Has NHS funding been blocked for glucose sensors?

Published: 1st Aug 2018

In brief

Claim

Theresa May blocked NHS funding for a brand of glucose sensor which is a lifeline to diabetics.

Conclusion

The sensor has been available for funding on the NHS across the UK since November 2017, though whether it is available in a particular local area is a lottery. Some areas have chosen to make it available while others have not.

“Clearly one rule for one & one rule for the elite. Circled here on @theresa_may  is a freestyle Libre continuous glucose sensor. You know the type she blocked NHS funding for? These are a lifeline to diabetics. Double standards???”

Viral tweet, 13 July 2018

We were asked by a reader to factcheck this tweet claiming the Prime Minister had blocked funding for a type of glucose sensor used by diabetics. At the time of writing it had been retweeted over 3,000 times.

The particular brand of glucose sensor mentioned in the tweet is available on the NHS across the UK to some extent.

In November 2017 it was added to the drug tariff—which sets out how much pharmacists and GP practices will be reimbursed for prescribing various drugs or medical devices to patients.

In England—where the UK government is responsible for healthcare—it is ultimately up to individual groups of GPs, consultants and other NHS staff responsible for spending on healthcare in the local area to decide whether the sensor is funded and available.

These glucose sensors are available to some extent on the NHS across the UK

The FreeStyle Libre is “a small sensor... placed under the skin to check glucose levels in the tissue’s fluid. The sensor stays in situ and transmits information about glucose levels to a monitor.”

The brand of sensor in question is now available on the NHS across Great Britain to some extent and through Health and Social Care Northern Ireland (the NHS equivalent there).

The original tweet appears to come from a Scottish account. In Scotland the FreeStyle Libre was available in seven of the fourteen NHS health boards as of June 2018.

In England the FreeStyle Libre has also been introduced in some areas but not in others. Diabetes UK maintains a map of areas that offer the FreeStyle Libre on the NHS around the UK. According to this data (which Full Fact hasn’t been able to independently verify) it is available in 117 areas, not available in 49, with a further 34 areas where it is either under review or implementation plans are being finalised (and 21 areas where no information was available).

Approving glucose sensors for use across the UK

There are a number of stages between a drug or health appliance being ready for the market and people being able to purchase it or get it on prescription from the NHS.

The licence and use of drugs and medical devices in the UK is monitored by two agencies, the European Medicines Agency which functions across the EU and European Economic Area (EEA), and the Medicines and Healthcare Products Regulatory Agency, which is a branch of the Department of Health. In order to be made available in the UK a drug or health appliance has to be approved by one of these organisations.

In September 2014 the FreeStyle Libre glucose sensor was approved by the EMA for use on the European market.

The route to the NHS

Guidelines on various treatments in England they’re produced by the National Institute for Health and Care Excellence (NICE)—though NICE guidance can be used in the rest of the UK too.

These guidelines are produced to help medical professionals and patients understand the evidence behind a new treatment or device and to help them make decisions about it.

According to the Scottish Parliament Information Centre “SIGN guidance is not mandatory but it is expected that healthcare professionals should take it into account in their practice. If it is considered that guidance does not reflect the most recent evidence, clinicians would be expected to look to more recent guidelines such as those from NICE.”

The most recent NICE guidelines say that “Continuous monitoring of interstitial fluid glucose using a continuous glucose monitor is not recommended for routine use but can be considered for some people (see table 1). No NICE guidelines currently include recommendations for intermittent interstitial fluid glucose monitoring (such as that provided by FreeStyle Libre)”.

Taking the guidance of these bodies into account it is then up to individual Clinical Commissioning Groups (across England) or NHS Health boards (in Scotland) to decide whether they will introduce the drug or technology in their area.

In England, Wales, Northern Ireland, and Scotland the FreeStyle Libre device has been available for prescription on the NHS since November 2017, thought the NHS says this is dependent on local approval and the person being prescribed it meeting certain criteria.

NHS England has advised Clinical Commissioning Groups to “give careful consideration to the available evidence in developing their policies on funding FreeStyle Libre.”

Where it is available, the NHS says patients typically need to test their blood glucose eight times a day and have “disabling hypos” before they would be prescribed a sensor.

Private purchase is also possible

It is also possible to purchase the FreeStyle Libre separately, rather than getting it on prescription. The NHS’s “rough guide” says that this will cost around £150 for the starter pack and then another £50 each for more sensors and readers to top this up.

 

Correction 8 August 2018

We incorrectly described the FreeStyle Libre as a “blood” glucose sensor and “continuous” glucose sensor.


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