Intermittently Scanned Continual Glucose Monitoring Devices (isCGM) in Leeds
Description of project
This is a joint proposal by Leeds Clincal Commissioning Group (CCG) and Leeds Community Hospitals.
Intermittently scanned continual glucose monitoring devices (isCGM) or ‘flash’ glucose monitors can hugely benefit people in self-management of diabetes, helping people progress and attain individual goals. isCGM can also help professionals work towards achieving parity of esteem for people living with diabetes, significantly reducing diabetes distress.
Leeds CCG has higher overall isCGM uptake (45%) compared to both the Sustainability and Transformation Partnership (STP) (40%) and national average (39%). However, there is still significant variance. Primary care network levels range from 30% (Crossgates) to 66% (Otley) with variance also aligned to deprivation. Practices with relatively few patients in deprivation have higher uptake (52%) compared to those with higher deprivation levels (34%).
The NHS Long Term Plan includes a commitment to target variation in access to technologies such as isCGM and this project will evaluate and challenge barriers in eligible populations.
The project will optimise system access across Leeds and organisations to enable integrated pathways, with the person living with diabetes moving freely between tiers of care receiving the right care, at the right time, in their preferred location from informed practitioners.
Target population group
Flash glucose monitoring is aimed at specific groups of people. It aims to reduce inequalities and prioritise groups who are most likely to benefit including those who might find it difficult to access and stick to other ways of managing thier own care. With that in mind the target population includes anyone who qualifies for Freestyle Libre in Leeds CCG, based on the 2020 updated NHSE criteria for access. It could also include those who are eligible under the NICE guidelines due to be published in March 2022:
- Type 2 diabetes in adults: management - glucose monitoring (including people with learning disabilities)
- Type 1 diabetes in adults: diagnosis and management – glucose monitoring and diagnosis
- Type 1 and diabetes in children and young people: diagnosis and management – glucose monitoring and diagnosis
How will success be measured?
System level
- Identify variation in isCGM access and adherence using minimum data sets
- Identifiy people’s experiences in accessing and adhering to isCGM, exploring barriers and facilitators within the system that lead to decrease in effectiveness
- Develop a pathway model to support improved access to CGM with supporting equality impact assessment
- IMplement a pilot pathway
From pilot:
People with diabetes
- Improved information and access to isCGM, across missing populations
- Improved ability to self-manage
- Improved physical and mental health
Clinical team
- Improved resources, skills, knowledge, and confidence to offer isCGM to those who are eligible
- Improved monitoring of access, adherence, and outcomes