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NHS providing flash glucose monitoring for people with Type 1 diabetes


The NHS today announced action which will bring an end to the current postcode lottery that patients are facing to access Freestyle Libre. The change in policy will come into effect on 1 April 2019, and could benefit tens of thousands of people. 

Under the current system, it is up to the individual clinical commissioning groups (CCGs) to decide whether flash glucose monitoring is available to patients in their area, which means the CCG can dictate the criteria for patients who are eligible for the device, and decide whether they offer it at all. 

There are currently 51 CCGs who do not offer flash glucose monitoring at all. At the moment only 3 to 5% of people with Type 1 diabetes have access. It is hoped that this policy will help 20 to 25% of people with Type 1 to be prescribed the device. This will happen by making the criteria that patients need to meet universal, and making Freestyle Libre® available to all CCGs.  

Chris Askew, CEO of Diabetes UK, said:

“Today’s announcement is a huge step forward, and will be welcome news to the many thousands of people with Type 1 diabetes whose lives will now be changed for the better by access to Flash Glucose Monitoring. Once in place, these measures should mean an end to the variation in availability and the postcode lottery that have dogged access to this life-changing technology.
“This decision demonstrates that the NHS is seizing the opportunities presented by new technology, but also that it has listened to the voices of many thousands of people living with and affected by diabetes across the UK. Everyone who has called for fair and equitable access to Flash – through both funding and eligibility criteria – should feel rightly proud that they have been heard today. 
“The diabetes crisis is a fight that must be fought on many fronts, and Diabetes UK will continue to champion access to new and established technology – and gold standard care – wherever variation and inaccessibility exist.”

The news was announced on World Diabetes Day by NHS England Chief Executive Simon Stevens. We have has lots more information about our Fight for Flash campaign, and what these new changes will mean for people with Type 1 diabetes

The criteria

1. Patients who undertake intensive monitoring >8 times daily 

2. Those who meet the current NICE criteria for insulin pump therapy (HbA1c >8.5% (69.4mmol/mol) or disabling hypoglycemia as described in NICE TA151) where a successful trial of FreeStyle Libre® may avoid the need for pump therapy. 

3. Those who have recently developed impaired awareness of hypoglycaemia. It is noted that for persistent hypoglycaemia unawareness, NICE recommend continuous glucose monitoring with alarms and Freestyle Libre does currently not have that function. 

4. Frequent admissions (>2 per year) with DKA or hypoglycaemia. 

5. Those who require third parties to carry out monitoring and where conventional blood testing is not possible. In addition, all patients (or carers) must be willing to undertake training in the use of Freestyle Libre and commit to ongoing regular follow-up and monitoring (including remote follow-up where this is offered). Adjunct blood testing strips should be prescribed according to locally agreed best value guidelines with an expectation that demand/frequency of supply will be reduced.

The full criteria are available from the Specialist Pharmacy Service.

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