Not quite,
@Thebearcametoo. Dexcom One was a junior version of the G6. Dexcom One+ is a junior version of the G7.
When, in 2022, NICE upgraded their Guidance Notes NG17 and NG28 they did a number of things but in particular: they approved a wider selection of lower cost CGMs; they added onto the approved list of devices for the NHS in 2 categories of lower and higher cost; and they improved the availability of those in the lower cost bracket by specifically delegating the prescribing of lower cost CGMs to GPs - without a GP needing to be instructed by a Consultant to raise the repeat prescriptions. A GP could (should) use their own judgement.
One thing that got tangled up in these significant changes,
@Kwilkins, was financial approvals. Pre Covid, in England (I'm not sure about Wales or Scotland and NI was already an Integrated set up) a major rearrangement of the myriad of small, discrete Cost Centre Groups (CCGs) was set up to become a much smaller number of regional Integrated Care Systems (ICS) each to be run by Integrated Care Boards (ICBs). In Bucks several CCGs were merged with several in Oxfordshire and several in West Berkshire to become the single Bucks, Oxon and Berks (W) Integrated Care System managed by the BOB(W) ICB.
After Covid the "go live" date for this significant rearrangement was set for 1 July 2022. However because of Covid much of the detailed admin work needed to implement this big change had not been done and GP Surgeries were left in transition still answering the their former CCGs, which still flexed their muscles because the ICBs existed on paper but not in practice. Indeed, even today that integration within the BOB(W) ICB is still murky: their is no postal address for it, no phone number only a web-site and direction to send questions etc to PALs. But the CCGs seem to have been subsumed into this ICB.
So NG17 and NG28 are in place, Guidance Notes without financial provision, with amendments from Spring 2022 and sometimes without GP Surgeries understanding they now have independent authority to prescribe - possibly because their former CCG hasn't provided the financial cover and maybe has also now become a different financial authority.
Libre 2 (now 2+) and Dexcom One+ are in the lower cost bracket, now wholly within the gift of GPs - subject to their ICB budget authorisations. Libre 3, Dexcom G6 and G7 are in the higher cost bracket and need Hospital based approval. Historically these more exoensive CGMs were only associated with pumps and the higher tech duabetes systems. Once approved the prescription is raised and managed by that Hospital Trust. In most cases the Hospital's have call-off contracts with Abbott or Dexcom and for my G7 I receive 9 x 10 day G7s every quarter, automatically. No necessity for requesting a repeat script and none of this nonsense of being constrained to monthly repeats (ie effectively no reserve when the tech fails).
You asked,
@Kwilkins, "Is this correct, does anyone have it without a pump please?". The answer is Yes. I have G7 with no pump and there are forum members with G6 and no pump. But, as I understand matters, we each have these provided by their Hospital, after a Consultant has made a business case to their financial masters, and that supply comes direct to the patient. The GP is by-passed. Until recent upgrades to phone models and/or Android or ios, Dexcom One+ was a pretty good system, slightly different in detail to Libre 2 / 2+, but essentially the same. One useful difference is that Dexcom One+ has the ability to work to a handheld Receiver (the equivalent to Libre's hand held Reader) INDEPENDENTLY of any mobile phone.
Your son ought to be able to nudge his GP to prescribe that Receiver, as part of ensuring his "prescribed medication" (ie Dex One+) can be used. The chances are your GP won't know this is possible, or is constrained by financial authority (who have a natural intent to resist - won't want to open a flood gate). Any user can purchase their own Receiver direct from Dexcom, c.£50 (VATexempt). With a Receiver your son will have excellent easy use of his sensors, but will periodically need to upload and share his Receiver data to wherever it was going automatically, from his phone.
The whole business is an administrative bureaucratic mess, which can't keep up with technology changes, nor the massive widening of CGM requirements and availability since Covid. Further complicated by Abbott and Dexcom trying to increase their market share and approaching GPs direct with sales techniques that seem to be swaying Surgeries to alter their scripts, sometimes without a GP (who isn't expected to deal with T1 insulin dependent patients anyway) asking the Patient first.
It does help to know how the system works to be able to influence change/adjustment/improvement. Do let us know how this unfolds, please. Your son may be helping adjustment by creating precedent!
