is what gives me tight control over Bg levels at all times. (Before my Cancer treatment that is )

I advocate frequent testing for newbies and old hands......knowing what is happening in your body has to be the right thing to do. finger pricking and sight of blood just is one of those things a Diabetic has to overcome......there are far worse things I can assure you.....

Ken.

Cowboy Jim.
You only get free prescriptions in the UK as a Diabetic if you are on Diabetic medication, tablets or other injectable meds. So as the OP is diet only then he/she would not be entitled to any free prescriptions.
Ken.

It is my opinion that some of the NHS policy on some health issues will actually cost them more money in the long term, but I have to seriously doubt if distant future costs are considered if short term gains can be shown.

The present policy can be shot down if medication is prescribed that can cause a hypo, because the patient will have a means of detecting a hypo before the situation becomes dire: But where does this leave those not on any meds and those on non hypo inducing meds ...limbo!
Limbo is no place to take on and treat diabetes and here in the UK I feel that more need to be done to get our MPs to lobby for a better deal in the treatment of diabetes for ALL those so inflicted.

To take the first poster as an example ... diet only and no supported testing, so how are they to know what foods are going to considerably raise their BG other than reading about general diets. They are an individual, as as we all know, we are all different in what affects Mr A might affect Mr B differently .. but without dedicated home testing they are not going to find out. So by not finding out, their condition may well deteriorate to the point where meds need to be administered.
At this stage they immediately qualify for free prescriptions for ALL meds no matter what they are prescribed for. By looking through BNF the charge to the NHS for 50 test strips is between £12 and £14.65 and if any prescribed meds can cause a hypo, there is a case that test strips will have to be prescribed anyway.

So bearing all this in mind, NOT to provide free test strips is very short sighted and something we all need to keep reminding the politicians about.

My PCT openly says its cost that prevent my having strips on presription. and then add i don't ned to test anyway. Still,I feel a need and so I buy from Abbott DiabetesCare. I only test twice a day unless something is going on.
Hana

Thanks Ken et al.
The thought occurs to me that one should get medicated just to get the free strips! Another case of personal choice. 8)

Cowboyjim.
Yes.....I have suggested what you have thought to people......not that you should take my advice of course. :twisted: :lol:

Ken

I just rang nhs direct as I am feeling rather under the weather. First thing they asked me??? You guessed it, my blood sugar. The lovely nurse then advised me to test frequently till I feel better and contact a dr if I went over 15. How would I have done all that if I didn't fund my own strips? And if I hadn't been able to self test then I would have been using a valuable appointment up at the drs.
I bet if they really looked at the costs it would be cheaper in the long term to prescribe strips.

I am in the age range than qualifies for free prescriptions, but that doesn't help in my discussions with the PCT. They are adamant. As a Stable T2 onMinimal Metformin Only, I don't need to test more than once a week.
Hana

Ken, you are a cheekie chappie too then!
When I told nursey I had gone to Boots to buy a meter she said oh you shouldn't have done that I could have given you one... had several in the cupboard....! Durh.
Seems a case of saving pennies to lose pounds but it all looks better on the near term finances.
TTFN 8)

Cowboyjim.
Me......cheekie....whatever gave you that idea ???? :wink:

Seriously, if they are going to use the system to deny us things then I have no hesitation in using that same system to our advantage, if we get what we want........that is all that matters.

Ken

Ken
I find it engaging 'pushing the envelope' against authority in whatever form. They should not assume we are all ignorant. Even if I am unaware of everything about my condition I can learn. I have a science degree so I am a bit more fortunate in that respect than most.

But I get the distinct impression this is the grand plan for us all to be treated equally. They assume things like we won't stick to diets or take our meds etc. Don't want us to think for ourselves on matters like self-test and diet. Their plan doesn't work but they persist for lack of an alternative.

BTW my sister was an SRN and when she was in hostipal they wrote that on her chart... as if to say be warned, she isn't a thicko patient. One of us not one of them. Maybe it helps NHS types cope.

On another matter I sometimes ponder how many in the NHS actually have DM. Statistically there must be some.... a bit like council officials... they must live in houses and use services etc., so why behave like some of them do when dealing with the hoi polloi?
Rant over... for now.
ATB 8)

They don't like prescribing for T2's at my surgery either.

You are right - it's down to NHS cost.

However, I used to work in PR and I'm used to getting my own way by threats, foot stamping and rending of garments... sorry, I meant persuasive argument, of course.

I asked them for three months supply ONLY so that I could test my normal diet in this time. (You could try two - or even one month).

And then not bother them any further.

I emphasised preventative medicine and said that in the long run, testing how my body reacted to porridge and bananas ( which seem to be a bit debatable on websites) would help me to find out my individual reactions to such food items etc etc... Bore on a bit here about changing levels during the day in a spirited way. And recognising danger points.

Cynically, if I know anything about surgeries, they will forget about the three months 'testing ground' and continue to prescribe.

If they remember, I've done my homework and got the free meter.


* Forgot to say... say to your doctor that you are going to increase your exercise ( see his/her eyes brighten at this magic word).

And you want to monitor which exercise is preferable and if it really helps.
Clearly if you see for yourself that exercise helps - you would be much more likely to do more of it.

In my opinion people with diabetes will suffer the physical, and thereby emotional, problems of the complications in the long term because PCTs want to save money in the short-term but tell us that the nurse/doctor will control our diabetes on one hand, and tell us to take responsibility for our health on the other.

Cowboy Jim - I remember the saying 'penny wise and pound foolish' which used to be said years ago and this is basically what you are saying too.

Dippy3103 - about checking blood glucose levels when ill - well exactly, how are people susposed to check them when they don't possess the meters and strips?

I honestly can't understand the NHS either - learning what foods effect you (and therefore removing them) will only lower the chances of complications long term and probably save money. If they gave people these tools and the knowledge to use them then this will only help long term

The biggest problem is that there would appear to be no long term planning in the NHS and the ‘here and now’ is all that is taken into account or put into the budget.

It is doubtful that any of the people currently working for the NHS will still be there when those who have been prevented by cost from looking after themselves properly will be suffering from complications. This means that these consequences can be ignored as nobody will be answerable if no longer in post. A bit like politicians really! :evil: :roll:

I would just let them know that you are keeping a diary of your requests for test strips and their rejections, and will present the evidence should you ever get admitted for complications (retinopathy, neuropathy, leg ulcers etc.)

If they change their minds, thank them profusely - positive feedback is always better than punishment !

Hi

I hesitate to 'fess up here but I have type 2 and worked in NHS for 18 years (just left).

I'm absolutely horrified that people aren't being given the opportunity to self-test and manage their own diabetes. This is a totally false economy for the NHS, as other posters have said. My own PCT had a stupid policy of rationing testing for T2 diabetics to twice a week, and I challenged the PCT Chief Executive about this in person (I knew her anyway). She couldn't justify the policy on any grounds other than cost. However, in practice most local GP's (including mine who is fantastic) seem to ignore this policy and prescribe freely and encourage testing.

If anybody out there is trying to fight their PCT, I'd encourage you to keep trying, however frustrating and plain dumb they are. If your GP or hospital diabetes team are prepared to help you to lobby, so much the better. Other tactics would include quoting some evidence at the PCT (they won't be very well equipped to deal with that) and asking the odd question at their public meetings. I recognise that this is hard work and that people may not feel up to doing it, but good luck if you want to mount a challenge. I have seen this done successfully in the past on other issues by other patient groups.

Best wishes
Helen

Good advice there Helen!

Nigel