The Dorset Clinical Commissioning Group (CCG) has agreed that the Freestyle Libre® device can be prescribed to monitor blood glucose levels for some children with type 1 diabetes aged four or older, who are under the care of specialist doctors and likely to benefit most from its use.
The CCG’s Clinical Commissioning Committee met on 17 October 2018 and agreed the change after an application from the paediatric diabetes specialists in Dorset.
As a result, the Clinical Commissioning Committee agreed to fund the use of the device, under the care of specialist doctors only, for the following groups of children:
- already blood glucose test 8 times or more daily
- have an HbA1c of 68 mmol/mol (8.5%) or higher, or unable to achieve this without disabling hypoglycaemia, thereby meeting pump referral criteria
- have two or more admissions with DKA in a year, or two or more severe hypoglycaemia episodes
- are unable to manage without third party assistance and where conventional blood testing difficult, e.g. for behavioural reasons.
- are training or working where constantly dirty hands makes testing impracticable
- have impaired hypoglycaemia awareness or inability to communicate hypoglycaemia.
Patients will have to agree to a contract for monitoring and assessment of the benefits of the device, and for data to be submitted to the national teams evaluating this product.
Specialist doctors will initiate the device for a 6-month period, after which the patient will be assessed to see how well it is working. It is likely that use of the device would be discontinued if there is no demonstrable benefit to the patient.
Patients will need to be trained to use the device. This will be organised and coordinated by secondary – hospital – care.
The new arrangements for use of the device will continue to be reviewed pending further evidence and cost effectiveness information that is made available.
The full commissioning statement can be on the pan Dorset formulary www.dorsetformulary.nhs.uk.