Asked by: Chi Onwurah (Labour - Newcastle upon Tyne Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to take steps to promote to patients the use of hybrid closed loop technology for patients with type one diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Care and Excellence (NICE) has published its draft guidance on Hybrid Closed Loop (HCL) technology which recommends the cohorts of patients with type 1 diabetes that it should be rolled out to. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023. Recognising HCL represents a step change in care for patients living with type 1 diabetes, NICE has agreed with NHS England a planned five year roll out for this technology recognising that both clinicians and patients require training to safely use the HCL technology.
The Department welcomes NICE’s draft guidance and supports the NHS England phased approach to adoption. NHS England will make clinicians aware of the priorities for access, to help reduce healthcare inequalities.
If a patient meets the eligibility criteria for the hybrid closed loop, then their clinician can recommend this in line with NICE recommendations. NHS England is engaging with integrated care board leads, trust clinical leads working within children, young people and adults services, professional bodies and patient representative groups as part of the implementation strategy’s development.
Asked by: Chi Onwurah (Labour - Newcastle upon Tyne Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to take steps to promote to clinicians the use of hybrid closed loop technology for patients with type one diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Care and Excellence (NICE) has published its draft guidance on Hybrid Closed Loop (HCL) technology which recommends the cohorts of patients with type 1 diabetes that it should be rolled out to. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023. Recognising HCL represents a step change in care for patients living with type 1 diabetes, NICE has agreed with NHS England a planned five year roll out for this technology recognising that both clinicians and patients require training to safely use the HCL technology.
The Department welcomes NICE’s draft guidance and supports the NHS England phased approach to adoption. NHS England will make clinicians aware of the priorities for access, to help reduce healthcare inequalities.
If a patient meets the eligibility criteria for the hybrid closed loop, then their clinician can recommend this in line with NICE recommendations. NHS England is engaging with integrated care board leads, trust clinical leads working within children, young people and adults services, professional bodies and patient representative groups as part of the implementation strategy’s development.
Asked by: Chi Onwurah (Labour - Newcastle upon Tyne Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department plans to take steps to ensure that all patients with protected characteristics are included in the roll-out of hybrid closed loop technology for patients with type 1 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
National Institute for Health and Care Excellence (NICE) has published final draft guidance on the use of the hybrid closed loop (HCL) systems for managing blood glucose levels in type 1 diabetes to the National Health Service in England. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023.
NHS England are engaging with integrated care boards (ICBs) and other stakeholders as part of the development of the HCL implementation strategy. The strategy will provide advice and guidance to ICBs and NHS providers on the phased approach to implementation. Prioritisation will be based on patient need within the eligible population and through the National Diabetes Audit, activity rates and outcomes will be reported to monitor unwarranted variation in access and address health inequalities.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the adequacy of the diabetes workforce across NHS England in the context of the NICE Technology Appraisal on Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) has published final draft guidance on the use of the hybrid closed loop (HCL) systems for managing blood glucose levels in type 1 diabetes to the National Health Service in England. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023.
NICE has accepted a funding variation request from NHS England which will see the technology rolled out across England over a five-year period.
The introduction of the HCL systems represents a step-change in care for people living with Type 1 diabetes and NHS England is ensuring that the NHS has the staff, training and patient support in place to safely rollout the technology across the country.
NHS England is engaging with integrated care boards and other stakeholders as part of the development of the HCL implementation strategy. The strategy will provide advice and guidance to integrated care boards and NHS providers on the phased approach to implementation.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what funding his Department plans to allocate to support the adoption of the NICE Technology Appraisal on Hybrid closed loop systems for managing blood glucose levels for people living with type 1 diabetes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) has published final draft guidance on the use of the hybrid closed loop (HCL) systems for managing blood glucose levels in type 1 diabetes to the National Health Service in England. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023.
NICE has accepted a funding variation request from NHS England which will see the technology rolled out across England over a five-year period.
The introduction of the HCL systems represents a step-change in care for people living with Type 1 diabetes and NHS England is ensuring that the NHS has the staff, training and patient support in place to safely rollout the technology across the country.
NHS England is engaging with integrated care boards and other stakeholders as part of the development of the HCL implementation strategy. The strategy will provide advice and guidance to integrated care boards and NHS providers on the phased approach to implementation.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department has to ensure the NICE Technology Appraisal on Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes is adopted by integrated care systems.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) has published final draft guidance on the use of the hybrid closed loop (HCL) systems for managing blood glucose levels in type 1 diabetes to the National Health Service in England. The draft guidance is out for comment until 28 November 2023. If there are no appeals, then the final guidance will be published in December 2023.
NICE has accepted a funding variation request from NHS England which will see the technology rolled out across England over a five-year period.
The introduction of the HCL systems represents a step-change in care for people living with Type 1 diabetes and NHS England is ensuring that the NHS has the staff, training and patient support in place to safely rollout the technology across the country.
NHS England is engaging with integrated care boards and other stakeholders as part of the development of the HCL implementation strategy. The strategy will provide advice and guidance to integrated care boards and NHS providers on the phased approach to implementation.
Asked by: Catherine West (Labour - Hornsey and Wood Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that people with type 1 diabetes have access to new diabetes technology.
Answered by Will Quince
In March 2022 the National Institute for Health and Care Excellence (NICE) recommended that all adults and children with type 1 diabetes should have access on the National Health Service to continuous glucose monitoring. Both intermittent and real-time Continuous Glucose Monitors (CGMs) are available to people with type one diabetes under the NHS. CGMs can be provided under NHS prescription and sensors collected from local pharmacies.
NICE is currently developing technology appraisal guidance, which considers clinical and cost effectiveness, on hybrid closed loop systems for managing blood glucose levels in people with type 1 diabetes.
In 2022/23, funding worth £36 million was allocated to integrated care boards, weighted by local levels of deprivation, to support more people to receive all recommended diabetes care processes, alongside other NHS Long Term Plan diabetes commitments. The Diabetes Programme national and regional teams monitor progress and provide support to systems through national guidance and clinical networks.
Asked by: Mike Amesbury (Labour - Weaver Vale)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of making (a) the Dexcom G6 Continuous Glucose Monitor and (b) other glucose sensors available to people with type-one diabetes.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Both intermittent and real-time Continuous Glucose Monitors (CGMs) are available to people with type one diabetes under the NHS. CGMs can be provided under NHS prescription and sensors collected from local pharmacies.
The Dexcom One is one model of CGM that is available under the NHS. Currently the Dexcom G6 model is being considered for provision as part of the Hybrid Closed Loop (HCL) system. The HCL system includes a higher specification CGM with an algorithm that ‘speaks’ to the insulin pump to adjust the amount of insulin the pump is administering as necessary.
The National Institute for Health and Care Excellence have been assessing the cost effectiveness of HCL and are due to publish their recommendations soon.
Different HCL systems are available and some are built by combining interoperable devices from different companies. Because of the large number of combinations of components available to the NHS, this appraisal considers HCL systems as a class of technologies rather than individual components or systems. The Dexcom G6 is included in this assessment.
Hybrid closed loops systems are only recommended if the companies and NHS England agree a cost-effective price for the systems on behalf of the relevant health bodies.
Asked by: Kevan Jones (Labour - North Durham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will list the Integrated Care Systems in England which do not have a formal commissioning policy for real-time continuous glucose monitoring for adults and children with type 1 diabetes.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Health Service across the North East is dedicated to supporting patients in monitoring and managing their lifestyle with cutting edge technology. This has resulted in a high proportion of type 1 diabetic patients in the North East utilising the latest glucose monitors and insulin pumps to manage their condition. Local services are being redesigned to improve access to the latest technologies and reduce variation in care for vulnerable patients living with type 1 diabetes.
The National Institute for Health and Care Excellence (NICE) is currently developing technology appraisal guidance on hybrid closed loop systems for managing blood glucose levels in type 1 diabetes, which considers their clinical and cost effectiveness.
TARGET DATE 26/05/2023
Should NICE recommend Hybrid Closed Loop and issue eligibility criteria, NHS England will then work with integrated care boards (ICBs)to support meeting their commitments.
It is not possible to list the ICBs in England which do not have a formal commissioning policy for real-time continuous glucose monitoring for adults and children with type 1 diabetes as this information is not collected. ICBs must pay due regard to NICE guidance, however local decision making applies in terms of deciding whether to utilise their funding to implement the recommendation or not.
Asked by: Graham Brady (Conservative - Altrincham and Sale West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department has to increase equality of access to medical technologies for people with type one diabetes.
Answered by Will Quince
NHS England have achieved their Long-Term Plan objective of 20% of all Type 1 diabetes patients in receipt of Flash Glucose Monitoring by April 21. Performance was 50% at June 2021 with an even distribution of access across all deprivation quintiles.
The ratio of prescribing Flash glucose monitoring between the most and least affluent areas has been reviewed and has reduced in every English region. When the programme started Flash was twice more likely to be prescribed to patients living in the most affluent areas, but current ratios show virtual parity between the most and least deprived patient groups across England.