Striving for a healthier Scotland...
|How to get a pump|
What to do if you want a pump
Getting a pump is Scotland is not always as simple as it should be. It is still very much a postcode prescribing lottery meaning getting a pump is dependent on where you live. More and more clinics in England and round the world are offering pumps as a first course of treatment particularly for pre-school age children (due to precise dosing) however it is still unusual for people to be offered a pump in Scotland even when they meet criteria in most areas. If you are looking for a pump in England please visit INPUT
It is more usual for a patient to approach their team to enquire about pump therapy. In many cases you will be fobbed off with excuses, e.g. you are already on an intensive regime (MDI) so a pump will be of no greater benefit, a pump would not suit your lifestyle, a pump is no good for needle phobics, we are unable to provide training, there are more needy people than you, we don't have funding for pumps, you don't meet guidelines, you are too old, you are too young, you don't have the intelligence to use a pump, you are too well controlled, you don't have good enough control - to name but a few of the excuses reported to us!
Unlike England and Wales who follow NICE TA (Technology Appraisal) Guidance, Scotland's Health Boards do not have clear guidance they must follow. The Government expects each board to have a strategy covering insulin pumps over the next 3-5 years however local implementation of the strategy is the responsibility of each NHS Board. Some of this may become clear when the long over-due Diabetes Action Plan is launched in August. Scotland have publically commited to NICE but only Some boards clearly follow their guidence while others may just consider it and others not follow it at all. SIGN Guidanceis also used in Scotland, read CSII p33 of SIGN 116. We will detail further information of individual boards in their own section (see In your area) The statement by the SNP Government in September 2011 has given us some hope of better pump provison ahead. Expect more details around the end of Febuary 2012
*** UPDATE 27th Feb 212
The Government reaffirmed their position on pumps by releasing a statement of targets they have set out for Scotland. We are very pleased to see the targets are per board; however we will have to wait and see how it progresses in practice. Some concerns have come to light, you can read Diabetes UK Scotland's latest letter to the Petitions Committee - http://www.scottish.parliament.uk/S4_PublicPetitionsCommittee/General%20Documents/PE1404_J_Petitioner_23.03.12.pdf
A letter was sent to each Health Board Chief Executives (CEL 2102 04) with full details of targets and what is expected of each board - http://www.ipagscotland.org/images/pdf/cel2012_04.pdf We are pleased at targets as a starting point and hope to see pump provision now start to increase significantly in Scotland.
We will be looking for clarification on potential lack of choice and patients perhaps not being able to receive the pump which suits them best. Always do your homework on available pumps and ask for the pump which suits you. All pumps available are listed here - http://www.ipagscotland.org/images/pdf/ukpumpcompare.pdf
29th March 2012
Humza Yousaf, SNP Glasgow received a response to his PQ, which again reaffirms the government’s commitment to pumps.
We hope to have a better picture of how boards intend to meet targets once we see the plans they have submitted to the government.
For adults if you continue to have a HbA1c greater than 8.5% despite your best efforts on MDI or if you suffer from disabling hypoglacaemia you may be eligible for a pump. (For the purpose of this guidance, disabling hypoglycaemia is defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life)
Children under 12 years old are eligible when MDI is inappropriate or impractical
A pump is not a magic cure, however the vast majority of people will find a good improvement in their control over MDI if they have the motivation and commitment to make the pump work for them.
If you feel you would like to go ahead with a trial of insulin pump therapy the next step is to approach your care team.