# pump postcode lottery - Kent report



## rossoneri (Sep 3, 2010)

I picked this up doing a quick Google News search of diabetes stories - I am missing Northerners regular links posts in the News section.
http://www.yourthanet.co.uk/kent-news/Diabetes-patients-miss-out-on-insulin-pumps-choice-newsinkent39474.aspx?news=local

If you open it you will get a Kent local news report about the local pump provision figures for the county.  It does look like Kent is not currently doing very well out of the lottery except in the western district.  Although I do not live in Kent I still found it a worthwhile read because of the national statistics provided, mainly: -

the NICE target is 12% of all Type One diabetics (this is how it is stated in the report, it may in fact be 12% of all insulin dependent diabetics)
the current national average is 3.9%
uptake rate in other (Western?) European countries is 10-20%, 15-20% in (North?) America.
NICE recommends insulin pumps because they can improve the quality of life for many users and pumps are an efficient use of NHS resources - does pump treatment in fact pay for itself in the long term even ignoring the reduced likelihood of long term complications if control is improved?
There is also the usual observation that pump treatment is particular helpful for treating children.

Even with the Kent aspect of the report it states that 'nobody who meets the NICE criteria is turned away' and that it was claimed that uptake was now beginning to accelerate even in the area with the smallest uptake figure in the report.


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## rossoneri (Sep 3, 2010)

A further quick Google found this press release published just this week and talking about the pump lottery on a national scale.
mtg.org.uk/download/file/Insulin Pump PRESS RELEASE.pdf

It does give an example of the upper and lower limits of the uptake rate (Blackburn and Luton respectively) but unfortunately does not give the full figures for each health authority, maybe they can be found elsewhere.


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## Adrienne (Sep 3, 2010)

The lady who has worked and is working tirelessly called Jacqui Double in the article is one of my very very good friends, she knows so much about diabetes type 1, especially where children are concerned.  She is a mum, like me and she is so good she talks at seminars etc, our hospital ask her to.   She really is fantastic and a real boon to the diabetes world and to my life also.

I lived in Kent for the first 7 years of Jessica's life and our local hospital were utter carp (not a spelling error, you just need to change the letters around)  They would not even put Jessica onto MDI when Lantus first became available (before Levemir was out), they said it was for teens only.  We had an admission into GOSH instead as they said they would do it for us but they were learning alongside us.     When we finally transferred hospital to UCLH and got a pump, we went back to the old hospital and when they saw the pump, they turned their nose up and said, we don't do those things, they don't work and are rubbish.    What a load of old bull and how ignorant.  They have a new consultant there (well they did 4 years ago) and he said he would like pumps but hasn't got the budget, also bull.   This is all in Kent.


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## Patricia (Sep 4, 2010)

Hello - we are in Kent... The initial stuff was handled quite badly, as I've written elsewhere, but very soon after diagnosis - within a month - we had all agreed that what we wanted was a pump. The team were very frank and let us know that they were just getting started with them, so it would be a year at least. 

By various side routes we eventually ended up at one of the big centres and were on a pump within 7 months of diagnosis - obviously paid by the PCT. out of area. 

The Kent team are pro-pump now but CHRONICALLY underfunded and not brilliantly trained. The DSNs are run fairly ragged and are only now really gaining experience of pumping. The is NO Paed diabetologist in east Kent, so our clinic is run by a paediatrician. 

So I guess what I'm saying is that in our recent experience the will is pretty much there but the infrastructure let's everyone down.


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## Patricia (Sep 4, 2010)

Sorry, my keypad playing up, please excuse grammar error in last entry - can't fix it 

Kent now seems to be well funded - everyone who is funded for a pump is also funded for CGM - but the roll out is arduous and of the 'learning alongside' type. On a completely different scale, like jaqui d we find now that the local team is up with our situation by virtue of being local - we do not learn from them; in fact it's possibly vice versa. 

But the staffing and training are quite grim. A classic case of lots of money and inadequate groundwork. I have a friend (on this board too, Adrienne you know her), who seems to have received quite decent care. It's not great, no. But an improvement upon our experience.


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