Monday, 18 April 2011
10 Downing Street Petition Response.
Post Code Lottery For Pumps Response: Our ref: DE00000604718 Dear Madam, Thank you for Diabetes Power's recent petition to the Prime Minister about insulin pump therapy for people with diabetes. As the issues raised relate to health, the petition was passed to the Department of Health and I have been asked to reply. The National Institute for Health and Clinical Excellence (NICE) first published guidance on insulin pump therapy in 2003. In July 2008, NICE issued its review and re-appraisal of insulin pump therapy, which resulted in a change to the guidance. The guidance now recommends pump therapy as an option for adults and children of 12 years and older with Type 1 diabetes, provided that multiple daily injection (MDI) therapy has failed and that those receiving the treatment can use it effectively. The guidance also now recommends that insulin pump therapy can be used as a treatment option for children younger than 12 years with Type 1 diabetes, provided that MDI therapy is considered to be impractical or inappropriate. Children on insulin pumps would also be expected to undergo a trial of MDI therapy between the ages of 12 and 18 years. The full guidance can be found on the NICE website at: http://guidance.nice.org.uk/TA151. However, the Department is aware that more needs be done to increase the uptake of insulin pumps in line with the NICE recommendations. The NHS National Technology Adoption Centre has published guidance to support NHS organisations in the adoption of these devices. In addition, Dr Rowan Hillson, the National Clinical Director for Diabetes, is currently chairing a working group to focus specifically on the uptake of insulin pumps. The membership of this group includes the Medical Technology Group and the Juvenile Diabetes Research Foundation. The ‘Operating Framework for the NHS in England 2011/12’, which was published on 15 December 2010, also highlights the need to do more to make these devices available. Paragraph 4.47 of the Framework states ‘NHS commissioners and providers must do more to ensure insulin pumps are available for those people with diabetes that meet the criteria recommended by NICE’. The Framework is available on the Department of Health website at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_122738. Whilst insulin pump therapy can make a difference to glycaemic control and quality of life in some people, it is not appropriate for everyone. Therefore, all decisions about insulin pump therapy must be made in consultation between the person with diabetes (and/or their parents or carer) and their healthcare professional. For those people with diabetes who have been identified by their healthcare professional as being suitable for insulin pump therapy, the Department would not expect there to be any unnecessary delays in the provision of insulin pumps. NICE was set up to help the NHS focus its resources on those treatments that will best improve people’s health. Authoritative, evidence-based guidance from NICE helps to spread best practice, but also tackles the problems of wasteful or ineffective practice. The NHS Constitution makes it clear that a patient has the right to drugs and treatments that have been recommended by NICE for use in the NHS (subject to any criteria specified in NICE’s guidance) if that patient’s healthcare professional considers that they are clinically appropriate. The Constitution also states that patients have the right to expect local decisions on the funding of new drugs and treatments ‘to be made rationally following a proper consideration of the evidence’. If the local primary care trust (PCT) decides not to fund a new drug, then it should explain that decision. Where there is evidence that PCTs are restricting access to NICE-recommended treatments, the Department of Health looks to strategic health authorities to intervene. I hope this reply is helpful. Yours faithfully, Rahul Patel Customer Service Centre Department of Health The sad thing is we all know the above, whilst I a disappointed with the response, hopefully the working group, Rowan Hilson & Jdrf are dedicated to supporting people with Diabetes. What I would say to anyone if you are having a problem getting a pump, print up this post and take it with you to your next appointment.