Not one, but two important announcements!

Webinar

The first T1DCC-UK Webinar will be on 27th February, 5-6 pm. Professor Nick Oliver and Dr Jackie Elliott will be presenting on the subject of 'Flash Glucose Monitoring and Continuous Glucose Monitoring'. The ideal way to experience the webinar is undoubtedly live. We hope that at least some of you will be able to sit down as a multidisciplinary team and enjoy it together. If that appeals to you please make arrangements to finish your clinical activity by 5pm. If you miss the webinar live it will be made available on the collaborative's website afterwards to enjoy at your convenience. CPD credits are being sought for those who complete a brief assessment afterwards. You will receive details of how to participate in the webinar, in particular the equipment specification, very soon.

Session at Diabetes UK Professional Conference

I am delighted that we have been allocated a parallel session on Wednesday 14th March, 5-6.30 pm. If you have already registered or intend to register to attend the conference at Excel, London then please come to the session. We have a stellar cast!

Provisional programme

This will be followed by a meeting of the core group.

Pumps and Technology

FreeStyle Libre Update

Marc Atkin led on the production of a paper on behalf of the collaborative in response to the announcement that the device would be on the NHS drug tariff from 1 November, 2017. The recommendations (selected patients with T1 Diabetes) have subsequently been used by the Regional Medicines Optimisation Committees (RMOC) in England to advise, but not mandate, Area Prescribing Committees. It seems that a ‘post code lottery’ cannot be avoided in the short term but there are encouraging signs that FSL is being made available across the UK. Northern Ireland was an early adopter, Greater Manchester, Cumbria, Merseyside, Humberside, Hampshire and Brighton have all 'gone green', although the East Midlands remains black at the time of writing. In Scotland the decision is devolved to each of the 12 Health Boards, and decisions are pending. Wales has put in a national application. A funding agreement is not the only challenge; starting a large number of people on FSL is a practical challenge for specialist teams. The collaborative will look for ways to support teams in this.

Continuous Glucose Monitoring

The availability of this technology featured in the NICE T1 Guideline is generally poor. NW London is a notable exception. It cannot be the case that funding for CGM is currently covered by the NHS tariff in England. Individual funding requests have had a low success rate. The collaborative will be prioritising access to CGM for 2018, and will be represented on an expert group being convened. ACDC is making an application for paediatric diabetes at a national level. It is not clear what the best strategic approach is to obtain funding, so for the time being any attempt to make a case for inclusion in the national tariff as a high cost therapy, as has been suggested, is premature.

The ABCD IPN-UK has been very productive. Apart from annual conferences linked with the ABCD spring meeting – diary date 23 May 2018 in Glasgow, a number of local educational events have been staged and well-received. Two guidelines will be published early in 2018 to support pump teams – one on clinical care, the other on what a high quality pump service looks like. Emma Wilmot will present at our session at DUKPC.

Animas and Diasend

The decision by Animas to leave the pump market has meant that pump teams using Diasend free of charge as part of the package are facing the unexpected cost pressure of a licence for Diasend.

The interest in technologies other than insulin pumps has led to a rebranding of the network soon to be known as 'ABCD Diabetes Technology Network-UK' or DTN-UK for short.

Metrics and Quality Improvement

Anne Kilvert and Emma Wilmot have circulated a Type 1 Service Level Audit to members of the core group. The National Diabetes Audit will be adopting a version of this in due course but it would be helpful to collect data before then. If we go ahead we have to arrange for the data to be analysed. I hope that the partner organisations will be able to assist in funding this. I believe that answering the audit questions will expose gaps in our services that we can work to close.

Enabling Success

The ExTOD/PEAK conference co-hosted jointly by ABCD and JDRF in October was inspirational and will go a long way to addressing the barriers perceived by some healthcare professionals to people with T1 diabetes doing exercise and sport safely.

To my astonishment it appears they may still be vacancies for the next Knuston Hall Diabetes Counselling Course 1-4 May 2018. If you are interested contact via info@DiabetesCounselling.co.uk

Patient Education

A framework is being developed to provide a 'kite mark' for educational courses with a view to assuring the quality of those commissioned. This will apply both to traditional face-to-face courses and to newer digital offerings. An information portal Type 1 Digital will direct patients to locally-available education programmes. The intention is that they will be able to search for and book into programmes themselves.

T1 Resources – At the core group we heard how T1 Resources had been set up to meet a need for accredited educational material about T1 diabetes. It has been highly successful, but it is doubtful whether the current model, relying heavily on volunteers, is sustainable. Please register to find suitable material for your patients.