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FreeStyle Libre available on the NHS from April 2019, but…
To coincide with World Diabetes Day, Simon Stevens, Chief Executive of NHS England, announced action to end the postcode lottery for access to the FreeStyle Libre flash glucose monitoring system. A press release was issued:
“From April 2019, the device will be available on prescription for all patients who qualify for it in line with NHS clinical guidelines. These patients will be able to receive it on prescription from their local GP or diabetes team helping them to better manage their blood sugar levels.
The device should ultimately help people with Type 1 diabetes to achieve better health outcomes and benefits including:
- Easily noticing when their sugar levels are starting to rise or drop, so action can be taken earlier,
- Giving patients more confidence in managing their own condition, Not having to do as many finger-prick checks.
The funding for this will come from next year’s funding growth for local health groups which will allow flash monitoring throughout the country.”
The Press release also says:
“It is estimated that around 3-5% of patients with Type 1 diabetes in England have access to Freestyle Libre but if clinical commissioning groups (CCGs) were following the guidance correctly, this figure could eventually rise to at least 20-25%. Currently, 144 of 195 clinical commissioning groups have signed up, and today’s announcement mean thousands of patients still missing out will now get access.”
The news was very much welcomed by people with Type 1 diabetes across the country and it was good to know that apparently people with diabetes have been heard. It appears to end the unfairness that has existed whereby there has been a postcode lottery of availability of the Libre but there were various points that are still unclear and left unanswered questions.
On November 21st 2018, IDDT wrote to Simon Stevens with copies to Dr Partha Kar, Associate National Clinical Director for Diabetes, Mr Matt Hancock, Secretary of State for Health and Social Security and Mr Keith Vaz MP. The points we have made are:
- The announcement only mentions people with Type 1 diabetes and not people with Type 2 diabetes who are injecting insulin but the NICE guidance for the approval of the FreeStyle Libre states that “it is an alternative to routine blood glucose monitoring in people with Type 1 and Type 2 diabetes who use insulin injections”. Why has this group been excluded from the benefits of the FreeStyle Libre? This seems grossly unfair and is a divisive decision.
- People who have been refused access to the FreeStyle Libre by the CCG in their local area, have been told that CCGs make decisions according to local need. While appreciating that this device will be funded from next year’s funding growth for local groups, how can CCGs be effectively forced to fund the FreeStyle Libre when the NHS system specifically gives them control over local spending according to local need? Are people with diabetes going to have to go through the process of refusal again?
- The press release states that the FreeStyle Libre will be available “for all patients who qualify for it in line with NHS Clinical guidelines”. We are aware that the Guidelines that have been used have varied geographically, could we be told what these guidelines are, especially now that there is a second version of the FreeStyle Libre with an alarm system?
IDDT has still not received any response to our letter of November 21st 2018.
NHS Long Term Plan
In January 2019 the NHS 10-year Plan was announced and one of the paragraphs under the title of ‘Diabetes’ promised:
“People with Type 1 diabetes will benefit from flash glucose monitors from April 2019 in line with clinical guidelines to end the variation of availability across the country.”
We will have to see how this works in practice…