Policy Number: SRP 112
Policy Name: Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes
Status: Individual Prior Approval
Effective Date: 13 January 2025
Next Review Date: 13 January 2027
MSE ICB commissions Hybrid closed loop (HCL) systems in line with NICE TA 943.
HCL systems are recommended as an option for managing blood glucose levels in type 1 diabetes for adults who have an HbA1c of 58 mmol/mol (7.5%) or more, or have disabling hypoglycaemia, despite best possible management with at least 1 of the following:
- continuous subcutaneous insulin infusion (CSII)
- real-time continuous glucose monitoring
- intermittently scanned continuous glucose monitoring.
HCL systems are recommended as an option for managing blood glucose levels in type 1 diabetes for children and young people.
HCL systems are recommended as an option for managing blood glucose levels in type 1 diabetes for women, trans men and non-binary people who are pregnant or planning to become pregnant.
HCL systems are only recommended if they are procured at a cost-effective price agreed by the companies and NHS England, and implemented following NHS England’s 5 year implementation plan. HCL technologies will be initially rolled out to type 1 diabetes patients where the need is greatest and to those who are likely to benefit most. Initially the following groups will be prioritised.
- Children and young people
- Women, trans men and non-binary people who are pregnant or planning a pregnancy.
- Adults already using insulin pumps who want to transition to an HCL system.
In accordance with NICE principles MSE ICB supports funding of the HCL system with the lowest acquisition cost that meets the clinical needs of the patient.
HCL systems will only be funded when initiated by specialist trained multidisciplinary teams experienced in continuous subcutaneous insulin infusion and continuous glucose monitoring in type 1 diabetes.
HCL systems will only be funded if the person or their carer:
- is able to use them, and
- is offered approved face-to-face or digital structured education programmes, or
- is competent in insulin dosing and adjustments.
Funding for patients not meeting the above criteria will only be made available in clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Further information on applying for funding in exceptional clinical circumstances can be found on the ICB website.