Disparity between health boards with poorest areas worse off

Scotland’s poorest struggle to access to vital diabetic medical equipment, a new report has revealed.

Diabetes Scotland says there are large disparities between different health boards with people from the poorest areas struggling most to access vital services. 

The Diabetes Tech Can’t Wait report, published to coincide with World Diabetes Day (14 November), says inconsistent access across the country is having a damaging impact on the wellbeing of thousands of people living with diabetes.

It means far too many people with diabetes are being left to have to fight for access to technology to manage their condition, says the charity’s national director Joe Kinnear.      

“Accessing the healthcare you need shouldn’t be a struggle, yet we’ve heard from countless

people who are having to fight to access diabetes tech,” he said.

“This means people who don’t have the resources to research and make a case for themselves end up being left behind, which only makes inequalities worse.”q

Diabetes Scotland’s 2023 survey of over 1,500 people living with and affected by diabetes in Scotland, revealed that over four in five respondents who use wearable diabetes technology agreed (33.1%) or strongly (49.6%) agreed that their technology helped them to manage their diabetes in the past year.

In March 2022, following a recommendation from the Scottish Health Technologies Group, the Scottish Government committed £14.6 million for NHS boards to roll out hybrid closed-loop technologies, also known as an ‘artificial pancreas’, across the country. 

One year on, the charity launched its Diabetes Tech Can’t Wait campaign to understand what difference this investment has made to access to diabetes technology in Scotland.

The new report shares learning from the campaign and brings together insights from people who have accessed or tried to access diabetes technology.

Stephen Nixon, 47, from Edinburgh lives with type 1 diabetes as does his son Lewis, age nine who was diagnosed with the condition when he was six. Stephen said: “When I was diagnosed with type 1 diabetes in 2019, I was offered a flash glucose monitor. I felt lucky because I have friends in other areas who have had type 1 for years and still don’t have access to this tech.

“My son Lewis received an insulin pump from the NHS after 16 months on a waiting list. After using the pump and flash glucose monitor for six months, we decided we wanted access to a closed loop system.

“To do this, we had to self-fund a continuous glucose monitor that was compatible with Lewis’s pump. We did this for a year before the NHS prescribed closed loop in June of this year.

“Hybrid closed loop is a game changer for my son and us as parents. What I have seen with Lewis is that diabetes tech means it's been much less stressful for him. Lewis doesn't need to make as many decisions every day.

“To begin my own journey to closed loop, I recently started using an insulin pump. My health board has apparently run out of funding for a continuous glucose monitor that talks to the pump I have so I’m currently self-funding so I can benefit from closed loop technology too.

“The NHS spends money on strips, lancets, glucose meters. It feels like a no brainer that they instead fund the more up to date tech. I get that funding is difficult, but the NHS is meant to be free at the point of use. Spending on diabetes tech is short term pain for long term gain because it can mean less diabetes complications as people get older and if we act now the NHS would save money.”

John Kinnear added: "We know health boards are seeing huge increases in demand for tech and that many clinicians want to support people to access the tech they are eligible for. But right now, health boards simply don’t have the capacity to make this a reality for everyone who needs it.

“Our report showcases areas of good practice in the NHS and innovative approaches to prescribing tech. It also sets out clear recommendations for the Scottish Government and NHS Scotland to continue crucial work towards delivering fair and equal access to diabetes tech.

“Fair and equal access to diabetes tech for people living with diabetes who could benefit is vitally important as it aims to prevent thousands of people from developing complications and free up NHS resources in the long term.

“We’ve seen cross party support for rolling out diabetes tech. But now we need to see action.”