Today’s BBC news report re. Libre sensors availability on NHS

[suk]

Hi, I’m told there was an item on the BBC news today that the sensors will be available to all type 1 diabetics from April 2019. Is this correct?

 

[becca59]

Hi, I’m told there was an item on the BBC news today that the sensors will be available to all type 1 diabetics from April 2019. Is this correct?

for a certain few! Though to be fair, I think more than are getting it now. I think they quoted 25%. The report is very disingenuous. I’m not holding my breath.

 

[suk]

Thank you Becca. I am sceptical, I doubt I’ll meet the criteria. I’m probably too well controlled

 

[kev-w]

for a certain few! Though to be fair, I think more than are getting it now. I think they quoted 25%. The report is very disingenuous. I’m not holding my breath.

They are making all the CCG's stick to what's called the RMOC criteria -

It is recommended that Freestyle Libre® should only be used for people with Type 1 diabetes, aged four and above, attending specialist Type 1 care using multiple daily injections or insulin pump therapy, who have been assessed by the specialist clinician and deemed to meet one or more of the following:

1. Patients who undertake intensive monitoring >8 times daily
2. Those who meet the current NICE criteria for insulin pump therapy (HbA1c >8.5% (69.4mmol/mol) or disabling hypoglycemia as described in NICE TA151) where a successful trial of FreeStyle Libre® may avoid the need for pump therapy.
3. Those who have recently developed impaired awareness of hypoglycaemia. It is noted that for persistent hypoglycaemia unawareness, NICE recommend continuous glucose monitoring with alarms and Freestyle Libre does currently not have that function.
4. Frequent admissions (>2 per year) with DKA or hypoglycaemia.
5. Those who require third parties to carry out monitoring and where conventional blood testing is not possible.

In addition, all patients (or carers) must be willing to undertake training in the use of Freestyle Libre® and commit to ongoing regular follow-up and monitoring (including remote follow-up where this is offered). Adjunct blood testing strips should be prescribed according to locally agreed best value guidelines with an expectation that demand/frequency of supply will be reduced.

The availability then is up to each and every one who wants one, point 1 will do it and in my opinion people should be testing at this frequency anyway if they want decent control, but no I'd say it's very positive....

 

[suk]

I’ve just looked at my reader’s sensor usage which shows 21 scans per day. I’m always scanning because I feel it gives me more control ie tells me if I’m going up or down at a glance

 

[becca59]

@kev-w unfortunately in Leeds no 1 has to go hand in hand with at least one if not two of the other criteria. I can easily reach more than 8 tests a day. Having worn the Libre for over a year, if I don’t wear it, I go through a shed load of testing strips. You just so want to know where you are.
I got my Fiasp prescription today. My brother also in Leeds can only get it through the hospital as his Gp won’t prescribe it. The whole thing is utterly bonkers!

 

[Robinredbreast]

Hi, I’m told there was an item on the BBC news today that the sensors will be available to all type 1 diabetics from April 2019. Is this correct?

If that is correct, that would be a nice 30th year present................

 

[kev-w]

@kev-w unfortunately in Leeds no 1 has to go hand in hand with at least one if not two of the other criteria. I can easily reach more than 8 tests a day. Having worn the Libre for over a year, if I don’t wear it, I go through a shed load of testing strips. You just so want to know where you are.
I got my Fiasp prescription today. My brother also in Leeds can only get it through the hospital as his Gp won’t prescribe it. The whole thing is utterly bonkers!

But that's as it is now, this statement means that the blood tests alone would qualify you as the CCG's are being obliged to work to the RMOC criteria, that's how it reads to me anyway, but then again, what will they do for self funders like yourself and perhaps suk if she's having to self fund, and that needs looking in to.

 

[EllieM]

I wonder whether they'll fund dexcom for those who qualify for libre but are allergic to the sensors? (Never clear what proportion of users become allergic, but it does appear to be significant...)

 

[annliggins]

The funding is being taken away from the CCGs and has landed in the lap of the central NHS fund. Which is good as the so called ' post code lottery 'stops.
The criteria to be funded is stiff , quite rightly , there are some people that have never looked after themselves in terms of HBA etc etc that will want a 'freebie thinking the libre will make them better..not even understanding how it works .its not a bottomless pit , the NHS has to be careful with money ...so it boils down to imo if you demonstrate that youve improved your hba1c and are healthy , if youve self funded and are healthy youll get approved .. youre a good bet.. If youve rested on your laurels for the past xx number of years and your HBA1C is rubbish youll not be funded untill you demonstrate some motivation and improved BGL . Thats how i interpret it its not generally my opinion but a little bit is.

 

[tim2000s]

@kev-w unfortunately in Leeds no 1 has to go hand in hand with at least one if not two of the other criteria. I can easily reach more than 8 tests a day. Having worn the Libre for over a year, if I don’t wear it, I go through a shed load of testing strips. You just so want to know where you are.
I got my Fiasp prescription today. My brother also in Leeds can only get it through the hospital as his Gp won’t prescribe it. The whole thing is utterly bonkers!

Hi Becca, this is the point of the announcement,. It overrides the local CCG variability.

From now on, RMOC guidance counts, not what the locals have come up with, so in Leeds, you now only need to apply one of the criteria. That's the main point of the announcement. Harmonising the entirety of NHS England under one set of common criteria.

I wonder whether they'll fund dexcom for those who qualify for libre but are allergic to the sensors? (Never clear what proportion of users become allergic, but it does appear to be significant...)

No, they won't at the moment. Dexcom is not a prescription tariff offering. It's purely "Individual Funding Request" and is at the discretion of hospital/CCG, although recommended under NICE NG17 for those with severe hypo unawareness.

Until their pricing aligns with that of the Libre (essentially £70 per month to the NHS), then it won't be added to the prescription tariff. That's not to say that people aren't working on that....

The criteria to be funded is stiff , quite rightly , there are some people that have never looked after themselves in terms of HBA etc etc that will want a 'freebie thinking the libre will make them better..not even understanding how it works .its not a bottomless pit , the NHS has to be careful with money ...so it boils down to imo if you demonstrate that youve improved your hba1c and are healthy , if youve self funded and are healthy youll get approved .. youre a good bet.. If youve rested on your laurels for the past xx number of years and your HBA1C is rubbish youll not be funded untill you demonstrate some motivation and improved BGL . Thats how i interpret it its not generally my opinion but a little bit is.

I don't know if you've read the press release or seen the data collected from a number of Scottish clinics? It shows that those with the highest Hba1Cs have benefited the most from use of the Libre (extract below):

In addition, the press release discusses the National Guidance that was referenced earlier. High Hba1C (greater than 8.5%) qualifies you alone.

No-one will be rolling it out to those who struggle without education, but there's been a huge amount of that going on within the HCP world and Libre "workshops" are pretty common place in many clinics now. It will have nothing to do with whether you have self funded and are healthy, just the direct criteria as already stated. That makes the device available to most people, as most people qualify under the current national guidance. We wait to see if that changes.

 

[kev-w]

@tim2000s Cheers for posting that Tim, this was this thread that had me asking you about self funders in the other thread.

 

[becca59]

I am still dubious. But hope to be proved wrong.

 

[Copernicus]

What it doesn't say about the 8 plus blood tests a day is that they must be finger prick tests. Testing using the Libre system does not count. So myself, who has been self funding for nearly 3 years now, and test at least 12 - 14 times a day, will still not qualify for the Libre on the NHS and yes, if you don't look after yourself and need frequent hospital visits and have hypo's left right and centre, you will qualify for Libre on the NHS. Totally unfair if you ask me.

 

[suk]

I agree, so unfair to penalise those of us that actually care about taking control of this condition and test constantly to remain within the set range. It is a continuous balancing act all day every day. Why penalise us. We are helping to save money by stopping complications. It makes me want to stop caring about the diabetes. That’ll cost!!
Sorry, I just needed to vent!

 

[slip]

What it doesn't say about the 8 plus blood tests a day is that they must be finger prick tests.

It says those that under take intensive monitoring >8 time a day

doesn't say blood tests so scanning is the same as 'monitoring' surely...........

 

[Rokaab]

It says those that under take intensive monitoring >8 time a day

doesn't say blood tests so scanning is the same as 'monitoring' surely...........

I hope the libre scans will do, mine reckons I'm averaging about 23 a day over the last month, and I am certainly not doing finger pricks that often - not sure I've have any fingers left if I did!
If nothing else it shows I'm using it

 

[tim2000s]

Of course for everyone complaining about doing well and using Libre, there's a very simple solution. Stop using Libre, go back on Fingerprricks for a couple of months and do 10 a day. They'll rapidly pay for your Libre.

 

[Kimberley2026]

The article I read seems to suggest it was dependent on where you lived - postcode lottery!

I’ve trialled the libre and think it’s fab but unfortunately I don’t meet the said criteria!

 

[tim2000s]

The article I read seems to suggest it was dependent on where you lived - postcode lottery!

I’ve trialled the libre and think it’s fab but unfortunately I don’t meet the said criteria!

The whole point of the announcement is to remove the postcode lottery. If your area doesn't allow it or allows it with rigourously restrictive criteria, then now the RMOC criteria supersede that.

And that means if you have an Hba1C of more than 8.5% or you fingerprick test more than 8x per day, then you qualify.