Pump funding update

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imtrying

imtrying

Well-Known Member
Relationship to Diabetes
Type 1
ok, so I finally heard back from my DSN (well, she finally heard back from who she was waiting on!)....and this is what she said -

Hi Katie,
I have heard back from the lead nurse from Havering PCT. Basically, the GP needs to apply for special funding from the PCT but we need to assess suitability.
Obviously the main issue is regards to meeting the NICE criteria for funding, which is either HbA1c over 8.5%; or disabling hypos or fear of disabling hypos if Hba1c improved; or pregnancy.
I think if you are interested in a pump we should arrange to meet up and discuss the idea and explain what is involved. The most likely criteria for pump would be disabling hypos or pregnancy so we need to make sure you 'fit the bill'.
Let me know your thoughts on this.
Margaret

Can anyone help me understand what this means?? Does this mean so long as I am deemed 'suitable' I will get one??

Sorry to ask such a stupid question, but I'm struggling to understand what the implications/meaning is of the email.

Thanks guys.
 
Hi Katie!

By the sounds of it, yes! Sorry if I have missed loads - why is your GP (as opposed to a hospital consultant) applying for you? It will be your GP/consultant who requests funding for you so ideally a meeting with them to get them to agree to request it is what is needed. Either way, I think you should get in to see your DSN asap to get the ball rolling.

Don't forget that as long as they agree you would be suitable for one, the PCT can't say no 🙂

Siobhan
 
It is basically stating that you will be assessed to see if you meet the NICE criteria.........

So if you meet one of them, your in with a reasonable chance, I think......
 
shiv said:
Hi Katie!

By the sounds of it, yes! Sorry if I have missed loads - why is your GP (as opposed to a hospital consultant) applying for you? It will be your GP/consultant who requests funding for you so ideally a meeting with them to get them to agree to request it is what is needed. Either way, I think you should get in to see your DSN asap to get the ball rolling.

Don't forget that as long as they agree you would be suitable for one, the PCT can't say no 🙂

Siobhan
Click to expand...


Thanks Shiv...it's because my diabetes team are not in the same PCT area (I kept my brilliant team when I moved as I didn't want to lose such a great team)....but I live in a different area so I think that its my GP who needs to say yes as the funding comes from a different PCT to my diabetes team...I think!!

I'm seeing my GP on Friday anyway for my 'diabetic annual review' so am going to bombard them with why I should go on a pump...then I'm now off to my DSN at 4pm that afternoon to get things moving there.

My diabetes team want me on one, my problem is I improved my HbA1C after going on their DAFNE course.... so may have shot myself in the foot. I can't claim disabling hypos as I'm a daily driver and I'd loose my license. Will see what they say Friday I suppose!
 
imtrying said:
my problem is I improved my HbA1C after going on their DAFNE course.... so may have shot myself in the foot. I can't claim disabling hypos as I'm a daily driver and I'd loose my license. Will see what they say Friday I suppose!
Click to expand...

Only one thing for it then...........BABIES......................😉

Only kidding, I hope it goes well.............you just dont know with the way things are across the country, some PCTs give them away, others claim to deny the existence of such a device..........:D
 
Hi Katie

Good luck with your application.

Here's a question - do you have a tendency to run your BGs a bit high 'just to be on the safe side' for driving? Have you ever had a nasty hypo and do you fear having another if you don't keep things nailed down? How many mini/low level dips (below 4) do you have a week? Do you absolutely *always* spot them? Do your team want you to reduce that number?

The NICE criteria allow for interpretation in terms of 'fear of disabling hypos'. I was quite honest with my DSN that I hadn't had anything like a severe episode or one that needed 3rd party assistance for years. I still qualified though, because I worried about having one. I was able to say that I spotted almost all my hypos in the 3's with good clear warning signs - but every-so-often I missed one and this made me nervous. I also said that I tended to avoid driving if possible - and when I did I made sure my levels were high 'just in case'. All of which meant the criteria were met despite an A1c that was well below 8.5%.

Sounds like your DSN wants to help you secure the funding - so good luck!
 
Whats to stop people lying about their fear of hypos then, is there any physiological test done.......?
 
novorapidboi26 said:
Whats to stop people lying about their fear of hypos then, is there any physiological test done.......?
Click to expand...

Just a consultation. How could you test it anyway? I AM scared of having nasty hypos! Isn't everyone?!
 
everydayupsanddowns said:
Just a consultation. How could you test it anyway? I AM scared of having nasty hypos! Isn't everyone?!
Click to expand...

I suppose, I have this picture in my head of them doing everything to prevent funding, however I have never been through the process so I dont really know...........

I know that I couldn't say I was scared of having hypos, when realistically if I was having one, I would be scared at the time..........
 
everydayupsanddowns said:
Hi Katie

Good luck with your application.

Here's a question - do you have a tendency to run your BGs a bit high 'just to be on the safe side' for driving? Have you ever had a nasty hypo and do you fear having another if you don't keep things nailed down? How many mini/low level dips (below 4) do you have a week? Do you absolutely *always* spot them? Do your team want you to reduce that number?

The NICE criteria allow for interpretation in terms of 'fear of disabling hypos'. I was quite honest with my DSN that I hadn't had anything like a severe episode or one that needed 3rd party assistance for years. I still qualified though, because I worried about having one. I was able to say that I spotted almost all my hypos in the 3's with good clear warning signs - but every-so-often I missed one and this made me nervous. I also said that I tended to avoid driving if possible - and when I did I made sure my levels were high 'just in case'. All of which meant the criteria were met despite an A1c that was well below 8.5%.

Sounds like your DSN wants to help you secure the funding - so good luck!
Click to expand...

Totally agree with everything you have said Mike. The NICE guidelines for a pump are a semi-joke and a pump should be considered on a case by case application. Understanding carb counting, ratios and adjustments are all important, as are being in control of your diabetes and diabetes education. My consultant agreed to my application even though I didn't really meet the NICE guidelines (apart from what Mike has already said above)....I basically said 'do you want me to have a higher Hba1C next time'......to meet NICE criteria! 😉. Katie my DSN and consultant are also in a different county to my PCT (like yours) but because they recommended me for a pump....I got one, with no hassle from my GP or PCT. Good luck!
 
''The most likely criteria for pump would be disabling hypos or pregnancy so we need to make sure you 'fit the bill'.''

I like this part of the DSN e-mail, which translates into, we are fully behind you and will ensure what ever you'll will fit the bill...

The GP applying for funding is just part of the lovely protocol of paperwork source. As it's probably easier to go through the system via your GP in your area than a consultant from outside the PCT area..

Disabling hypo's can be fudged quite a bit, there's a little leeway in white lies here, 3rd party intervention did somebody pass you your hypo treat! But also surrounding this, is to improve control you hit a problem with your sensitivity to insulin causing a hypo, and you really, really scared of having a hypo aren't you🙄 Then you go along the line of impact of hypo's... Not good when your job depends on meeting deadlines and you can't meet the deadline because of a hypo, even if it's just finishing off typing the letter before you go off to the loo! Just don't mention what sort of deadline you'll talking about.

Good luck with your meeting, and by the sounds of it, your DSN is as keen for you to have a pump as you are...
 
Thanks everyone.

everydayupsanddowns said:
Here's a question - do you have a tendency to run your BGs a bit high 'just to be on the safe side' for driving? Have you ever had a nasty hypo and do you fear having another if you don't keep things nailed down? How many mini/low level dips (below 4) do you have a week? Do you absolutely *always* spot them? Do your team want you to reduce that number?
Click to expand...

Mike, yesI do, but figured this was just 'normal'. I've had one very very bad hypo about 10 years ago and have run high ever since. I hated the feeling of having a hypo so I just ran high all the time. I've now bought it down and started the carb-counting in October, but I do urge on the side of caution. I also won't inject to eat if I know I'm going to be driving soon after. I'd say as well of living in fear of hypos, I also live in fear of losing my license...does that count too??!

novorapidboi26 said:
Only one thing for it then...........BABIES......................😉
Click to expand...

hahahaha do you think my hubby will fall for it??!! could be a win-win situation there! but in all seriousness, it won't be too many years until we're wanting kids, so it is an option so I'm prepared for it.
 
Phil65 said:
..I basically said 'do you want me to have a higher Hba1C next time'...
Click to expand...

Hahaha! That's pretty much exactly what I said too at one point, 'Would you like me to push my A1c into double figures? I can do that no problem...' My DSN said that would not be necessary :D
 
imtrying said:
...I'd say as well of living in fear of hypos, I also live in fear of losing my license... does that count too?!?
Click to expand...

BABOOOOOM! She shoots... she scores!
 
Ellie Jones said:
''The most likely criteria for pump would be disabling hypos or pregnancy so we need to make sure you 'fit the bill'.''

I like this part of the DSN e-mail, which translates into, we are fully behind you and will ensure what ever you'll will fit the bill...

The GP applying for funding is just part of the lovely protocol of paperwork source. As it's probably easier to go through the system via your GP in your area than a consultant from outside the PCT area..

Disabling hypo's can be fudged quite a bit, there's a little leeway in white lies here, 3rd party intervention did somebody pass you your hypo treat! But also surrounding this, is to improve control you hit a problem with your sensitivity to insulin causing a hypo, and you really, really scared of having a hypo aren't you🙄 Then you go along the line of impact of hypo's... Not good when your job depends on meeting deadlines and you can't meet the deadline because of a hypo, even if it's just finishing off typing the letter before you go off to the loo! Just don't mention what sort of deadline you'll talking about.

Good luck with your meeting, and by the sounds of it, your DSN is as keen for you to have a pump as you are...
Click to expand...

Thanks Ellie. Yeah she's great and real advocate for pumping. The pump was her idea to start with! So glad I was off Friday anyway so I can get to see her asap to get the ball rolling...and already booked in to see my GP about my diabetes on Friday too...dare I say 'it was meant to be???' No, not tempting fate yet!

Will let you know how it all goes... (there goes my day off resting, but hey! I know which I'd prefer!).
 
imtrying said:
I can't claim disabling hypos as I'm a daily driver and I'd loose my license. Will see what they say Friday I suppose!
Click to expand...

Quite right, but you do have a fear of hypos........ Don't you? yes you do. Repeat after me.....
 
But does no one feel bad twisting the truth and therefore stopping someone who actually is scared of dying from a hypo.........:D
 
novorapidboi26 said:
But does no one feel bad twisting the truth and therefore stopping someone who actually is scared of dying from a hypo.........:D
Click to expand...

It's actually not twisting....I do fear hypos, and I fear losing my licence from having one, I just don't really talk about it as I thought that's just 'normal' so why mention it!!

😉
 
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