How we are working to improve tech access in Scotland

Technology plays an increasingly significant role in diabetes care, and huge progress has been made over recent years to help people with diabetes live better and longer.

There is a growing range of devices and tools available, from flash glucose monitors and continuous glucose monitors, smart pens, insulin pumps and closed loop technology.

Benefits of diabetes technology

Diabetes technology has been shown to improve blood sugar management and reduce the risk of complications like stroke, eye damage and kidney disease. It can improve mental wellbeing and quality of life, both for people living with diabetes and their families.

And it’s cost-effective - upfront spending on diabetes technology supports people to manage their condition and reduces complications and hospitalisations that ultimately cost the NHS more.

At the beginning of 2022, following new guidance from the Scottish Health Technologies Group, the Scottish Government allocated £14.6 million for Health Boards to increase access to hybrid closed loop tech across Scotland.

But data for 2023 showed that only 18% of people with type 1 diabetes in Scotland had access to an insulin pump, and only 8% had access to a continuous glucose monitor. 

What is our Diabetes Tech Can't Wait campaign?

In March 2023, we launched our Diabetes Tech Can’t Wait campaign as far too many people in Scotland are missing out, unable to access the technology that people tell us is life changing. 

With the Tech Collective, a group of people passionate about access to tech because they live with diabetes and know the difference it can make, we united 1,400 campaigners to call for fair and equal access to diabetes tech for everyone who could benefit, regardless of postcode and without having to fight for it.

Our postcode lookup enabled people to check local tech usage against the national average.  We held an online event about diabetes tech that 200 people joined. We gathered and shared stories via social media, press, workplaces and meetings with Scottish Government and health decision-makers.  TV, radio and print media coverage included features on BBC Scotland, STV, Radio Clyde, Forth and Tay, The Herald, the Glasgow Times and The Press & Journal.

In November 2023, at a reception in Parliament on World Diabetes Day, we were proud to stand alongside supporters to launch our Diabetes Tech Can't Wait campaign report to 100 stakeholders that included MSPs, healthcare professionals, third sector organisations and people living with diabetes.

Our report shares our learning from the campaign, bringing together insights from people who have accessed or tried to access diabetes tech. It reflects on areas of good practice in the NHS and considers innovative approaches to prescribing tech. Importantly, it sets out clear recommendations for the Scottish Government and NHS Scotland to continue their crucial work towards delivering fair and equal access to diabetes tech.

We have made progress

• Senior Scottish Government Advisors have said our campaign is one of the most successful health campaigns, raising the profile of diabetes across Government. 
• First Minister Humza Yousaf said: “We’ve got to remove the barriers that mean you have to pay out of your pocket for a piece of equipment that’s absolutely essential for your quality of life.”
• Scottish Government invested £350,000 to create a national onboarding programme to accelerate the distribution of diabetes closed loop systems across Scotland.
• We have seen universal support for diabetes technology. Opposition parties wrote a joint letter to the Minister for Public Health endorsing the campaign’s recommendations. 

The campaign has enabled people to raise their voices and drive change as a community. People with diabetes have told us how ‘inspiring’ the campaign has been. It has helped empower Kirsty to self-advocate for and secure a hybrid closed loop.

Thank you

We would like to say a heartfelt thank you to everyone who has played a part so far - to everyone who has shared their story and contacted their MSPs, Ministers and Health Boards, it really does make a difference.

The Tech Collective have been such inspiring and motivating partners to work with, as have colleagues we have worked with across the health system to develop a set of recommendations that we think will transform what it means to live with diabetes.

We know there is more to do 

Systems change is a complex and non-linear process. It is often slow, and by nature enacted over time, which can be a source of frustration.

So, let’s not lose sight of the positives that have come from individual and collective action so far, and recognise the importance of perseverance and continued collective action. Which is not to say our call for action should lack urgency.

We have made decision-makers sit up and listen. We know there is more to do. We continue to act.

New opportunities to influence

Earlier this month the Scottish Intercollegiate Guidelines Network (SIGN) updated its clinical guideline ‘Optimising glycaemic control in people with type 1 diabetes’. 

The updated guideline now includes Scottish Health Technologies Group (SHTG) recommendations, specifically advising that healthcare professionals proactively initiate meaningful discussions with all patients with type 1 diabetes about the suitability of a closed-loop system for their individual circumstances. 

Read how this guideline has for the first time been developed in toolkit format as a decision-support tool to help healthcare professionals to support people with type 1 diabetes to improve their blood glucose control. 

We welcome the inclusion of SHTG recommendations in the guideline and will use the updated SIGN guideline to keep up pressure to influence change. Our plans include writing to all Health Board chief executives to invite them to tell us their plans to incorporate the latest diabetes technology related recommendations into diabetes care in their Board.

Funding to roll out this technology to the people that need it is vital

In England, roughly two months after the National Institute for Health and Care and Excellence (NICE) announced their appraisal for hybrid closed-loop systems, there is now a clear plan for rolling out this technology to certain groups of people living with type 1 diabetes.

NHS England has confirmed that it will cover 75% of the costs for the local health board. People will have to meet the criteria and the plan is over five years, however this is a huge step forward.

The Scottish Health Technologies Group made recommendations for a rollout of diabetes technology across Scotland at the start of 2022. Nearly two years on, we are still waiting for a comprehensive funding plan for rolling out hybrid closed loop systems.

Diabetes Scotland has seen universal support for diabetes technology, and we know there are ongoing discussions between the Scottish Government and the NHS around funding for the roll out of hybrid closed loop in Scotland.

Resolute, vital next steps are to meet again with Minister for Public Health Jenni Minto, and, for the first time, with Scotland’s new Cabinet Secretary for NHS Recovery, Health and Social Care Neil Gray. Backed by messages from our supporters, we will insist that Diabetes Tech Can’t Wait and demand a plan to turn rhetoric into reality.

What can you do right now?

Read our guidance on how to engage with your MSP directly about issues that matter to you to make sure your voice is heard.