An insulin pump is a small electronic device that releases the insulin your body needs through the day and night.
You need to have it attached to your body most of the time for it to work properly, otherwise you could be at risk of developing diabetic ketoacidosis (DKA) very quickly because when you’re on an insulin pump you only have fast-acting insulin.
Insulin pump systems are generally licensed and recommended for children and adults with type 1 diabetes in guidelines, but may also benefit people living with other types of diabetes.
In this guide you’ll find what you need to know about the eligibility criteria for insulin pumps in England, Scotland, Wales and Northern Ireland.
These are guidelines only. Diabetes healthcare teams may have a local policy which they have to use in line with national guidelines as a minimum.
While there are guidelines for who can access insulin pumps in the UK, it is important to note that there are also guidelines on the use of hybrid closed loop systems – which connect a compatible insulin pump with a continuous glucose monitor (CGM) – and in many cases these will be offered to eligible people.
If you think you're eligible for tech for the first time, speak to your healthcare team when you're next due to see them and ask what the guidelines mean for you.
Who can get access to an insulin pump on the NHS?
The guidelines to insulin pump access on the NHS differ depending on your age, diabetes type, and where you live in the UK.
Guidelines from the National Institute for Health and Care Excellence, or NICE for short, say for anyone moving to an insulin pump that this should be managed by a trained specialist team. This should consist of a doctor with a specialist interest in insulin pump therapy, a diabetes nurse a dietitian.
This specialist team should provide structured education and advice on eating and exercise as part of your insulin pump treatment.
Children and young people under 18 with type 1 diabetes
If your child is under 12, and you live in England or Wales, a pump may be recommended if multiple daily insulin injections aren’t practical or appropriate, say NICE guidelines.
If your child is over 12 and you’re in England or Wales, they should be offered a pump if they meet one of the following, say NICE guidelines:
- They can’t get to their target HbA1c without disabling hypos.
- Their HbA1c remains high (69 mmol/mol - or 6.5% - or higher) despite carefully trying to manage their diabetes.
For children in Scotland, national guidelines say the same criteria for insulin pumps above should apply. Guidelines also say that people who require very small doses of insulin (often babies or very young children) should be considered for insulin pump access.
For children in Northern Ireland, check the rules on insulin pumps for your child with your healthcare team.
Adults with type 1 diabetes
If you’re 18 or over and have type 1 diabetes and live in England or Wales, you should be offered an insulin pump if one of the following applies, say NICE guidelines:
- You can’t get to your target HbA1c without disabling hypos.
- Your HbA1c remains high (69 mmol/mol - or 6.5% - or higher) despite carefully trying to manage your diabetes.
If you live in Scotland and have type 1 diabetes, national guidelines recommend the criteria listed above should also be used to determine if you can access a pump.
If you live in Northern Ireland, check the guidance with your healthcare team.
Adults, children and young people under 18 years old with type 2 diabetes
If you have type 2 diabetes or another type of diabetes, your main option is to self-fund a pump. However, you should discuss this with a healthcare professional as it might not be a suitable treatment for you. Read more about this below.
Pregnancy with diabetes
Pregnant women with diabetes in England, Wales and Northern Ireland who take insulin should be offered an insulin pump if both of the following apply, say NICE guidelines:
- They use multiple daily injections of insulin
- They do not achieve blood glucose control without significant disabling hypos.
In Scotland, there are no explicit recommendations on prescribing insulin pumps during pregnancy. You can ask your healthcare team for more information.
What about people with other types of diabetes?
There isn’t national guidance on tech access for other types of diabetes such as Latent Autoimmune Diabetes in Adults, know as LADA for short, or those caused by another illness or rare genetic condition. But do check with your healthcare team.
Depending on how you manage your diabetes you may or may not qualify. Your healthcare team are likely to apply the guidance for type 1 or type 2 diabetes based on the type of treatment you’re receiving to help manage your diabetes.
Which insulin pumps can people get on the NHS?
The insulin pump you might be offered on prescription will depend on many factors, such as individual needs and the functionality of the pump.
If you get an insulin pump on the NHS, the NHS funding will also cover your orders of other parts such as reservoirs and cannulas, which you would usually order from the manufacturer.
Read more about the types of insulin pumps.
What can I do if I’ve been denied access to an insulin pump on the NHS?
If you don’t qualify for tech
We know it can be frustrating if you don’t meet the criteria set out by the NHS to access your tech. But there are steps you can take to try and change this.
Firstly, you can make your case to your healthcare professional, explaining how and why using an insulin pump will help you to manage your condition.
It may be that making certain changes to your management could help you without having an insulin pump, and you can work with your consultant on making these changes.
However, if you disagree with the decision, then you have the right to ask your GP to refer you to a specialist at a different NHS hospital for another opinion.
Individual funding requests
Sometimes local policies mean you may not get access to the technology you need.
You can ask your healthcare professional if they can help you submit a request for individual funding – an approach used to ask local decision-makers to fund technology outside of their normal policies.
Your healthcare professional should know what the process is for your part of the UK and whether this is the right approach for you.
Write to your ICB or health trust or board
If this doesn’t help, you can also write to or email your Integrated Care Board (ICB), Health Trust or Board and outline why you should be provided with the tech you want.
When making your case for any type of tech, include answers to the questions below if they’re relevant, giving as much detail as possible.
- If you’ve been self-funding your tech, what did you notice about your diabetes management before, during and after using the device?
- What are the challenges you’re currently facing with your diabetes management?
- How do you think using the tech would help you with your blood sugar levels?
- Do you experience regular hypos and what are the effects of this on your day-to-day life?
- How does your lifestyle make it hard to monitor your diabetes without tech?
- How would tech benefit you if you regularly play sport?
Find your ICB or health board
England
Integrated care boards (ICBs) replaced clinical commissioning groups (CCGs) in the NHS in England in July 2022.
You can use the ICB finder on the NHS England website, which will list your local services and their contact details.
Wales
There are seven Local Health Boards across Wales. Find out which Board covers your region on the NHS Wales website, along with more information and contact details.
Scotland
There are 14 Health Boards covering all of Scotland. Find the full list and contact details on the NHS Scotland website.
Northern Ireland
In Northern Ireland, there is a Health and Social Care Board (HSC) and five Local Commissioning Groups (LCGs). Find your local group and their contact details.
What happens to my insulin pump if I move area?
If you move areas and you’re registering with a different hospital, you may be under a new ICB or local health board.
ICBs and health boards are responsible for local NHS services and budgets. Each has its own guidelines on diabetes tech, so your new area might offer different tech to your previous one.
If you want to continue using the insulin pump you currently have, or there’s a specific model you’d like to use, you can ask your GP to refer you to a clinic where that insulin pump is used. You can also ask the manufacturer which hospitals their insulin pumps are used in.
If there aren’t any hospitals in your new area that offer the insulin pump you’d like, or there’s a lack of choice of other insulin pumps, ask why this is the case. It might be that the staff have only been trained on one type of pump so they might be willing to get training on the model you want. It might take some time for this training to happen.
If the lack of choice is because of the ICB or health board’s policies, you might be able to submit an Individual Funding Request through your diabetes team. This is when an application for the funding will be sent to a panel for review.
Self-funding an insulin pump
If you live with type 1 diabetes and don’t qualify for a pump, or have type 2 diabetes or another type of diabetes, your main option is to self-fund a pump.
In some circumstances, you may be able to submit an Individual Funding Request. Speak to your diabetes team for more information on this.
Whatever type of diabetes you have, if you use insulin and are interested in using an insulin pump, talk to your healthcare team. They can help you decide if a pump might suit you and in some cases offer advice on different types of pumps.
How much does an insulin pump cost?
The costs of self-funding an insulin pump can vary depending on the device. You can ask your healthcare professional for more advice on this.
Get support from our helpline or online forum
Please give our confidential helpline a call if you’re looking for more information, advice or just someone to chat to. Whether you’ve got specific questions about the different types of tech available, or just want to talk through your options with someone, our highly trained advisors are ready to help.
Or head over to our online forum to join hundreds of members talking about their experience with diabetes tech. You can ask questions, read conversations between existing members, or share your own knowledge and help others.
What we’re doing to help everyone get the tech they need
Everyone with diabetes should be able to get the tech they need to live well with diabetes and we won’t rest until that happens. But nearly half of those who have tried to get diabetes tech have been refused it at some point.
We know that the emotional impact of not being able to access the tech you want and need can be really difficult. That’s why we want you to know we’re here for you.
Improving access to diabetes tech has the potential to impact many millions of people with diabetes. That’s why our strategy focuses on working towards a system where both existing diabetes tech, and the new innovations that become available, are accessible to all those who could benefit from their use.
Through campaigns like Diabetes Tech Can’t Wait, we’ve called for everyone living with diabetes to have fair and equal access to the diabetes tech they’re eligible for. Find out more.
