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[IPk] Pressure for pump funding

Having spoken to every Health Authority in the UK regarding their policy and
criteria for funding pumps, (if any). We would make the following

Insulin pumps are regarded by "the majority of Health Authorities" as a low
priority treatment on par with tattoo removal, cosmetic surgery, and gender
reassignment surgery. Pumps are regarded as less clinically effective and a
retrospective treatment option due to the old style pump available in the
1970's, with it's associated bad press which is still remembered.
Alternative treatment options for diabetics such as MDI are therefore seen
as a more effective option.

Treatment funding is however left to the individual consultant to decide. If
pump therapy is decided as the best course of action, this will be paid for
within the Health Authority's Service Level Agreement which is agreed with
the provider (the hospital at which the patient requiring the treatment
attends). The SLA is adjusted each year to account for new treatment options
and areas which may be over or under-funded.

If a consultant is requesting pump therapy for several patients and this
area is seen to be over performing (i.e., this treatment option is required
by many patients), then money is removed from under-performing areas who
have  more than they require to provide their service. If an area is
over-performing, GPs and consultants may be asked to cease referrals for
patients requiring expensive treatments. In theory, if more money needs to
be spent it should be made available through the SLA rather than patients
ceasing to be referred.

The Health Authority may decide not to fund a treatment option due to cost
pressure if they felt it is unaffordable. In this case, treatments are
prioritised. An example is with anorexic girls which cost thousands of
pounds per week to treat in specialised centres. In this case there is no
cheaper treatment alternative, and the patient may die if they do not have
this treatment. Insulin pump therapy is therefore not seen as a necessity as
injection therapy is the alternative, the patient may develop
life-threatening complications, but they will not die if they do not receive
pump therapy.

It is the responsibility of the Diabetologist to bid for the cost pressure
of insulin pump therapy as a necessary clinical need for individual
patients. Finance will be decided as a cost pressure by the Health Authority
if Diabetologists push for this treatment.

Also, lobbying of the MP by the patient will prioritise the case of insulin
pump therapy with the Health Authority. When raised by the MP, the patient's
case will become more urgent as a result.

So folks, what you have to do, is pester the life out of your consultants,
force them to raise the issue of insulin pumps as a "cost pressure" with the
H/A. It is within their power to have pumps funded, it is how the system

Talk to your MP's, if you need clinical evidence we can provide it. We need
to start exerting our own pressure.

John Davis,
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