4 May 2007 – A petition sent to No 10 Downing Street.
“We the undersigned petition the Prime Minister to Stop restriction of blood glucose test strips to Diabetics.”
Details of petition:
I understand that a government policy is about to be passed limiting Type 2 diabetics to 100 test strips per year. The decision being partly based on the expense of the strips and partly on the fact that the medical profession seem to hold the opinion that T2s can do nothing with the results of their testing. This view is far from the truth, a determined diabetic can use the results of their testing to adjust their diet to obliterate high spikes in blood sugar caused by different foods, in order to avoid longer term complications. In addition they can adjust exercise to bring down any unexpected high readings. Surely to goodness avoiding long term complications such as amputation of extremeties, kidney dialysis and heart problems will save the NHS money in the long run! Motivated diabetics on medication or even diet and exercise should be given the tools to monitor their disease and adjust their lifestyle to minimise complications. Withdrawing test strips will severely limit their ability to achieve the control so important to avoiding such complications. I am asking, therefore, that you oppose this governmental measure in the interests of the health of the diabetic community.”
The Government’s response to the Petition
There is no Government policy restricting the supply of blood glucose testing strips to people with diabetes. It is for the patient’s doctor to decide whether or not a patient receives a particular treatment, and such a decision should be made on clinical grounds. This means that where a GP sees a clear clinical need for a particular drug or treatment he or she should prescribe it. Under their terms of service, GPs are allowed to prescribe any product that they consider necessary for the treatment of their patients under the NHS. GPs must, however, be prepared to justify any challenges to their prescribing by their Primary Care Trust (PCT).
The situation regarding blood glucose testing strips has arisen following the issue of guidelines from the National Institute for Health and Clinical Excellence (NICE) on the management of blood glucose in Type 2 diabetes. NICE advised that in Type 2 diabetes, self-monitoring of blood glucose has not been shown to have a significant impact on long term blood glucose control (HbA1c levels), decreased body weight, reduced incidence of hypoglycaemia or improved health-related quality of life. Some PCTs have taken this to mean that home blood glucose monitoring is not indicated, and have discouraged the prescription of the blood testing strips used in monitors.
However, the NICE guidelines go on to stress that there are benefits from self-monitoring programmes, particularly as part of an integrated self-help package and this is central to the National Service Framework for Diabetes. The ideal, exemplified in the Framework, is that people with diabetes have sufficient knowledge to take decisions in partnership with their healthcare professional about the best regime to manage their condition, including the benefits of home blood glucose monitoring. On the basis of this, Sue Roberts, the National Clinical Director for Diabetes, produced a factsheet for Strategic Health Authorities on home blood glucose monitoring. The factsheet reiterates the NICE advice, and suggests that PCTs may wish to link their strategy on self-monitoring to that on patient education.
A message reinforcing this advice was circulated through the Medical Directors, Chief Nursing Officers and GP Bulletins in February 2005.
Any PCT which is automatically discouraging the prescription of blood glucose testing strips is not acting in accordance with NICE’s advice that self-monitoring may prove useful to people in their overall approach to self-care.
If you have concerns about your own treatment, you should speak to your GP. You can also contact the Patient Advice and Liaison Service (PALS) at your local PCT. This can provide information and advice about NHS services, including information on how to make a complaint.