Less than 40 insulin pumps are available for Type 1 Diabetes sufferers in the Western Trust area and once those pumps are used up there is no funding available to buy more.


As the Northern Ireland Executive reconvenes this week, leading diabetes clinician Neil Black has called for funding for insulin pumps and has warned that the Western Trust “is going to run out before the end of 2016.”


The Western Trust was able to buy 183 insulin pumps with funding received from the Department of Health in 2012. No additional staff were appointed to support patients undergoing insulin pump therapy. As a result, 86 patients have begun insulin pump therapy over the last four years and the Trust admits that waiting times can seem “very long”.


In an interview with The Impartial Reporter, Dr. Black, Consultant Physician in Endocrinology and Diabetes based in Altnagelvin Hospital called for “a certain amount of funding each year for each trust to go towards the provision of insulin pumps.” He also revealed that there are two full time diabetes clinicians in Altnagelvin but the post in the South West Acute Hospital has been vacant for the past six months, with a locum clinician in place for the past month.


Currently, there are 1,360 adults and 230 children living with Type 1 diabetes in the Western Trust area. An insulin pump is a small, battery-operated pump which continually gives insulin through a fine tube that is attached to a small needle placed under the skin. 


A patient will initially receive several weeks of structured education on insulin dose adjustment and carbohydrate counting in order to develop their self management skills. Then, a patient undergoes three months of training and preparation for using the pump. This is followed by six months of learning about the pump’s advanced features in order to take full advantage of it.
Dr. Black stated: “Insulin pumps can revolutionise lives. God forbid, if one of my children developed diabetes an insulin pump is what I would want, it’s a total no-brainer.


“We know those pumps are going to be used in the next 12 months. There will be no more pumps and we will be back in the same situation we were in in 2009.” 


Of the 86 patients started since 2012, 42 were children and 44 were adults; 59 pumps have been issued as replacement pumps and there are 38 remaining.


At a recent meeting of Fermanagh and Omagh District Council, independent councillor Raymond Farrell asked that the Council write to Western Trust Chief Executive, Elaine Way regarding waiting times for insulin pumps after a constituent complained that they had been waiting a long time to be considered for an insulin pump.


In her reply, Mrs. Way said: “The service is offered within the existing staff resource and this has resulted in some delays for patients to start [insulin pump] therapy. For some patients the waiting time may appear very long.”
Dr. Black said the insulin pump service is integrated into his team’s already busy diaries. “The rate that we are able to start pumps is determined by staff availability and these staff have multiple other roles. Although very little staff time has been allocated to this, we still consider that part of our job,” he stated.


Dr. Black’s team has had to “work within our confines”, but, he said: “If we had more staff we would have been able to do this at a quicker rate, but we would also have run out of the pumps at a quicker rate.”
Outlining the situation, Dr. Black said that the Trust replaces an insulin pump after three years in order to stay in warranty.


“At the moment we have 38 pumps left. We’ve had to replace quite a few for people who were already on a pump and their warranty ran out after three years. Over the next one or two years, the pumps that were started in 2012 are going to be out of warranty so there’s an acceleration of the proportion that are being used to replace those that are already in place.”


Northern Ireland needs “an ongoing funding commitment”, Dr. Black said.
He is hopeful that a draft regional strategy for diabetes will be on the Health Minister’s desk soon. He concluded: “Clinicians, department of health officials and Diabetes UK will hold another meeting next Wednesday about a regional strategy for diabetes. It will be convened by the Chief Medical Officer but is primarily overseen by Dr. Anne Kilgallen, the former medical director of the Western Trust. 


"Pumps are specifically mentioned in that draft strategy document, that’s why that strategy is so important.”