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New proposal for hybrid closed-loop system rollout

NICE announces consultation over draft proposal to smooth the rollout of hybrid closed-loop systems for people with type 1 diabetes in England and Wales.

NICE has announced a new consultation on whether to accept a variation in funding request from NHS England for the rollout, over the next five years, of hybrid closed-loop (HCL) systems to people with type 1 diabetes.

In January 2023, NICE released draft guidance for England and Wales recommending the use of HCL systems for people with type 1 diabetes who meet the stated criteria. They were welcomed as a significant step in making the technology available on the NHS. HCL systems link insulin pumps and continuous glucose monitors using a computer algorithm, in order to calculate the amount of insulin to deliver. Evidence shows that they help in the management of blood glucose levels, with fewer hypos and easier self-management.

If approved, the request from NHS England would result in local health systems not being required to provide HCL technology to all of those who meet the criteria within three months of the final NICE recommendation. Rather, a phased approach would be put in place to provide access sooner for those who would benefit the most. It is hoped that this would reduce pressure on stretched NHS services.

While a date has not been confirmed, NICE expects to finalise later this year who the technology will be recommended for and how it will be rolled out. Although the recommendations will apply only in England and Wales, the Scottish government recently announced investment to accelerate the distribution of HCL systems.

In response to the news, Nikki Joule, Policy Manager at Diabetes UK, said: “Hybrid closed-loop technology has the potential to transform the lives of people with type 1 diabetes, improving both clinical outcomes and their quality of life. Getting that rollout right is of paramount importance, and we’re working with the NHS and NICE to help ensure everyone who could benefit from this technology has access to it.”

The draft technical appraisal from NICE is available here.

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