Here are some questions we’re frequently asked about the campaign. If you need any further information or advice and support, please get in touch with our Helpline.
About the campaign
What is the purpose of the Diabetes Tech Can’t Wait campaign?
The aim of this campaign is to make sure people living with diabetes, regardless of postcode, ethnicity or economic status have an equal opportunity to access the diabetes technology (Flash, Continuous Glucose Monitors and insulin pumps) that they’re eligible for and that could benefit them, in line with national guidelines.
You can use our online postcode lookup tool to find out how to take action to support the campaign in your area.
Who is eligible for diabetes tech?
You can read more about who is eligible for Flash, continuous glucose monitors (CGM) and insulin pumps across the UK here.
Why are you asking healthcare professionals to do more when they’re already going above and beyond?
We appreciate healthcare professionals work extremely hard to provide the best care for people with diabetes. With this campaign, we hope to provide information to show the differences in access to tech across the country and empower people living with diabetes and healthcare professionals to understand what is happening in their area and advocate for positive change.
Where does the campaign data for England come from?
We received information about local policies by contacting each of the 42 Integrated Care Boards (ICBs) responsible for organising the delivery of NHS services locally in England in January 2023, to ask about their progress adopting NICE guidelines on CGM and Flash.
We have used the responses and publicly available policies shared with us following this enquiry and have also received further updates from local clinicians and policy-makers through follow-up conversations with our regional teams.
Where does the campaign data for Scotland come from?
Data on diabetes in Scotland is kept on a system called SCI, which is accessible to healthcare professionals but not the public.
Key data from SCI is published in the yearly Scottish Diabetes Survey report, which is usually about 9 months out of date by the time it's published. The 2021 report was delayed for much longer and was only released in February 2023; this is where the 2021 data we're using in the campaign comes from.
The data from 2023 is taken directly from the SCI database, with permission from each Health Board.
What about the upcoming NICE guidelines on hybrid closed loop? Will the campaign also include hybrid closed loop?
Hybrid closed loop systems are also currently being assessed by NICE to see if they can be made available on the NHS in England and Wales, with a final decision expected this summer.
The assessment is still ongoing so we don’t yet know who will be eligible. But we want to see this technology available to as many people as possible. And we’ve made this case in response to the draft recommendations published in January. You can read more about this on our website.
As the appraisal is ongoing we haven’t included information on policies for hybrid closed loop in England on our postcode lookup at this time.
However, based on the draft recommendations from the appraisal, we expect that as part of the criteria to access to hybrid closed loop, people should already be using Flash, CGM and/or an insulin pump. So, this is partly why we are calling for access to these component devices to be offered to people with type 1 diabetes, in line with current guidance.
Information for people living with diabetes
Why do other areas have better access to tech than mine?
NHS care in England is delivered by 42 integrated care boards (ICBs) who agree clinical policies for the local area. As a result there can be variation by region and some areas will be further along in providing access than others.
We think it is essential that access to tech is based on clinical need but appreciate that ICBs face different challenges, for example in terms of their resources and staffing, that can cause variation according to location.
This is why we have developed a tool to illustrate how ICBs are progressing and are encouraging areas to share their policies and plans with a view to improving access across the country. Use our postcode lookup to find out more about the situation in your area.
The area I live in doesn’t have NICE aligned policies, what should I do?
If your area doesn’t have policies in line with NICE guidelines, unfortunately your healthcare team may not be able to offer you the tech you should be entitled to. You can help us to change this. Use our postcode lookup to find out more about the situation in your area, and what you can do to make sure everyone living with diabetes can get the tech they need to live well with diabetes. This can be as simple as joining our campaign so we can let you know about new ways to get involved as they arise or sharing your story so we can learn more about your experiences on the ground and use that to show decision makers why diabetes tech can’t wait.
It could also be that your area has not agreed or shared a NICE aligned policy but can still offer you tech – so it’s worth asking about it when you next speak to your healthcare team.
My area says it has policies in place and I meet the criteria, but I still can’t get access – what should I do?
We’re sorry to hear you’re not able to access the tech you’re entitled to. We know that in some areas people may still have problems accessing the tech they’re eligible for despite there being a policy in place. Our regional teams have regular conversations with health decision makers and want to learn more about these kind of issues so that they can show where things may need to change. If you’re comfortable sharing your story with them, you can complete this form. You can opt to remain anonymous and we’d never share anything that identifies you without your permission.
Why are you prioritising CGM and Flash over other types of diabetes tech like insulin pumps?
We are initially focusing on CGM and Flash for this campaign because it has been over a year since NICE guidelines recommended wider access to these for people with diabetes, and we want to assess how they are being adopted on the ground.
National guidelines such as these are highly influential and it is important that ICBs follow them and feel confident to do so. The March 2022 updates were particularly significant because they looked at both people with type 1 and type 2 diabetes and represent a shift to CGM and Flash as a basic standard of care from finger-prick testing for many.
People with diabetes can also benefit from other types of technology, such as smart connected pens, insulin pumps and hybrid closed loop systems, but the significance of the recent guidelines provides a strong platform to campaign for better access to CGM and Flash now.
Why is campaign activity only in Scotland and England?
Last year, the Scottish Health Technologies Group published new guidelines recommending extending access to hybrid closed loops. And in March 2022, the Scottish Government committed £14.6m to enable Scottish Health Boards to do this.
In March 2022, National Institute for Health and Care Excellence (NICE) also published new guidelines for England, which recommend extending access to Flash and CGM technologies for people living with diabetes.
Following the new guidelines in England last year and the new guidelines and funding in Scotland, we’ve decided to focus our campaign on ensuring local policies in England reflect the national guidelines. And the extra funding is resulting in an uplift in the uptake of diabetes tech in Scotland.
The new NICE guidelines apply in Wales, as well as England. However, Wales has a nationwide policy in line with these guidelines, whereas in England, policies are decided locally by Integrated Care Boards (ICBs). Similarly, there is a nationwide policy in Northern Ireland.
The Scottish Health Technologies Group recommendations apply to the whole of Scotland and are in addition to the existing Scottish Intercollegiate Guidance Network (SIGN) guidelines on diabetes technology.
However, beyond the scope of this campaign, we’re working with people living with diabetes and health services in Wales and Northern Ireland to understand the experiences you’re having when it comes to accessing the diabetes tech you are entitled to. This will help us shape our work in this area in the future. You can share your experiences here.
I live in Wales – how can I get involved?
The NICE guidelines published in March 2022, which recommend extending access to Flash and CGM technologies for people living with diabetes, also apply to Wales.
However, the new NICE guidelines haven’t been applied consistently across Wales. So, we’re working with the Welsh Government to ensure these new guidelines are adopted as soon as possible, so that access to tech is fair and consistent across Wales. To do this effectively, we need to find out more about current access.
Tell us about your experience of access to tech in Wales, so we can make sure people have more choice and get the care they need. You can share your story here.
To learn more about our work on diabetes tech and our broader campaigns, sign up to get the latest updates here.
I live in Northern Ireland – how can I get involved?
In November 2022, Northern Ireland adopted guidelines from the National Institute for Health and Care Excellence (NICE). It recommended giving adults living with type 1 diabetes a wider choice of Flash and Continuous Glucose Monitoring (CGM) and increasing access to Flash for adults living with type 2 who use insulin.
Diabetes UK Northern Ireland worked with the Diabetes Network and people living with diabetes to co-produce two new care pathways for Flash and CGM, to put these guidelines into action. All five Health and Social Care (HSC) Trusts have been instructed to make local arrangements to implement the pathways in full.
We know many of you are keen to get access to Flash or CGM, or to find out more about your eligibility. The best way to do this is by chatting to your diabetes team at your next appointment
To learn more about our work on diabetes tech and our broader campaigns, sign up to get the latest updates here.
We’d also be really interested to hear about your experiences with diabetes tech to help us plan our future work in this area. You can share your story here.
I’ve never heard of NICE or NICE guidelines – what are they?
NICE stands for the National Institute of Health and Care Excellence. They are an arms-length body sponsored by, but separate from, the Department for Health and Social Care.
NICE develops guidelines on specific drugs or medical devices, and which people should have access to. They also produce clinical guidelines which define what good care should look like. The guidelines published are clinical guidelines.
When NICE develop guidelines, they look at cost-effectiveness – so whether something brings enough benefit to the patient to be good value for money for the NHS. This means with the new recommendations on access to Flash and CGM, NICE thinks these technologies are cost-effective for people they say should have access.
I’ve never heard of the Scottish Health Technologies Group or the Scottish Intercollegiate Guidance Network – what are they?
The Scottish Health Technologies Group (SHTG) is a national health technology assessment agency. They provide advice to NHS Scotland on the use of new and existing health technologies, likely to have significant implications on people’s care. They are part of and receive funding from Healthcare Improvement Scotland, but they produce their advice independently using the best available evidence on clinical effectiveness, safety and cost-effectiveness, as well as the views of patients and healthcare professionals.
The Scottish Intercollegiate Guidance Network (SIGN) is the name of the body which provides national clinical guidelines on effective practice in Scotland. Like the Scottish Health Technologies Group (SHTG), it is part of and receives funding from Healthcare Improvement Scotland but is editorially independent from them. Unlike the SHTG, it does not only focus on health technology.
SIGN currently has two main pieces of guidance on diabetes, SIGN 116: Management of diabetes, and SIGN 154: Pharmacological management of glycaemic control in people with type 2 diabetes. These both include recommendations on diabetes technology, but not on hybrid closed loop technology, which had not yet been developed at the time of publication in 2017.
We’re working to support the development of an update to the guidelines, which is due to be published in 2024. In the meantime, our Diabetes Tech Can’t Wait campaign in Scotland is focused on the delivery of the Scottish Health Technologies Group recommendations and the Scottish Government funding for hybrid closed loop technology.
Are there any disadvantages to using diabetes technology?
There is a robust, growing collection of evidence that shows how CGM and Flash can help people better and more easily test their glucose levels and self-manage but tech isn’t right for everyone and there may be reasons why people may choose not to use it.
For instance, CGM and Flash are not always as accurate as doing a finger prick check particularly when sugar levels are rising or falling quickly, and it can take a while to get used to using the technology. It also isn’t a total replacement for capillary blood testing and people using CGM and Flash always need to have equipment to finger prick test when they need too, especially if they are driving.
It can also take time to get used to the additional data you get from these devices, which can be confusing or worrying.
Some people also find wearing the sensor can be irritating, dislike the look of it or are wary about showing people that they have diabetes.
Is diabetes tech safe?
All diabetes technology available through the NHS has been assessed for safety and licensed for use by people with diabetes by the Medicines and Healthcare products Regulatory Agency (MHRA).
I would like access to diabetes tech but don't think I’m eligible. What can I do and what is Diabetes UK doing about this?
You can read more about who is eligible here. We’re campaigning for fair and equal access for everyone who is currently entitled to diabetes tech, in line with national guidelines. However, we want to hear about your experiences and why you think it would be helpful for you to have access to diabetes tech, how not having access has impacted you. You can share your story here.
I have another type of diabetes (like Type 3c or Mody). What do the guidelines mean for me?
The NICE and SIGN guidelines apply to people living with type 1 and type 2 diabetes and there's limited specific advice on tech for people living with other types. But it’s worth speaking with your healthcare team if you think you should be considered for Flash or CGM access, even if you have another type of diabetes.
Your healthcare team are likely to apply the guidance for type 1 or type 2 diabetes based on the type of treatment you’re receiving for your blood sugar levels. So, depending on your treatment and management you may be able to get access to Flash or CGM even if you don’t have a diagnosis of type 1 or type 2 diabetes, for example if you take multiple daily insulin injections and are expected to regularly finger prick test.
Information for healthcare professionals and ICBs
I’m a healthcare professional – where can I learn more about these changes and what can I do to implement them?
We know that many healthcare professionals working in diabetes will want to support the adoption of these guidelines. You can see our guide to who is eligible here.
There is a lot of support for you out there, including training on technology on various platforms. The Diabetes Technology Network UK and Eden provide free training which covers a range of devices.
A lot of manufacturers of Flash and CGM also offer support around starting people on these technologies and supporting people with diabetes to use them well – you should be able to reach out to them directly if you want to know more.
We are also developing a new free CPD module on diabetes technologies for healthcare professionals which will be launched in the coming months and shared.
The Diabetes Technology Network (DTN UK) and the professionals section of our website also provide tools and resources to help you support the adoption of these exciting new NICE guidelines where you work.
What does the colour coding on your maps mean and what is this based on?
We have used the information shared by ICBs in England about their local policy for CGM and Flash and colour coded them based on how they align with the 2022 NICE guidelines for people with type 1 and type 2 diabetes.
We have split our ranking of ICB policies into four categories depending on type of diabetes and device: type 1 diabetes and CGM, type 1 diabetes and Flash, type 2 diabetes and CGM, and type 2 diabetes and Flash.
We have used three shades of blue to denote how local policies align with NICE – with the darkest representing full alignment, the middle partial alignment and the lightest shade representing areas who are not aligned, or we have not had sight of a policy from yet.
For people with type 1 diabetes, full alignment for CGM means that the policy says everyone with the condition is able to access a full choice of device depending on their individual needs and preferences – which should include procured devices with additional functionality alongside cheaper prescribed options.
For people with type 1 or type 2 diabetes, full alignment for Flash means that the policy says everyone who meets the NICE eligibility criteria can access Flash.
For people with type 2 diabetes, full alignment for CGM means that the policy says that those who meet the NICE criteria can access a CGM device that is available at the same or lower cost to Flash.
Areas may be marked as having partial alignment because, for example, they have agreed a policy with full access to CGM for children and young people with type 1 diabetes – but are yet to do so for adults.
Areas with no alignment are using policies that are based on limited criteria developed before the NICE update in 2022 or have not made their new policy publicly available yet.
The information for my ICB is no longer accurate
We appreciate that this is a changing situation and, whilst we have made efforts to ensure our information is up-to-date, there may be cases where it may not be.
Our intention with this campaign is to support local areas to adopt policies that can improve care and provide information for people with diabetes to understand what they are eligible for.
If any of our information is out of date, please contact us at policy@diabetes.org.uk with a link to any relevant policy documents available and we will be happy to update our records as soon as possible to reflect this.
What is Diabetes UK doing to support local health systems with this and other issues?
Diabetes UK has lots of resources to support local health systems to improve diabetes care, including through diabetes technology. Including the following. We’ve included some below, but please don’t hesitate to get in touch with our helpline if you need more information.
Reports/data sources
DUK Diabetes is Serious Report 2023
National Diabetes Audit - NHS Digital
Leadership programmes
What care to expect
What diabetes care to expect | Diabetes UK
what care to expect - Diabetes UK Shop (free leaflets to download)
Structured education for people with diabetes
Diabetes education courses | Diabetes UK
Education and training
Guide to other courses and events
National Diabetes Audit Quality Improvement Collaboratives
NDA Quality Improvement Collaboratives
Improving inpatient care
Making hospitals safe: Four years on
Information prescriptions for healthcare professionals
DUK professional membership
DUK research opportunities
Diabetes Research Steering Groups
Sir George Alberti Research Training Fellowship
Harry Keen Intermediate Clinical Fellowship
