Help us make sure that people who need them have access
This campaign was launched in England and Scotland during Diabetes Week 2007, but we still need your help to make sure that people who need them have access to insulin pumps. Pumps can save the NHS money and improve the quality of life for people who use them. However, despite national guidance which states that pumps should be available, this is not the case for too many people.
If you have been affected by this issue and would like to take action, there are a few ways to get involved.
How to get involved
Send letters to your local health care service provider (Primary Care Trust, Health Board) and political representative (MP, MSP, AM) – templates for these are available to download on the right. Remember to address and sign the letters so you can receive a response. It is always better to personalise the letter with your experience, preferably in the first paragraph. This will catch your political representative’s attention so she/he will be more inclined to act on your behalf.
- Get press coverage for this important issue by sending the pro forma press release (downloadable on the right) to your local newspaper. The press release has been written to help you increase your chances of receiving press coverage
- Service user representatives – please use the downloadable briefing to raise this issue at your next planning group meeting
- Encourage friends and family members to get involved with this campaign. Feel free to photocopy the letters for them.
Important - Once you have sent the letters/press release, please let us know by phoning 020 7424 1148 or emailing dcn@diabetes.org.uk
Further background information
In 2008, the National Institute for Health and Clinical Excellence (NICE) issued revised guidance for insulin pump therapy for people with diabetes.
The guidance states that people with Type 1 diabetes aged 12 years or over could have access to insulin pump therapy if they are experiencing “disabling hypoglycaemia” or have an Hba1c of 8.5 per cent or greater whilst using multiple daily injections (MDI) despite trying to achieve good control. Children under 12 with Type 1 can have access to insulin pump therapy if MDI are considered impractical or inappropriate. However, once they reach the age range of 12–18, they will be expected to have a trial of MDI if they did not do so prior to starting to use a pump.
Diabetes UK and INPUT have expressed their disappointment that the cost effectiveness considerations implied by the guidelines have created eligibility criteria that could be seen as a perverse incentive against good blood glucose control. We are also concerned that children under 12 who are enabled to have a pump without a trial of MDI will be required to have this trial at some stage between the ages of 12 and 18.
Diabetes UK and INPUT believe this could compromise the care and quality of life of those who are doing well on a pump. Decisions about treatment alterations must be reached between a healthcare professional, the child and their carers and this decision making process must be respected by PCTs.
Diabetes UK and INPUT believe that the devices should be available to people with diabetes based on individual clinical need, personal choice and suitability rather than based on cost considerations. PCTs must ensure that they make funds available to enable all people with diabetes who meet the criteria for pump therapy to have access to an insulin pump.
Guidance surrounding implementation needs to ensure that there is not another post code lottery of provision. It is clinicians and people with diabetes who must jointly agree that insulin pump therapy is a suitable treatment choice, and PCTs must respect the decisions that clinicians make.
It is estimated that around two per cent of people with Type 1 diabetes use pumps in the UK, although the percentage may have increased since the data was collated in 2006. This compares to between 10 and 20 per cent in other European member states and around 15 to 20 per cent in the United States. In Sweden, an amazing one quarter (25 per cent) of all children with diabetes are on pumps.
Evidence has shown that an estimated saving of £23,532 over two years can be derived from insulin pump use, which offsets its costs. Using an insulin pump can improve blood glucose control, which in turn can lead to fewer complications. In terms of quality of life and incalculable weeks off work, the costs of treating poorly controlled diabetes vastly outweigh the costs of using a pump.
Diabetes UK is currently revising its position statement on insulin pumps. The revised statement will be available to view here: http://www.diabetes.org.uk/About_us/Our_Views/Position_statements/Insulin_pump_therapy/
Diabetes UK Scotland is about to launch an important new campaign to improve the take up of insulin pumps in Scotland. If you would be interested in contributing your views and ideas please contact the Scotland Office scotland@diabetes.org.uk