Minutes:
Dr Angela Bhan, Managing Director, Bromley Clinical Commissioning Group provided a verbal update on Diabetes Flash Glucose Monitoring. These were devices for Diabetics to self-monitor their glucose levels, without the need for a pin-prick test. The devices were placed under the skin, and monitored the levels of glucose in the fluid found between cells in the body. This was intended to develop a better understanding of each patient, and was a new way of continuously recording the glucose found in their bloodstream.
Despite there being only a very limited amount of evidence as to the outcomes of their use, these devices were taking off by popular demand. However, there was a cost to the CCG associated with their use, and for the patients in Bromley that were eligible, and most severely affected by Diabetes, this would be at least an additional £250k per year. It was recognised nationally that to provide the devices, the CCG’s funding would be top-sliced and that the devices would be rolled-out gradually.
The Chairman said that a constituent had spoken with her, and questioned why they had not been able to obtain a Flash Glucose Monitoring device, and asked for further information on their availability. The Managing Director, Bromley Clinical Commissioning Group said that information regarding eligibility had not been distributed effectively. This had led to the demand for the devices growing within patient groups that were not eligible to receive them, and also a number of patients obtaining devices when they were not necessarily the most appropriate solution for the individual patient. It was acknowledged that there had not been a cohesive approach, and that there was a need for a patient education programme. It was noted that there was still a need for evidence to gauge the long-term impact of the devices, such as whether they made patients more anxious, and resulted in them constantly checking their glucose levels.
A Member expressed that they felt this was a major step forward, however there were concerns as to what would be done with the data gained from the device, and the implications as to how Diabetes was managed. Some Flash Glucose Monitoring devices could be bought ‘off the shelf’ and the extra demand could lead to patients modifying their own treatment, which could be counter-productive.
Another Member said that she was aware of the devices through a Child Looked After (CLA), and that the definition as to who could, and could not, receive the devices was unclear. It was felt that children were a relevant group of patients to be receiving these devices, especially those that had hospital admissions as a result of their Diabetes, and it could be considered a safeguarding issue if the devices were not provided to them. It was noted that the devices could be particularly helpful for parents dealing with their children ‘midnight eating’, as it would allow them to monitor the child’s glucose levels on their phone. It was requested that Members be provided with a copy of the patient criteria to receive a Flash Glucose Monitoring device, and the questions asked to consider eligibility. The Managing Director, Bromley Clinical Commissioning Group agreed to provide Members with a copy of the patient criteria, and noted that alongside a patient education programme, GP’s also needed to be further educated about the devices. It was noted that patients who had received the devices would have their use reviewed every three to six months by a specialist Diabetes team.