The NHS is planning to gradually offer hybrid closed-loop (HCL) technology to eligible people with type 1 diabetes over the next five years, following national guidelines, with an aspiration to move faster where possible.
In mid and south Essex, this technology has been available for some priority patients, based on individual needs, for several years. Plans are being developed to make this technology more widely accessible, and details on how it will be rolled out to broader groups of eligible people are still being finalised.
Hybrid closed-loop systems are the next step in the evolution of diabetes technology as it links Continuous Glucose Monitoring (CGM) with insulin pump technology. However, given clinical capacity constraints in the NHS, and ongoing workforce specialist training requirements, the introduction needs a phased implementation over a 5-year period.
What is currently available in mid and south Essex?
Standalone insulin pump therapy (CSII) is available for people with type 1 diabetes aged 12 and over if they:
- experience severe low blood sugar (hypoglycaemia) with daily injections, or
- Have high blood sugar (HbA1c levels of 8.5% or more) despite trying to manage their diabetes well with daily injection.
They must also have completed an NHS-approved diabetes education course, like DAFNE.
For children under 12, NHS Mid and South Essex offers insulin pumps, if daily injections are not practical. However, these children will be expected to try injections again between ages 12 and 18.
The ICB also provides continuous glucose monitors (CGMs) following their current policy, which can be found online here.
Currently, hybrid closed loop systems will only be considered in very specific cases, such as when someone has disabling low blood sugar, even when using both an insulin pump and a CGM.
By prioritising the implementation of hybrid closed loop technology on the basis of clinical need and cost effectiveness in the interim, we believe we will be in a better position to manage the wider implementation, developing our capacity and workforce in readiness for the increased demand. This will enable us to ensure equitable access to technology and appropriate care for our population.
For more information, please visit this website.
Our patient experience team are here to answer queries, pass on feedback or handle any complaints that you may have, details about how to contact them can be found here.