Diabetes Technologies

Derek Thomas Excerpts

Wednesday 23rd November 2016 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I beg to move,

That this House has considered access to diabetes technologies.

It is a pleasure to serve under your chairmanship, Mrs Gillan. It is also good to see the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), in her place; I served under her chairmanship when she chaired the Select Committee on Science and Technology. I intend to use this debate to consider what can be done to accelerate access to new, innovative diabetes technologies.

This is a complex subject. I know there are patients who would benefit from technologies such as insulin pumps and glucose monitoring systems but are not able to access them. For many, access to diabetes technologies will have a transforming effect on their lives, enabling them to live full lives, be economically active and reduce the burden on primary and secondary care.

First, I recognise that progress is being made in this area. The intention behind the debate is to highlight the opportunity we have dramatically to transform people’s lives by accelerating access to diabetes technologies. I am here not to criticise but to say, as my schoolteachers regularly said to me, “You could do better,” because I believe we can in this area. Secondly, I want to use this opportunity to pay credit to the work of the all-party parliamentary group on vascular disease, and in particular its inquiry into patient access to technology last summer. The APPG recognised that access to technology facilitates the earlier and more accurate identification of people at potential risk of diabetes-related complications.

I want to refer to three of the 12 recommendations listed in the APPG’s report. The first is that the NHS must consider steps to become more flexible when commissioning or supporting the commissioning of new technologies designed to improve patient outcomes. Its second recommendation is that the NHS and industry should work together to harness innovation and promote better treatment for patients. Thirdly, it recommends that NHS England should consider how to introduce measures to incentivise the screening and diagnosis of patients at risk of peripheral arterial disease in primary care settings. Those recommendations help me to impress on the Minister a matter of great urgency, importance and opportunity for diabetic patients in the UK.

I would like us to consider the need to accelerate access to existing technologies; how the NHS can accelerate the development, testing and application of new technologies; and how information technology can be used to inform and educate patients, giving them greater power to manage their condition and lead full and free lives.

[David Simpson (Upper Bann) (DUP)]

I congratulate the hon. Gentleman on obtaining this debate. He will be aware that in our schools today there is a problem with young children administering insulin where teachers are not trained to do it and cannot, because of child protection rules. If new and innovative technologies were used, we could perhaps get over that difficulty.

--- Later in debate ---

[Derek Thomas]

I thank the hon. Gentleman for his intervention. I will speak later about the opportunity as regards children. If we do not help them to manage their condition, the complications later on are significant indeed.

I do not intend to go over the sheer scale of the problem of diabetes in the UK and its impact on people’s quality of life, our health system, community and social care services and economic productivity. We all know the stats. Despite that, it is my belief that the NHS fails to take full advantage of the latest technology available to patients, including flash glucose monitoring technology, known as FGM. That issue is being targeted by NHS England via the national obesity and diabetes prevention programme. The programme is a joint initiative between NHS England, Public Health England and Diabetes UK, and it aims significantly to reduce the 5 million people in the UK expected to have diabetes by 2025.

Flash glucose monitoring technology is available to support the NHS and NHS England to achieve their objectives related to diabetes. Today’s debate is an opportunity to see how the Government might take full advantage of that and other technologies in the future. It is timely therefore to concentrate our minds briefly on the benefits of technologies such as flash glucose monitoring. Just a few years ago, who would have thought that someone with diabetes could turn their back on routine finger pricking to test their glucose readings and instead rely confidently on readings taken via a small sensor worn on the body?

Just a few years ago, diabetics must have dreamt of a day when they could take a glucose reading as many times a day as they liked, without having to worry about pain, discomfort, inconvenience or running out of test strips. Imagine a world where schoolchildren or people in full-time employment avoided the interruption of finger prick testing and the stigma of testing in public. That world exists, and accelerated access to FGM, which delivers those benefits, could help to improve people’s health, avoiding the need for people who are in work to take extra sick leave by simply enabling better management of their condition.

Flash glucose monitoring provides a current glucose reading, an eight-hour history and information about the direction glucose is going in. That allows people to monitor whether their glucose levels are rising or falling quickly and can support them to take action before their condition worsens. That can only be a plus for patients, GPs and the wider health system. Furthermore, long-term accurate data on glucose levels must be invaluable for clinicians and patients as they make choices about how they manage diabetes.

I would like to ask the Minister a few questions. How confident is she that patients are accessing the treatments and technologies that are available today? What action is required of the Department of Health to ensure that the patient pathway is smooth, well signposted and not too long? Are clinicians fully aware of what technologies are available and how to operate them? Are they equipped to train patients to operate these technologies and make the best use of any data provided? What more can the Minister do to apply pressure to clinical commissioning groups to make diabetes technologies such as insulin pumps and glucose monitoring systems available? I know of patients in my constituency who have waited and waited before getting an insulin pump. In the meantime, their condition has been unbearable, and living any sort of normal life has not been possible. I am glad to say that once they get the insulin pump, their lives are transformed. However, I know others who still wait.

I want to move on to the opportunity we have to embrace emerging technology. One of the greatest developments in healthcare and public health must be the availability and use of emerging technologies. In 2004, Derek Wanless described the NHS as a “late and slow adopter” of innovation. I know that the Government are committed to improving that and to taking advantage of the opportunities on offer from innovative technologies. An excellent example of that is the commissioning through evaluation programme, launched in 2013, which was an innovative solution to the problem of developing real-world data to support the use of innovative medical procedures. I would like the Minister to shed some light on where we are with that programme.

I recognise that CTE set out to accelerate treatments for a far wider group of illnesses and conditions and should be a subject for another Westminster Hall debate. However, commissioning through evaluation is an example of good forward thinking that has been successful in accelerating access to treatments for patients and is the perfect tool for accelerating diabetes technologies and treatments. The reality is that patients, the NHS and UK plc will see the benefit if we find ways quickly to develop the technologies and give patients accelerated access.

Finally, I am keen to know what role the Department believes information technology has in informing and educating people so that they can play a greater role in managing their condition. If a diabetic only gets to see a specialist once a year, can online information help to close the gap? What responsibility does the Department of Health have to ensure that patients with diabetes are signposted to reliable, safe and helpful information? Should the Department actively back charities such as Diabetes UK, so that people have confidence about to whom they should turn? I would also like the Minister to outline what role she believes information technology can play in informing and educating people with diabetes.

I am glad to have secured the debate. This is one of the most pressing issues facing us today, and there is a great opportunity ahead of us. It is an opportunity for patients, because if we get this right, they will be able to manage their condition much more effectively and will be much more likely to be active in the world of work. We will be able to hold off lower limb amputations and sight loss and offer a much brighter future for people with diabetes.

There is also an opportunity in relation to health and social care. One in five hospital admissions for heart failure, heart attack and stroke is of a person who has diabetes, so by getting this right and ensuring that patients have access to advanced technologies, we can reduce the burden on primary and secondary care and reduce the £14 billion spent annually on diabetes in the NHS. The savings potentially go further when we consider the costs associated with adapting people’s homes and workplaces following amputations or sight loss, for example.

There are also opportunities for UK plc. If we get this right, the UK will be seen as the place to do research and development, and manufacturing. It must be the aspiration of the Government for the UK to become a hotbed of innovation, and I am certain that the NHS could exploit its sheer size and buying power much more effectively, giving UK patients the best access to the latest treatments.

--- Later in debate ---

[Derek Thomas]

I am grateful for the opportunity to have this debate under your chairmanship, Mrs Gillan; I think I have 37 minutes left.

I thank the Minister for the information she has given today. I have learned things, and the challenge now is for us to make sure that patients and clinicians will also know what is available to help them. We want acceleration in technology and the integration of services so that patients can be diagnosed as early as possible, have reliable online information about what is available and how to look after themselves and also get the specialist care they need, as well as access to the most appropriate technology. It seems to me that we are all singing from the same song sheet, and I am encouraged to hear that the Government are doing and will do all they can to support patients.

I appreciate that there have been distractions in the House today, but I think this debate has been a useful exercise; I am sure there will be others in future about how to continue with this important matter.

Question put and agreed to.

Resolved,

That this House has considered access to diabetes technologies.