Date lodged: 25 June 2018
To ask the Scottish Government how it plans to increase expertise in diabetes technology in all NHS boards.
Answered by: Jeane Freeman 10 July 2018
In December 2016, the First Minister announced £10m of additional funding over the course of this Parliament, to further increase the number of adults accessing insulin pump therapy and to substantially increase availability of Continuous Glucose Monitor devices (CGMs) for people in all age groups for those with the greatest clinical need.
The additional funding includes the provision for a part time senior Diabetes Specialist Nurse (DSN) to support NHS Boards to increase awareness and pace of adoption of CGM technology to ensure that clinical teams have the appropriate infrastructure, skills and training in place to safely and effectively deliver this important technology.
Continuous Glucose Monitors
A Continuous Glucose Monitor (CGM) has three parts: Sensor – this senses how much glucose there is in the interstitial fluid and is inserted into the skin. This is connected to the Transmitter which is worn on the skin and communicates with the Receiver (usually wirelessly) recording results and displays them on a pager size device often worn on a belt or carried in a handbag. Systems that display immediate results are often called ‘real-time’. This allows patients to see their blood glucose levels 24 hours a day and will alert patients through an alarm/vibration if the sensor detects blood glucose values that exceed or will exceed the target zone set for their glucose levels, helping them to optimise glycaemic control.
The Scottish Government has worked with the Scottish Diabetes Group (SDG) to develop a national approach to the introduction of CGM into the patient pathways based on the National Institute for Health and care Excellence (NICE) (Guideline NG17), the Scottish Intercollegiate Guidelines Network (SIGN) (Guideline 116), and the clinical evidence available. These guidelines advise that CGM devices may be useful for a small number of people with diabetes as an aid to improve glycaemic control, but do not recommend the use of CGM devices for routine use.
Technology Enabled Care Programme
The £9m per year Scottish Government funded Technology Enabled Care Programme continues to see progress in the uptake of digital solutions for self-management. This includes on the use of Home and Mobile Health Monitoring of conditions. The SMS text messaging service FLORENCE (simple telehealth) is available to use for all health boards in Scotland and has already been proven to aid those with diabetes to better manage their condition. Staff have been involved in this programme from the very start and continue to be supported via the TEC workforce development support team.
My Diabetes My Way / SCI-Diabetes
We have been working closely with the Digital Health and Care Institute (DHI) on the development of diabetes care and the interactive self-management platform “My Diabetes My Way” was recently awarded a grant of £1million from Innovate UK to continue research into the use of artificial intelligence. This award winning service for people with diabetes and carers contains validated multimedia resources to improve self-management and also offers access to clinical data using information captured via SCI-Diabetes. By the end of 2017, there had been 15,574 people accessing their record and reading from the MDMW portal (48% increase from 2016) with this expected to continue to increase.
The Scottish Government recognises the importance of workforce development, continuing to share learning and expertise across our health and care services and this is recognised in Scotland's Digital Health and Care Strategy.