The information is not available in the format requested.

NHS Digital conducts the National Diabetes Insulin Pump Audit as a part of the National Diabetes Audit (NDA) Programme. Data from this audit shows that the number of people with diabetes attending specialist diabetes services in England in 2016-17 who were using an insulin pump was 9,735. Data for 2017-8 and 2018-9 is not yet available.

It should be noted that disclosure control has been applied to all figures, as per the NDA publication. All numbers are rounded to the nearest five, unless the number is one to seven, in which case it is rounded to five.

NHS Digital conducts the National Diabetes Insulin Pump Audit as a part of the National Diabetes Audit Programme. This element of the programme is conducted on the basis of specialist diabetes services that operate out of hospital trusts, so the data is not published at clinical commissioning group level.

NHS England has published information on the criteria for patients eligible for insulin pump therapy, which includes supporting guidance for clinical commissioning groups. This can be found at the following link:

https://www.england.nhs.uk/wp-content/uploads/2019/03/flash-glucose-monitoring-national-arrangements-funding.pdf

The National Institute for Health and Care Excellence also published guidance that should be used by prescribers to inform decisions on achieving the most relevant treatment for their patient. This can be found at the following link:

https://www.nice.org.uk/advice/mib110

Information is not held centrally on the number of people assessed and deemed not eligible for insulin pump therapy.

The cost of 1 FreeStyle Libre sensor, 1 sensor applicator, and 1 wipe is £35 as listed in the February 2019 Drug Tariff.

Net Ingredient Cost is the basic price of a drug as stated in Part II Clause 8 of the Drug Tariff.

On 14 November 2018, it was announced that flash glucose monitors will be available on prescription for every patient who qualifies for them, in line with National Health Service clinical guidelines.

The Department has not made any representations to Abbott since.

Clinical commissioning groups (CCGs) are responsible for commissioning diabetes services. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence, and take into account national guidelines. This should include consideration of access to diabetes technologies such as FreeStyle Libre.

The information requested is not centrally held.

The NHS Business Services Authority does not hold data for FreeStyle Libre flash glucose monitoring devices. However, prescription data for FreeStyle Libre Sensors prescribed in clinical commissioning groups in the financial years 2017/18 and 2018/19 to date can be found in the attached table.

This data refers to FreeStyle Libre Sensor packs that include one sensor, one sensor applicator, and one wipe.

The Driver and Vehicle Licensing Agency is currently amending the Assessing Fitness to Drive guidance on the use of new monitoring technologies for people with diabetes. The revised guidance is due to be published in February. This will allow the testing of interstitial fluid for driving licensing purposes for people with diabetes who drive cars or motorcycles. Drivers of goods vehicles and buses must continue to monitor blood glucose levels.

The Driver and Vehicle Licensing Agency is currently amending the Assessing Fitness to Drive guidance on the use of new monitoring technologies for people with diabetes. The revised guidance is due to be published in February. This will allow the testing of interstitial fluid for driving licensing purposes for people with diabetes who drive cars or motorcycles. Drivers of goods vehicles and buses must continue to monitor blood glucose levels.

Reducing variation in the management and care of people with diabetes by 2020 is an objective in the National Health Service mandate. The NHS RightCare diabetes pathway shows the core components of an optimal diabetes service, as well as evidence of the opportunity to reduce variation. Ultimately it is for clinical commissioning groups (CCGs), who are primarily responsible for commissioning diabetes services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence and take into account national guidelines. This includes determining whether specific technologies, such as flash glucose monitoring, form part of their service and if it is suitable for individual patients to support the ongoing management of their condition. The Regional Medicines Optimisation Committee North has issued advice on the use of Freestyle Libre to support the CCGs in doing this.

Freestyle Libre has been approved for reimbursement on National Health Service prescription from 1 November through listing in Part IX of the England and Wales Drug Tariff. The Drug Tariff is a price list, and the listing of Freestyle Libre should not be interpreted as a recommendation to prescribe it. Patients will need to discuss the ongoing management of their condition with their healthcare professional and consider whether flash glucose monitoring is suitable for them.

NHS England has established four Regional Medicines Optimisation Committees (RMOC) that are responsible for providing guidance on the use of drugs and other technologies that are not being assessed by the National Institute for Health and Care Excellence.

The RMOC (North) has issued guidance on the use of Freestyle Libre suggesting a careful start to its use and data collection to better understand the benefits. The Committee’s recommendations are available in full at:

https://www.sps.nhs.uk/wp-content/uploads/2017/11/Flash-Glucose-monitoring-System-RMOC-Statement-final-2.pdf

Data on insulin pump usage in England is now collected and published in the National Diabetes Insulin Pump Audit. The report for 2013-15 can be found at:

http://www.hqip.org.uk/public/cms/253/625/19/520/National%20Diabetes%20Insulin%20Pump%20Audit%20report%202013-15.pdf?realName=hOfPw8.pdf?v=0

Participation in the first audit was low, with 44 out of 183 units providing data, and so it does not provide an accurate count of the number of people using an insulin pump. Furthermore, the data does not provide information on access to insulin pumps or distinguish between insulin pumps provided by the National Health Service or those which are self-funded. This information is not collected centrally.

Information on the number of people using continuous glucose monitors is not collected centrally.

Data on insulin pump usage in England is now collected and published in the National Diabetes Insulin Pump Audit. The report for 2013-15 can be found at:

http://www.hqip.org.uk/public/cms/253/625/19/520/National%20Diabetes%20Insulin%20Pump%20Audit%20report%202013-15.pdf?realName=hOfPw8.pdf?v=0

Participation in the first audit was low, with 44 out of 183 units providing data, and so it does not provide an accurate count of the number of people using an insulin pump. Furthermore, the data does not provide information on access to insulin pumps or distinguish between insulin pumps provided by the National Health Service or those which are self-funded. This information is not collected centrally.

Information on the number of people using continuous glucose monitors is not collected centrally.

Data on insulin pump usage in England is now collected and published in the National Diabetes Insulin Pump Audit. The report for 2013-15 can be found at:

http://www.hqip.org.uk/public/cms/253/625/19/520/National%20Diabetes%20Insulin%20Pump%20Audit%20report%202013-15.pdf?realName=hOfPw8.pdf?v=0

Participation in the first audit was low, with 44 out of 183 units providing data, and so it does not provide an accurate count of the number of people using an insulin pump. Furthermore, the data does not provide information on access to insulin pumps or distinguish between insulin pumps provided by the National Health Service or those which are self-funded. This information is not collected centrally.

Information on the number of people using continuous glucose monitors is not collected centrally.

This Government is working hard to improve outcomes and quality of life for those already living with diabetes and those who will develop it in the coming years. One of our key goals in the mandate to the National Health Service is a measurable reduction in variation in the management and care of people with the condition within the lifetime of this Parliament. Funding has been secured through the spending review to help achieve this and NHS England is developing a programme to ensure that those clinical commissioning groups (CCGs) which need extra investment in this area, accompanied by sound plans for delivery, receive it.

In addition, the Clinical Commissioning Group Improvement and Assessment Framework will play a key role in delivering this as it contains two recognised evidence based measures of whether patients with diabetes are being supported to successfully manage their condition (achievement of the National Institute for Health and Care Excellence treatment targets and participation in structured education programmes).

Using data from the NHS Atlas of Variation, NHS Right Care is also working with CCGs and other local partners to make improvements in diabetes care and reduce variation by providing hands on practical support.

Since 2009/10, there has been an almost 70% increase in the proportion of people newly diagnosed with diabetes recorded as being referred to structured education courses, designed to help them manage their condition in the long term. However, whilst we know that the data on take up needs improving, there is still much further to go in enabling people with diabetes to access these programmes.

The Department, NHS England and Diabetes UK are working on ways to improve the take up of structured education including exploring how more diversity of provision might be delivered through digital and web based approaches. The Department recently held a seminar with key stakeholders to identify actions that would facilitate improved access.

CCGs are primarily responsible for commissioning diabetes services to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local population, are based on the available evidence, taking into account national guidelines. This should include consideration of access to continuous glucose monitoring for people with Type 1 diabetes who might benefit from it.

The Department has no current plans to collect data on insulin pump use in England. Insulin pumps and their consumables are non-prescription items and not currently captured in the annual Prescribing for Diabetes in England dataset.

The Association of British Clinical Diabetologists recently commissioned an insulin pump audit. This showed that there are at least 11,985 people over the age of 18-years-old and at least 4,447 people 17-years-old or younger using an insulin pump in England. Insulin pump therapy is a viable treatment for approximately 12% of adults and children aged over 12-years-old and 33% of children under the age 12 years, who have type 1 diabetes.