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[IPk] Pump funding

Firstly, you must obtain the backing of your diabetes team and/or your GP.
Ask them to support your request in writing, stating the reasons why the
pump will be beneficial to you. Our experience has shown that funding is
assessed "on the grounds of clinical need."  Health Authorities do not
accept "wanting a better quality of life" as a valid reason for changing to
pump therapy.

Be prepared to show that you have been doing your best to control your own
diabetes.  Patients using pumps are expected to do at least four blood sugar
tests a day and keep these recorded. This is necessary to show that the pump
is providing the amount of insulin you need at various times in the day (and
occasionally during the night).

A detailed log of your control prior to starting pump therapy is good
evidence of your requirement for this treatment. This should include insulin
dosages; levels of HbA1c; number of hypo's; any ketones in the urine; days
off sick; hospital visits; hospitalisation; and so on.  Any complications,
medical or social problems should also be stated.

If you already use a pump, do the same for the period you have been using it
and then chart the results as a comparison between the two. If you can
download the information from your Blood Glucose meter and provide graphs,
so much the better. Be prepared to answer questions about abnormal readings.

You may need copies of relevant clinical studies that have been undertaken
these can be obtained from us, free of charge.

Obtaining Funding

As from April 2002 Health Authorities will cease to exist as we know them,
they will be replaced by Primary Care Trusts, in many areas these PCT's are
already operating. Our advice is to approach your Primary Care Trust via a
letter to the Chief Executive or Commissioning Officer, your GP should have
the details and in many cases will make the application for you. A draft for
your guidance can be obtained from us. We have written to every Health
Authority in England, Wales & Scotland and will be writing to all 164 PCT's,
some will not be aware of the benefits of pump therapy when you make your
application, should you have any difficulties please contact us, we can
provide substantial evidence to support your case.

If you do not get a positive response from your Health Authority, PCT or PCG
it may help to write to your MP stating the problems you are having. They
will take the matter up with the Chief Executive or Consultant in Public
Health on your behalf. Lobbying of your MP will prioritise the case of
insulin pump therapy with the Health Authority. When raised by the MP, your
individual case will become more urgent as a result.

The task is not easy, your first application may not succeed but you have to
keep trying, perseverance in our experience does pay off.

The list of Health Authorities and Primary Care Groups that will assist in
funding pumps increases daily, so keep in touch and please let us know how
you get on.


John Davis,
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