Diabetes Tech

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John Din

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Type 2
Hi All
Any type 2 diabetics out there on insulin and using libre2 for glucose monitoring. I have to self fund as my CCG will not support the new NICE guidelines. Wondering how others are doing with their Doctor
John Din
 
Inka said:
I think there was some guidance about this that someone here kindly posted. Was it you, @Bruce Stephens ? (Sorry if it wasn’t)
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Quite likely me.

The advice is from Partha Kar that this should be challenged: if they're not following the NICE guidance now, when will they? What's stopping them? He's happy to help with challenging this if necessary (and does so frequently).
 
Hi
Thanks for response. I have asked the CCG why they are not implementing the NICE guidelines and have an appointment with my Doctor this afternoon where I will ask for further clarification as to why he cannot just prescribe the libre2. I will keep you posted
 
John Din said:
Hi All
Any type 2 diabetics out there on insulin and using libre2 for glucose monitoring. I have to self fund as my CCG will not support the new NICE guidelines. Wondering how others are doing with their Doctor
John Din
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Same here. Response was that nice guidance is just guidance. Each area decides their own criteria, which can be the same or different. Last time I asked my area hadn’t decided on their criteria so weren’t prescribing libre to type 2s
 
NICE guidance is national standards to which they are supposed to be held accountable, not "just guidance". It may be worth raising with your MP if the CCG continue to be difficult, as well as seeing if Partha Kar will take it up with them
 
42istheanswer said:
NICE guidance is national standards to which they are supposed to be held accountable, not "just guidance". It may be worth raising with your MP if the CCG continue to be difficult, as well as seeing if Partha Kar will take it up with them
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I don't think that's quite right, but ordinarily the things that used to be CCGs do try to follow NICE guidance (because providing such guidance is what NICE is for) so it's certainly worth challenging when they don't.
 
Bruce Stephens said:
I don't think that's quite right, but ordinarily the things that used to be CCGs do try to follow NICE guidance (because providing such guidance is what NICE is for) so it's certainly worth challenging when they don't.
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From the NHS constitution:

"

Your rights​

You have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you.

You have the right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence. If the local NHS decides not to fund a drug or treatment you and your doctor feel would be right for you, they will explain that decision to you."

Note that the second part about local decisions (I.e. where CCG may decide against funding) is " other drugs and treatments" not contradicting the first clearcut paragraph that you have the  right to treatments recommended by NICE if your doctor (not CCG) thinks they are appropriate.

NICE do offer a slight out on some of their guidance by this:

"

Using recommendations​

Our recommendations are based on:
  • the trade-off between the benefits and harms of an intervention
  • the quality of the underpinning evidence.
Some recommendations are made with more certainty than others. We word our recommendations to reflect this. Where there is clear and strong evidence of benefit, we will use the word 'offer'. Where the benefit is less certain we use the word 'consider'.
For more information take a look at our developing NICE guidelines: the manual.
" but the only part of the new Type 2 CGM guidelines which says "consider" rather than "offer" is the bit about rtCGM rather than isCGM if cost is same or lower.
 
42istheanswer said:

Your rights​

You have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you.
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OK, I didn't know that. So I'm wrong about that.

I wonder why some areas still feel OK not following the NICE guidance, in that case?
 
Bruce Stephens said:
OK, I didn't know that. So I'm wrong about that.

I wonder why some areas still feel OK not following the NICE guidance, in that case?
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No idea. Probably because they think they can get away with it... It would be kind of understandable if they were just saying "we have a date to review that guidance along with comparing to our current practice, we will implement it after we have had that review but currently we are reviewing XYZ guidance and don't have capacity to review this one yet" but if any CCG/ICB is just outright refusing to follow NICE guidelines then I think it's worth challenging them through any forum possible
 
Hi All
Thank you for your views and support. Attended the Doctor today and the access to libre2 will be funded outside of CCG . I am not sure how but feel grateful.
kind regards
john
 
That's great news John!
 
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