Access to life-changing diabetes technology risks stalling in Scotland

Access to life-changing diabetes technology risks stalling in Scotland

While significant progress has been made in improving access to advanced diabetes technologies in Scotland, the Royal College of Physicians of Edinburgh (RCPE) is concerned that momentum could stall, leaving thousands of Scots without access to treatments that could improve both quality and length of life.

Over the past two years, the Scottish Government has made a welcome and substantial investment to expand access to insulin pump therapy and related technologies. This progress has been achieved in the context of extremely tight public finances, and the commitment to improving diabetes care is recognised by the RCPE.

However, the RCPE understands that the Scottish Government’s expectation is now for Health Boards to fund closed-loop systems (CLS) for those who meet the clinical criteria, in line with NICE and SIGN guidance – without increased central funding to ensure that more people get access to vital advanced diabetes technologies.

Advanced diabetes technologies, including insulin pump therapy and hybrid closed-loop systems, are transforming the lives of people living with Type 1 diabetes and have the potential to significantly reduce the risk of devastating health complications such as kidney failure and sight loss. Just 25% of adults with Type 1 diabetes are currently funded to receive advanced diabetes technologies and many people already wait several years to access to this life changing therapy.

Because Health Boards across Scotland are under significant financial pressure, the RCPE says that without continued national direction and investment from central government, further roll-out is likely to be significantly limited meaning that waiting lists could increase. 

If there is to be no further centrally funded expansion, there must be clear national targets and timelines for future roll-out. Without these, there will be no consistent way to measure progress or hold systems to account, and unacceptable variation in access across Scotland is likely to persist or worsen.

Professor Mark Strachan, President of the Royal College of Physicians of Edinburgh and Diabetes Consultant said:

We know that technologies like insulin pumps and closed-loop systems are not just innovative - they are life-changing. They help people live safer, healthier lives and reduce the risk of serious long-term complications such as kidney failure and blindness.

The investment made by the Scottish Government in recent years has been very welcome and has made an enormous difference. But with approximately only a quarter of people currently able to access these technologies, we cannot afford for progress to stall.

If national funding is no longer expanding, then we urgently need clear targets and timelines so that Health Boards can deliver equitable access. Without that, variation will grow and too many people will be left behind.

This issue reflects a wider challenge facing Scotland’s health system. The RCPE has consistently called for a “national conversation” on the future of the NHS. They are calling on politicians to be transparent with the public about the scale of the funding challenges faced by the NHS. Ensuring fair and timely access to proven, life-improving technologies must be a central part of that discussion.