RAG rating
Document type
Patient information
Hertfordshire and West Essex ICB
Output type
Clinical Policies & Evidence-based Interventions

Continuous Glucose Monitoring for patients with Type1 and Type 2 Diabetes

CGM for Adults - ICB position statement


Hertfordshire and West Essex ICB commissions Continuous Glucose Monitoring (CGM) for adults, including FreeStyle Libre 2® and Dexcom ONE®, in line with the local CGM for adults policy.  See https://www.hweclinicalguidance.nhs.uk/clinical-policies/continuous-glucose-monitoring-adults-policy/

This policy reflects the NHS England funding criteria available at National-arrangements-for-funding-of-relevant-diabetes-patients-June-2020-Updated-final.pdf (england.nhs.uk)

Further information specific to FreeStyle Libre 2® and Dexcom ONE® can be found at https://www.hweclinicalguidance.nhs.uk/home  including a ‘Frequently asked Questions’ document for patients.

As you may be aware, the National Institute for Health & Care Excellence (NICE) updated their guidance for Type 1 and Type 2 diabetes in adults in July 2022, recommending significantly widening access to CGM. See https://www.nice.org.uk/guidance/ng28/chapter/Recommendations#blood-glucose-management   

All healthcare bodies (ICBs) have a duty to assess the effects of implementing NICE guidelines in the local health system as a whole. The ICB reviewed the updated NICE guidance recommendations and our existing policies for CGM. The local decision-making group responsible for CGM (Clinical Policies Group) met in December 2022 and recommended a phased approach to changing the policy. 

Phase one has been implemented with CGM available as an option for all children and young people with Type 1 diabetes, as well as aligning access criteria for adults across the local health system. 

Phase two, which involves a review of the feasibility to further extend availability for CGM as an option for other adults with diabetes was due to be completed by June 2023. Unfortunately, this date was delayed due to the awaited publication of the NICE technology appraisal on Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes which was delayed on a number of occasions and eventually published on 19th December 2023. 

HWE ICB is now in consultation with local stakeholders including commissioning, hospital and community specialists concerning the development of a 5-year implementation plan for the roll out of Hybrid Closed Loop Systems. This includes consideration being given to the impact on affected patient groups, the resources available to support them and the financial implications. 

Part of that extensive on-going work is to review the changes to the NICE guidance on the management of Type 2 diabetes in adults and the feasibility of widening access to CGM for local patients and consider who the priority groups would be. 

In line with accepted and required governance processes for local decision making, any revised guidelines will require review and approval by Hertfordshire and West Essex Area Prescribing Committee or Clinical Policies Group and ratification by Hertfordshire and West Essex ICB Commissioning Committee.

In the interim, clinicians are advised to continue to follow existing local guidelines.

Any update to local guidelines will be published on the Hertfordshire and West Essex ICB Prescribing, Policies and Pathways website at https://www.hweclinicalguidance.nhs.uk/home