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Right - I'm applying for that one.... Hands off everyone else...!we'll need a self-monitoring director"
Right - I'm applying for that one.... Hands off everyone else...!we'll need a self-monitoring director"
However, if this came from within the NHS....I think it's a great proposal; but I bet if it were raised as a possibility then there would be howls of protest about paying for the NHS at point of use. Even though it's an option not a requirement. If a tory government put it forward they would be hung out to dry for 'ending the free at the point of use' NHS model and Labour would never do this. That's because our politicians are not rational they are tribal and their tribal interests trump logic.
Well you don't get given £1059. You have a budget allocation of £1059. If you don't spend it all, then it's still the NHS budget. Given that something like 60% of people aren't even testing daily, I'm fairly sure that what I believe is the smallish number who would take this up won't bankrupt the NHS.The problem with this is that if I sign up I am forcing the NHS to spend the whole £1059 just on me.
I use approx. 3 boxes of 50 strips a month, so currently my testing regime cost the NHS about £530 (using NICE's estimated cost) I'm sure I'm not the only one who doesn't test 10 times a day but likely to sign up for a CGM, then there are those that won't sign up but use more the 10 strips/day.................the budget now has to be re-budgeted............and if patient X gets more than 10 strips/day funded on the NHS then I should get more than the £1059..............
And then the NHS, to save money(!), suggests this scheme to other areas of treatment..............
Well you don't get given £1059. You have a budget allocation of £1059. If you don't spend it all, then it's still the NHS budget. Given that something like 60% of people aren't even testing daily, I'm fairly sure that what I believe is the smallish number who would take this up won't bankrupt the NHS.
And no, you shouldn't get more if patient X gets more. Budgeting is based on the NICE models, not on individual care.
If you opt to stay in the standard model you can use as many strips as you like and if you want CGM you pay for it as and when. If you opt for the fund, it's up to you to manage how the money is allocated. That's a fair and equitable arrangement. And is no different to that which you'd get through an insurance policy.
Purely for testing. Based completely on the cost of SMBG10 in the NICE models for SMBG.Is this budget just for bg testing technology or would it also need to cover prescription medicine as well?
When SMBG came out, the strips were visual, so you didn't need a meter. Thus, the NHS didn't supply them and you had to buy them. At the time (in the 80s) they cost 100s of pounds. With inflation, they would cost now about £600. Similar price to the CGM receiver + Transmitter now. They only became free on the NHS when the strips moved to completely electronic.How did the NHS handle the introduction of the first self blood glucose testing kits back in the day? I'm sure back then they were equally expensive as todays CGMs, and now they are a requirement (you're not a proper diabetic if you haven't got one ) T1Ds have to have one to drive at least.
Did people have to fight tooth and nail to get one?
Well you don't get given £1059. You have a budget allocation of £1059. If you don't spend it all, then it's still the NHS budget. Given that something like 60% of people aren't even testing daily, I'm fairly sure that what I believe is the smallish number who would take this up won't bankrupt the NHS.
And no, you shouldn't get more if patient X gets more. Budgeting is based on the NICE models, not on individual care.
If you opt to stay in the standard model you can use as many strips as you like and if you want CGM you pay for it as and when. If you opt for the fund, it's up to you to manage how the money is allocated. That's a fair and equitable arrangement. And is no different to that which you'd get through an insurance policy.
And therein lies the rub. Essentially there are some details that need to be ironed out on this. One of the comments that's frequently made about use of CGM is that it needs to be used for a minimum of six days per week to be effectual.Those statements aren't any personal slight on any poster's moral compass, I'm just expressing my view, which, if put to the test (pardon the pun), could be fairly common.
It's not ignored at all. Due to the limits of the forum, I can't post the entire blog post. In that I state that if you are within the NICE criteria your first and foremost approach should be to aim to get funding from your CCG. That should always be the first thing that is done. The idea of the "budget" or "fund" is to reach those that don't fall within the NICE criteria.The thing is that is being ignored here with NHS suggestions of budgets is that some CCG's DO fund CGM's to those needing them.... It's just whether you know what your CCG policy is.
That's not really true. CGM access is based on Hypo Awareness. NICE recognise the benefits of long term control. The target blood glucose levels and Hba1C values show this. They even demonstrate a level of recognition that Glycaemic Variation should be minimised.The worst aspect is that NICE and NHS and CCG's following all the guidance is that everything is based upon hypo unawareness. NICE do not recognise the long term benefits of overall better control.
@tim2000s
Come on Tim. Where an individual is mindful to turn themselves a quick buck (and some will feel that way, whether due to a questionable moral compass, or financial hardship or whatever), there are always going to be those who will think, "best not put temptation in my way", and those who just think, "Bring it on".
I'm not well up on the details, but when the benefits system changed to mean claimants received rent money to be passed to the landlord, rather than direct payment to the landlord, rent arrears spiralled. Of course the vast majority of benefit claimants are decent people who are experiencing difficult times, for whatever reason, and they genuinely need support, but your proposition is just another temptation.
I don't think they are. GP systems currently account for the costs of items and the category they fall into. These are also attributed to each patient.The administrative cost of a scheme like this would HUGELY reduce the £ available to the patient.
- staff costs (salaries and oncosts)
- office space, documentation and equipment
- time and electronic (paper) shuffling