NICE guidance and quality standards

Here is a list of the various types of guidance produced by NICE relating to diabetes technology. The type 1 technology guides written by INPUT, Diabetes UK and JDRF provide a summary of all the guidance along with their criteria.

Technology appraisals guidance

NICE says “These assess the clinical and cost effectiveness of health technologies – such as new pharmaceutical and biopharmaceutical products – but also include procedures, devices and diagnostic agents. This ensures that all NHS patients have equitable access to the most clinically and cost-effective treatments that are available.

Regulations require clinical commissioning groups, NHS England and local authorities to comply with recommendations in a technology appraisal within 3 months of its date of publication.”

This means that if you meet the criteria and your clinic says you need the device, the funding body (your CCG for adults or NHS England for children & young people) MUST provide funding.

TA151 (July 2008)  – Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus

Guidelines (used to be called Clinical Guidelines)

NICE says “NICE guidelines make evidence-based recommendations on a wide range of topics, from preventing and managing specific conditions to planning broader services and interventions to improve the health of communities.”

This means they are recommendations for best care. Unlike technology appraisals, funding does not have to be provided for devices recommended by this type of guideline.

NG17 (Aug 2015/July 2016) – Type 1 diabetes in adults: diagnosis and management

NG18 (Aug 2015/Nov 2016) – Diabetes (type 1 and type 2) in children and young people: diagnosis and management

CG138 (Feb 2012) – Patient experience in adult NHS services: improving the experience of care for people using adult NHS services

Diagnostics guidance

NICE says “These focus on the evaluation of innovative medical diagnostic technologies in order to ensure that the NHS is able to adopt clinically and cost-effective technologies rapidly and consistently.”

Again these are recommendations for innovative technologies, and the funding of devices covered by this type of guidance is not mandatory.

DG21 (Feb 2016) – Integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes (the MiniMed Paradigm Veo system and the Vibe and G4 PLATINUM CGM system)

Click here to read our note on interpreting this guidance.

Quality standards

NICE says “Quality standards set out the priority areas for quality improvement in health and social care. Quality standards are developed independently, in collaboration with health and social care professionals, practitioners and service users. They are based on NICE guidance and other NICE-accredited sources. (They are not mandatory but) they can be used to plan and deliver services to provide the best possible care.”

QS6 (August 2016) – Diabetes in adults

QS125 (July 2016) – Diabetes in children and young people (note particularly quality statement 4 concerning CGM)

Medtech Innovation Briefings

NICE says “MIBs provide a description of the medical technology, including its likely place in therapy, the costs of using the technology and a critical review of the strengths and weaknesses of the relevant published evidence.

Their purpose is to provide objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals. By making this information available, NICE helps to avoid the need for NHS organisations to produce similar information for local use.

MIBs are not NICE guidance. They differ in format, contain no judgement on the value of the technology and do not constitute a guidance recommendation.”

MIB110 (Jul 2017) – FreeStyle Libre for glucose monitoring

MIB51 (Feb 2016) – MiniMed 640G system with SmartGuard for managing blood glucose levels in people with type 1 diabetes