I had been told that the Libre Sensor readers and sensor pads were available now on prescription. My GP gave me a prescription for 1 kit but since discovered she shouldn’t have and only certain Type 1 diabetics can get one. . I offered to buy reader myself and change prescription from test strips to sensor but told not possible??? Is it the the same everywhere? Very disappointed long time user of strips with overused fingers!!!
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Freestyle Libre
- Thread starter Ashcroft
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In April new national criteria were published that ALL CCGs have to abide by (Libre has theoretically been available on prescription since November 2017, but many areas point-blank refused to prescribe it).
These are the national criteria, which should allow approx 15-20% of the UK T1 population to access Libre on prescription:
It's pretty certain that you would need to speak to your hospital clinic if you meet these criteria, as Libre is being handled in 'secondary care' settings. If you are not currently being seen at the hospital you can ask your GP to refer you.
Good luck!
These are the national criteria, which should allow approx 15-20% of the UK T1 population to access Libre on prescription:
- People with Type 1 diabetes OR with any form of diabetes on hemodialysis and on insulin treatment who, in either of the above, are clinically indicated as requiring intensive monitoring >8 times daily, as demonstrated on a meter download/review over the past 3 months OR with diabetes associated with cystic fibrosis on insulin treatment
- Pregnant women with Type 1 Diabetes -12 months in total inclusive of post-delivery period.
- People with Type 1 diabetes unable to routinely self-monitor blood glucose due to disability who require carers to support glucose monitoring and insulin management.
- People with Type 1 diabetes for whom the specialist diabetes MDT determines have occupational (e.g. working in insufficiently hygienic conditions to safely facilitate finger-prick testing) or psychosocial circumstances that warrant a 6-month trial of Libre with appropriate adjunct support.
- Previous self-funders of Flash Glucose Monitors with Type 1 diabetes where those with clinical responsibility for their diabetes care are satisfied that their clinical history suggests that they would have satisfied one or more of these criteria prior to them commencing use of Flash Glucose Monitoring had these criteria been in place prior to April 2019 AND has shown improvement in HbA1c since self-funding.
- For those with Type 1 diabetes and recurrent severe hypoglycemia or impaired awareness of hypoglycemia, NICE suggests that Continuous Glucose Monitoring with an alarm is the standard. Other evidence-based alternatives with NICE guidance or NICE TA support are pump therapy, psychological support, structured education, islet transplantation and whole pancreas transplantation.However, if the person with diabetes and their clinician consider that a Flash Glucose Monitoring system would be more appropriate for the individual’s specific situation, then this can be considered.
- Education on Flash Glucose Monitoring has been provided (online or in person)
- Agree to scan glucose levels no less than 8 times per day and use the sensor >70% of the time.
- Agree to regular reviews with the local clinical team.
- Previous attendance, or due consideration given to future attendance, at a Type 1 diabetes structured education programme (DAFNE or equivalent if available locally)
It's pretty certain that you would need to speak to your hospital clinic if you meet these criteria, as Libre is being handled in 'secondary care' settings. If you are not currently being seen at the hospital you can ask your GP to refer you.
Good luck!
Robin
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We all got excited when we heard that they would be available on prescription....then we read the small print. They can only be prescribed by a hospital clinic at present (though this may change) and the criteria are so tight that it’s reckoned that only about 20% of Type 1s will qualify.
Edit
Ha, Mike beat me to it, and with a much more comprehensive answer!
Edit
Ha, Mike beat me to it, and with a much more comprehensive answer!
Thanks. I have spoken to Diabetic nurse and ring consider me as well maintained blood levels. Test around 8 times a day / have to be on top of it as live alone but that not considered. Was really pleased when GP wrote script but apparently didnt know what she was doing !? The would probably save money in the long run...,
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As a T1, if you need to check BG 8x a day then you qualify and the CCG have to fund you (see criteria #1 above). At 8x a day Libre and fingersticks are more or less the same cost - they will expect a reduction in strips, naturally!
TheClockworkDodo
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Thanks for posting those criteria, Mike, that's interesting. No 6 is certainly not happening in practice, is it?! (Not related to the Libre, I mean the other things - I did finally get a Libre, but CGM with alarm is certainly not standard in practice!) I didn't know the other requirements, no-one has mentioned them to me at all, and I'm not using the Libre >70% of the time as I wouldn't have enough arm space to keep putting one on where there isn't a sticky ring from the last one!
@Ashcroft - I was told I qualify because of testing more than 8 times a day (which I do because of frequent hypos/hypo unawareness, but it was the 8 times a day they picked up on as being the relevant thing) so it sounds as though you should be able to get one. It would be worth pointing out how frequently you test to your diabetes team.
@Ashcroft - I was told I qualify because of testing more than 8 times a day (which I do because of frequent hypos/hypo unawareness, but it was the 8 times a day they picked up on as being the relevant thing) so it sounds as though you should be able to get one. It would be worth pointing out how frequently you test to your diabetes team.
SB2015
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My control was good when I was prescribed mine, but i certainly fitted number 5, where I had the evidence that my HbA1 c dropped by 10 when I started to self fund the Libre. I hope that you can get it sorted.
With regard to left over blotches from previous sensors, I switch arms each fortnight and get someone to put new one in, as they can see previous middle marks and avoid these, by working alonghe ‘flab’. When I go back to the arm there is usually no ring just the central blob.
Keep asking, and let us know how you get on.
- Relationship to Diabetes
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I wasn’t involved in any of the conversations, but I imagine the heads around the table were very much wide to this. CGM is so hard to come by, that for many who are quietly struggling Libre might offer some benefit where the CCG would just refuse what they actually need (according to the non-binding guidelines).
I did see Partha Kar tweeting (the Consultant and NHS England Diabetes Lead who was a significant driving force behind getting these Libre criteria and the funding for them agreed)... he seems to have CGM access very much in his sights!
TheClockworkDodo
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- Type 1
My problem is I've no flab, and I need my right arm to sleep on!
Hi Ashcroft, hope you can get the Libre issue sorted out soon, I tried many times to get Libre from my GP he said the CCG won’t fund it so I went to see my consultant at the hospital clinic last week. Joy of joys they said that I would be an ideal candidate for Libre, so they have booked me on an induction course day to start on the Libre, they will also write to my GP to start repeat prescriptions. I test more than 8 times most days so get through 200 finger prick tests a month. Btw there is a very good document on the NHS England web site that explains the CCG process, worth a read. I have also had my Insulin changed from two jabs per day of Humalog mix25 to three jabs a day of Humalog + one of Lantus, so the Libre will be great for the changeover to monitor for highs and lows.
Thanks for that information. I need to keep requesting then. I never see a consultant anymore but I will see what I can do. I have a check up at GP practice in June but only with nurse but will push it again. Glad you have managed to get though.
SB2015
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- Type 1
I think you should be able to ask for a referral to ‘specialist care’, ie consultant at hospital. They are then more likely to be able to recommend it. In our area they were the only ones who were able to make the decision, and they then told the GP to prescribe it.
The other advantage of being in their care is that they are more likely to be up to date with the latest options for insulins etc, whereas the Practice care is much more familiar with dealing with T2.
Let us know how you w you get on
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