UPDATE: 30 September, 2024: NHS England has agreed cost-effective deals with manufacturers of artificial pancreas systems so that more people living with type 1 diabetes can be offered this technology this year.
NHS England has been planning a national rollout of hybrid closed-loop systems, also called an artificial pancreas, since April 2024.
Tens of thousands of children and adults living with type 1 diabetes across England will receive an artificial pancreas, and NHS England says that by securing cost-effective prices for these systems, more people will get access to them this year.
It is encouraging all prescribing trusts to review people with type 1 diabetes who are eligible for hybrid closed-loop systems under guidelines published last year by the National Institute of Health and Care Excellence (NICE).
What is an artificial pancreas?
An artificial pancreas – also known as a hybrid closed-loop system - continually monitors a person’s blood glucose, then automatically adjusts the amount of insulin given to them through a pump.
Over the next five years, local NHS systems will start identifying eligible people living with type 1 diabetes who health chiefs believe could benefit from the hybrid-closed loop system today.
The technology will mean some people with type 1 diabetes will no longer need to inject insulin but use technology instead. The hybrid closed-loop can also help prevent people having hypoglycaemia, also called hypos, and hyperglycaemia, also called hypers.
Colette Marshall, Chief Executive of Diabetes UK, said after the announcement of the rollout:
“It is incredibly exciting to see hybrid closed-loop technology being rolled out on the NHS in England for people with type 1 diabetes.
“Diabetes is a tough and relentless condition, but these systems make a significant, life-changing difference – improving both the overall health and quality of life for people with diabetes.
“This really is a landmark moment and we’ll be working with the NHS and others to ensure a fair rollout that reaches people as quickly as possible.”
How will the rollout work?
NHS England has previously published a five-year implementation strategy setting out how people with type 1 diabetes will be able to access an artificial pancreas.
The aim is that the technology will be offered to as many people as possible and focus on improving outcomes for those with the greatest unmet need first and reducing health inequalities in access.
NHS England is providing £14.1m to local health systems to provide the technology to people for the first year. It is encouraging all prescribing trusts to review people with type 1 diabetes who are eligible for hybrid closed-loop systems under guidelines published last year by NICE.
The mass rollout of the artificial pancreas builds on a successful pilot of the technology by NHS England, which saw 835 adults and children with type 1 diabetes given devices to improve the management of their condition.
Read more about NHS England's implementation plan on their website.
How do I know if I’m eligible?
NICE approved the NHS’s rollout of the technology in December 2023.
NICE recommends the devices should be rolled out to children and young people under 18 with type 1 diabetes, pregnant women with type 1 diabetes, and adults with type 1 diabetes who have an HbA1c of 58 mmol/mol (7.5%) or higher.
Read more about NICE guidelines for artificial pancreas systems.
How has an artificial pancreas helped people?
The hybrid closed-loop system has dramatically changed the everyday life of Gemma Lavery, 38, from Plymouth. She received an artificial pancreas as part of the NHS pilot and calls the technology a “game changer” that allowed her to find a sense of normality.
Gemma said:
“I no longer have to worry about work related stress affecting my blood glucose levels as the closed loop helps to sort this out before it becomes a problem.
“I can have a full night sleep without worrying about regular low glucose levels hindering my morning routine and I have found that my diabetes is more stable.”
Another person who has received an artificial pancreas from the NHS is 64-year-old Les Watson, from West Devon. Les has been living with type one diabetes for nearly 44 years, and experienced all of the technological changes in treatment first hand over that period.
Les said:
“The user interface is clean, clear and straightforward to grasp, the information that is required by a pump user is readily available and not tucked away somewhere deep in a stacked menu.
“The system is not overloaded with complicated options making its day-to-day use quick and easy. As a user I now spend hardly any time interacting with the system other than at mealtimes or telling it I’m heading out to exercise.
From research to roll out
Our research was there at the very beginning. We funded the UK’s first ever insulin and glucose delivery system – called the biostator – in 1977. And ever since we’ve been supporting research to drive forward the development of hybrid closed-loop tech and build the evidence to make its roll out a reality.
What about Northern Ireland, Scotland and Wales?
This NICE guidance also applies to Wales and NHS Wales have similarly agreed a five-year period to roll out hybrid closed-loop following the appraisal, though we don't yet have further details of this.
The guidance has also been adopted in Northern Ireland and there is work underway to agree on how it can be implemented there.
Scotland has separate guidance for hybrid closed-loop systems which was published in 2022 and the Scottish Government in May funded plans to accelerate implementation, including funding a dedicated innovation team to support roll out.
In Scotland, they are recommended for people with type 1 diabetes who are struggling to manage their blood sugars, are at a high risk of hypos, have impaired hypo awareness, or are experiencing diabetes-related distress.
