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Getting a free CGM, flash glucose monitor (Freestyle Libre) or insulin pump on the NHS – who should qualify?

If you live in England, Wales, or Scotland, see the latest guidelines on whether you — or someone you’re supporting— should be eligible for a flash glucose monitor (Freestyle Libre), continuous glucose monitor (CGM) or insulin pump to help manage diabetes.

If you live in Northern Ireland, you’ll need to check the guidance with your healthcare team. 

These are guidelines only, it’s worth saying. Diabetes healthcare teams may have a local policy which they have to use in line with NICE guidelines as a minimum. 

The information below includes guidelines for England and Wales that have come in from March 2022. Read our news story on these changes.

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. If you are using a flash glucose monitor and may now be eligible for a CGM, you may have to keep using the old one for a set time before being moved over.

Children under 18 with type 1 diabetes 

CGM and flash glucose monitor (Freestyle Libre) 

If your child is under 18 and you’re in England or Wales, they should be offered a continuous glucose monitor (CGM) say NICE guidelines.  

If your child is under 18 and you live in Scotland, national guidance says they should be offered a flash glucose monitor (Freestyle Libre). There is currently no guidance on CGMs. You’d need to check with your child’s healthcare team if you think this is something that would benefit them. 

If your child is under 18 and you’re in Northern Ireland, you’ll need to check the guidance with their healthcare team. 

Insulin pump 

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 severe hypos.  
  • Their HbA1c remains high despite carefully trying to manage their diabetes.  

For children in Scotland, national guidance says 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 also 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 

CGM and flash glucose monitor (Freestyle Libre) 

If you’re 18 and over and live in England and Wales and have type 1 diabetes, you should be able to choose between a CGM or flash glucose monitor (Freestyle Libre) say NICE guidelines. You should be offered CGM if you are pregnant and have type 1 diabetes.  

If you’re in Scotland, national guidelines recommend that you should be offered a flash glucose monitor (Freestyle Libre) if you have type 1 diabetes. There are currently no national guidelines in Scotland for the use of CGM in the wider adult type 1 population, although it is recommended that CGM should be available to you if you are pregnant.  

Insulin pump 

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 severe hypos.  
  • Your HbA1c remains high 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.  

Adult with type 2 diabetes  

CGM and flash glucose monitor (Freestyle Libre) 

If you have type 2 diabetes and use insulin two or more times a day and live in England or Wales, you should be offered a Freestyle Libre to help you check your blood sugar levels if any of the below apply, say NICE guidelines.  

  • you have recurrent or severe hypoglycaemia  
  • you have impaired hypoglycaemia awareness  
  • you can't monitor your own blood sugar levels but you could use a scanning device or someone else could scan for you
  • you should otherwise be advised to do a finger prick test at least 8 times a day. 

Adults with type 2 diabetes in England or Wales who use insulin and would otherwise need help from a care worker or healthcare professional to monitor their blood sugar should be offered a CGM. 

If you have a learning disability and use insulin, you should be offered a flash glucose monitor (Freestyle Libre) say NICE guidelines for England and Wales.  

In Scotland, national guidelines recommend people with type 2 diabetes who use insulin intensively (four or more injections per day).

If your child has type 2 diabetes, there are no guidelines on technology access. But we believe many children living with type 2 diabetes could benefit from Flash or CGM use and we will be pushing the health system to make it available. If you think your child could benefit from Flash or CGM, speak to your healthcare professional about what options you have. 

Pregnant with diabetes 

If you’re pregnant and have type 1 diabetes you should be offered a CGM. A CGM should be offered rather than a flash glucose monitor as evidence shows CGM can be particularly beneficial during pregnancy. 

If you’re pregnant and have type 2  diabetes or gestational diabetes you should be offered Flash or CGM if you have severe hypos regardless of your hypo awareness, or if you have unstable blood sugar, say NICE guidelines for England and Wales.   

If you’re in Scotland you should be offered CGM if you’re pregnant and have type 1 diabetes. There are currently no national guidelines for CGM or Flash use in pregnancy when you have type 2 diabetes of gestational diabetes in Scotland.  

If you’re in Northern Ireland, check the guidelines with your healthcare team. 

Adults with other types of diabetes  

There is very limited NICE guidance on tech access for other types of diabetes such as LADA 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 for your blood sugar levels.  

We would suggest that if you manage your diabetes with two or more insulin injections, you should be given access to a flash glucose monitor (Freestyle Libre) or CGM. 

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 a flash glucose monitor, CGM or insulin pump will help you to manage your condition. 

Sometimes they can loan you a device for a short time to see how much difference it makes to your quality of life – or give some insights on what is affecting your blood sugars so you can make positive changes to help manage them. 

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 CCG or health trust or board 

If you this doesn’t help, you can also write to or email your CCG, 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 control? 
  • Do you test as often as you have been advised or would like to? If not, why is that? 
  • 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? 
  • Do you struggle to perform finger prick tests regularly as part of your everyday routine? 
  • Do you work in an environment where it is difficult to perform finger prick tests regularly? Can you explain why? 
  • How would tech benefit you if you regularly play sport? 

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 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.  

Find your CCG or health board   

England

Enter your postcode into the Clinical Commissioning Group finder on the NHS England website. It will list your local services and their contact details. 

Wales 

There are 7 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 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 over the next five years 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. 

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