Finally all is revealed – the standard minimum criteria for people to access flash glucose monitoring on the NHS in England from 1 April 2019.
This is very exciting for the many people who have campaigned for better access to diabetes technology. We welcomed the announcement in November that flash glucose monitoring, or what we call Flash, would be rolled out across England, putting an end to the postcode lottery, and now we have more understanding of the criteria that will apply.
To qualify for Flash under the NHS England you will have to meet one of the following criteria:
- People with Type 1 diabetes who have previously self-funded and can demonstrate they have improved their HbA1c
- People with Type 1 diabetes or with any form of diabetes on hemodialysis and on insulin treatment who need to test frequently (over 8 times a day) or with diabetes associated with cystic fibrosis on insulin treatment
- People with Type 1 diabetes who find it difficult to carry out finger-prick testing
- Pregnant women with Type 1 diabetes
Will it mean everyone who wants to use Flash will get it on the NHS? Probably not.
But what it does mean is that no Clinical Commissioning Group (CCG) will be able to say they don’t have a policy and no GP should say they don’t prescribe it. This is a huge step forward and is intended to increase the numbers of people accessing Flash from around 3% up to an estimated 20% of the Type 1 diabetes population in England.
We wanted to see access for all children with Type 1 and advocated for this in terms of the benefits to the whole family and for the child’s quality of life and attainment at school. It will still be possible for many children to access through these criteria – either because they finger-prick more than 8 times a day or because their diabetes team assesses that they are unable to test as frequently as they should due to psychosocial circumstances, or because their parents have previously self-funded.
Access to Flash
We are actively campaigning for people with diabetes to get access to the best treatments and technology for them, and will work to ensure that those who can benefit from Flash are enabled to access through these criteria. We will monitor the situation as it develops during the year and ensure that the funding allocated is spent on increasing access for those who seek it.
It is also important to note that these are minimum criteria and CCGs are encouraged to continue to make Flash available to additional groups who may be able to benefit, and for those who were already funded under existing CCG policies and are showing observable improvements in their glucose management or psychosocial wellbeing.
Finally, these criteria are set in the context of the consensus Type 1 technology pathway we published last year and make reference to the use of continuous glucose monitoring (CGM) and insulin pumps where these technologies might be more appropriate for someone with Type 1 diabetes depending on their needs and if use of flash glucose monitoring is not achieving the anticipated results.