Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to update their guidance on the COVID-19 pandemic to reflect the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020; and in particular the guidance on (1) leaving a house and the frequency of such visits, and (2) the restrictions on the number of outside visits for exercise. [T]
Answered by Lord Bethell
Guidance is kept under constant review and regularly updated as legislation changes. On 11 May 2020, the Government updated its guidance, reflecting the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 as follows:
- Leaving the house and the frequency of such visits – now, people unaffected by COVID 19, can leave home for work, where they cannot work from home; go to shops permitted to be open to get food and medicine or collect goods ordered online or on the phone; for any medical need, to donate blood, avoid injury or illness, escape risk of harm or to provide care to help a vulnerable person; and
- the restrictions on the number of outside visits for exercise – now, people can exercise or spend time outdoors as often, or for as long as they wish.
The Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 contain a full list of reasons people can leave their homes.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the announcement in November 2018 that they intend to centrally fund Freestyle Libre glucose flash monitors, what plans they have to widen access to other diabetes technologies.
Answered by Baroness Blackwood of North Oxford
A range of diabetes technologies and methods of glucose monitoring, such as continuous glucose monitoring or blood glucose test strips, will continue to be available to those meeting the relevant clinical criteria.
One of the long standing and fundamental principles of the National Health Service is that the best way to address local challenges is through clinically-led decision-making, as close to patients as possible.
Clinical commissioning groups (CCGs) are responsible for commissioning diabetes services. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence, and take into account national guidelines. This should include consideration of access to diabetes technologies such as FreeStyle Libre.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the answer by the Earl of Courtown on 9 October (HL Deb, cols 9–11), how they are encouraging Clinical Commissioning Groups, including Southwark Clinical Commissioning Group, to make available free flash glucose monitoring devices.
Answered by Lord O'Shaughnessy
In January 2018, NHS England issued guidance in the form of a letter, dated 30 January 2018, to clinical commissioning groups (CCGs) concerning the provision of glucose monitoring devices. The guidance states that the treatment of diabetes and the provision of glucose monitoring devices is a service commissioned by individual CCGs. Local CCGs are responsible for deciding how they allocate resources dependant on the needs of their local population. A copy of this letter is attached.
The South East London Area Prescribing Committee, of which NHS Southwark CCG is a member, has published an updated interim position statement relating to FreeStyle Libre Flash Glucose Monitoring, which is attached. Mechanisms are currently being put in place to support delivery of a local implementation plan. It is not possible to place an exact date for completion of the local implementation plan. However, it is anticipated that eligible patients will be able to access FreeStyle Libre on the National Health Service in south east London in autumn 2018.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to monitor access to flash glucose monitoring to ensure its availability in all areas of England.
Answered by Lord O'Shaughnessy
The flash glucose testing monitoring system known as the Freestyle Libre was approved for reimbursement on National Health Service prescription from 1 November 2017 through its listing in Part IX of the NHS England and Wales Drug Tariff.
The listing of a medical device in the Drug Tariff should not be interpreted as a recommendation to prescribe a particular product. Flash glucose testing is not suitable for everyone. The Regional Medicines Optimisation Committee has issued advice on the use of Freestyle Libre to support decisions about its use. Patients will need to discuss the ongoing management of their condition with their healthcare professional and consider whether flash glucose monitoring is suitable for them.
The Department has no plans to ask clinical commissioning groups (CCGs) to review their prescribing policies or monitor access to flash glucose monitoring.
Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for CCGs, who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines. This includes determining whether specific technologies, such as flash glucose monitoring, form part of their service and if it is suitable for individual patients to support the ongoing management of their condition.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether there are plans to encourage Clinical Commissioning Groups to review their policies on prescribing flash glucose monitoring systems to those with type 1 diabetes on the NHS.
Answered by Lord O'Shaughnessy
The flash glucose testing monitoring system known as the Freestyle Libre was approved for reimbursement on National Health Service prescription from 1 November 2017 through its listing in Part IX of the NHS England and Wales Drug Tariff.
The listing of a medical device in the Drug Tariff should not be interpreted as a recommendation to prescribe a particular product. Flash glucose testing is not suitable for everyone. The Regional Medicines Optimisation Committee has issued advice on the use of Freestyle Libre to support decisions about its use. Patients will need to discuss the ongoing management of their condition with their healthcare professional and consider whether flash glucose monitoring is suitable for them.
The Department has no plans to ask clinical commissioning groups (CCGs) to review their prescribing policies or monitor access to flash glucose monitoring.
Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for CCGs, who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines. This includes determining whether specific technologies, such as flash glucose monitoring, form part of their service and if it is suitable for individual patients to support the ongoing management of their condition.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the effect of flash glucose monitoring on the management of diabetes.
Answered by Lord O'Shaughnessy
The flash glucose testing monitoring system known as the Freestyle Libre was approved for reimbursement on National Health Service prescription from 1 November 2017 through its listing in Part IX of the NHS England and Wales Drug Tariff.
The listing of a medical device in the Drug Tariff should not be interpreted as a recommendation to prescribe a particular product. Flash glucose testing is not suitable for everyone. The Regional Medicines Optimisation Committee has issued advice on the use of Freestyle Libre to support decisions about its use. Patients will need to discuss the ongoing management of their condition with their healthcare professional and consider whether flash glucose monitoring is suitable for them.
The Department has no plans to ask clinical commissioning groups (CCGs) to review their prescribing policies or monitor access to flash glucose monitoring.
Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for CCGs, who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines. This includes determining whether specific technologies, such as flash glucose monitoring, form part of their service and if it is suitable for individual patients to support the ongoing management of their condition.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to ensure that the FreeStyle Libre flash glucose monitoring system is accessible to all diabetes patients who would benefit from it.
Answered by Lord O'Shaughnessy
The flash glucose testing monitoring system known as the Freestyle Libre was approved for reimbursement on National Health Service prescription from 1 November 2017 through its listing in Part IX of the NHS England and Wales Drug Tariff.
The listing of a medical device in the Drug Tariff should not be interpreted as a recommendation to prescribe a particular product. Flash glucose testing is not suitable for everyone. The Regional Medicines Optimisation Committee has issued advice on the use of Freestyle Libre to support decisions about its use. Patients will need to discuss the ongoing management of their condition with their healthcare professional and consider whether flash glucose monitoring is suitable for them.
The Department has no plans to ask clinical commissioning groups (CCGs) to review their prescribing policies or monitor access to flash glucose monitoring.
Within its financial constraints, the NHS is committed to providing access to new drugs and medical technologies. Ultimately it is for CCGs, who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines. This includes determining whether specific technologies, such as flash glucose monitoring, form part of their service and if it is suitable for individual patients to support the ongoing management of their condition.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether the National Institute for Health and Care Excellence has undertaken any evaluation of glucose monitors used by people living with diabetes; if so, whether such monitors are approved for use; and what assessment they have made of the decision taken by some Clinical Commissioning Groups not to prescribe such monitors to diabetes patients.
Answered by Lord O'Shaughnessy
The National Institute for Health and Care Excellence (NICE) has evaluated the following glucose monitors used by people living with diabetes:
- Integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes (the MiniMed Paradigm Veo system and the Vibe and G4 PLATINUM CGM system). NICE has evaluated these products through its diagnostics programme. The MiniMed Paradigm Veo system is recommended as an option for managing blood glucose levels in people with type 1 diabetes only if they have episodes of disabling hypoglycaemia despite optimal management with continuous subcutaneous insulin infusion.
- MiniMed 640G system with SmartGuard for managing blood glucose levels in people with type 1 diabetes. This is a NICE advice product, developed under its Medtech innovation briefings (MIBs) programme. MIBs provide a summary of the best available evidence for selected new technologies and are designed to assist National Health Service planning and decision-making. MIBs are not designed to include treatment advice but provide a critical review of the strengths and weaknesses of the relevant evidence, therefore NICE do not make any recommendations for (or against) funding the device.
- FreeStyle Libre for glucose monitoring, which measures interstitial fluid glucose levels in people with diabetes. This is also a Medtech innovation briefing therefore NICE do not make any recommendations for funding the device.
In addition, the Regional Medicines Optimisation Committee (North), one of four Committees established by NHS England to provide advice to the NHS, reviewed the use of the Freestyle Libre at its meeting on 26 October 2017. In developing its advice, the Committee took into account the MIB published by NICE. The Committee has issued guidance on the use of Freestyle Libre suggesting a careful start to its use and data collection to better understand the benefits. Freestyle Libre has been approved for reimbursement on NHS prescription from 1 November through listing in Part IX of the Drug Tariff.
NICE does not have a role in proactively monitoring the delivery of local services, so it has not made any assessment of decisions taken by some clinical commissioning groups not to fund these technologies.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what funding increases they have proposed for type 1 diabetes in 2016–17 and in subsequent years.
Answered by Lord Prior of Brampton
Clinical commissioning groups (CCGs) commission services for people with type 1 diabetes and we would expect them to prioritise their funding in accordance with local needs and within the overall resources available.
The effective treatment and care of diabetes is one of the clinical priority areas highlighted in the CCG Improvement and Assessment Framework recently published by NHS England.
Asked by: Lord Morris of Aberavon (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what consideration they are giving to recent research by Professor Jeffrey Bluestone and others at the University of California on the immune system of those with type 1 diabetes; and whether funding will be made available to diabetes researchers in the UK to keep pace with such developments.
Answered by Lord Prior of Brampton
Research relating to immunotherapy for type 1 diabetes is being carried out by researchers at the University of California and at other institutions internationally. The National Institute for Health Research (NIHR) is funding research relating to immunotherapy for type 1 diabetes at the NIHR Cambridge Biomedical Research Centre. In addition, the NIHR funds a wide range of other research relating to diabetes.
The NIHR welcomes funding applications for research into any aspect of human health, including immunotherapy for type 1 diabetes. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.