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RE: [IPk] Funding of Designated Specialist Centres for Diabetic Insulin Pump Users



                                 [this is the second attempt at typing out
this message!]

John,

The funding of work carried-out at Hospital Trusts is undergoing change at
the moment. It is likely that PCGs/PGTs will take over a large element of
the commissioning of contracts with Trusts. They are established to take a
more local view of the world and may well be under pressure to justify
themselves by cutting expenditure in certain areas. I have no way of
predicting the outcome but it may well be that some PCTs will support their
local GPs simply because GPs will form part of their main boards, and favour
GP based diabetic care.

Some Trusts appear to be building up support for IP users. I believe when we
met at Milton-Keynes that you mentioned Bournmouth, Harrogate and I think
Birmingham as examples. As I say, my interest is to help these recieve
funding by putting them in touch with the team drafting the proposals. Can
you help me by providing a list of contacts, say the consultant at each
centre? I would prefer to use e-mail because it is quicker.

Philip


-----Original Message-----
From: John Davis [mailto:email @ redacted]
Sent: Thursday, October 12, 2000 5:38 PM
To: Insulin Pumpers
Subject: Re: [IPk] Funding of Designated Specialist Centres for Diabetic
Insulin Pump Users


This is not a new idea, both Disetronic and MiniMed have for some time been
trying to set up "Centres of Exellence" in regional hospitals across the UK.
The problem is to convince the medical professionals that pump therapy works
and to be prepared to set aside enough time to be trained in it.

In the real world, what happens is that the hospital say they want to
participate
in the training of new pump patients, but when it comes to the actual event,
the
DSN, in most cases, just "pops in and out," leaving the supplier's Nurse
Educator,
to get on with the initial training. As for the consultants!! They very
rarely show.
I am sure that Disetronic and MiniMed will confirm this. In addition both
Disetronic
and MiniMed send reams of information and literature to consultants, which
just
ends up being filed in the "Bin." At the recent INPUT Open Day in Milton
Keynes,
we sent out invitations to all the consultants and nurses in the area, from
Bedford,
to High Wycombe,  to Northampton and Hillingdon, not one of them made an
appearance.

In an ideal world, suppliers should be involved with the hospitals in the
initial training and support. Then the hospitals should take over continuing
support, after all pump patients are diabetics, and most of the problems
will be diabetes related. This would leave Disetronic, MiniMed and any
others who may decide to enter the UK market, to find and train new "Centres
of Excellence."

As far as the funding of these centres is concerned, we at INPUT believe
this should be done by central goverment through Local Health Authorities
and Primary Care Groups, a policy which is gaining ground rapidly. There are
many LHA's and PCG's already funding pump patients. Unfortunately, it is
very
much a case of "Post Code" prescribing. At present you have to put forward a
good case, but we can help with this.

We have also been involved with Diabetes UK in writing to the NICE
Secretariat,
part of that letter reads;

"Diabetes UK would therefore like to recommend that insulin pump therapy is
appraised by the National Institute for Clinical Excellence (NICE). NICE
guidance would be welcomed by people with diabetes and health professionals
alike."

Some Members of Parliament are also behind us and they are very interested
in individual cases, and are prepared to fight for their constituents
rights.

Pump Therapy in the UK is on the way, the number of users has DOUBLED in the
past 9 months, (there are over 500 of us now), but there is still much to be
done. The number of diabetologists and DSN's who are convinced that pumps
work, grows daily, but the main area of concern is to convince the rest of
the
medical professionals that pumps do work and they do not "kill people." They
are
the way forward for motivated diabetics. Only then will we see a growing
number of
regional "Centres of Excellence."

John Davis
INPUT







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