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‘Nonsensical’ to stop GPs approving access to glucose monitors
The decision to block GPs from certifying patient access to the devices ‘needs to be reviewed and rectified,’ the RACGP president says.
College says there is 'no logical explanation' for excluding GPs from approving the device.
On 1 July this year, the Federal Government announced expanded access to subsidised continuous glucose monitoring and Flash GM products for all patients with type 1 diabetes mellitus, via the National Diabetes Services Scheme (NDSS).
Since being developed, continuous glucose monitoring devices have been variously described as ‘empowering’ and a ‘real expansion in clinical utility’, allowing for better self-management of the disease.
However, uptake has been somewhat limited due to cost, with patients required to spend around $5000 per year on the devices unless they qualify for subsidised access – which prior to 1 July was only available for people with type 1 diabetes aged under 21.
As a result, the RACGP initially welcomed the expansion of the subsidised scheme, but another handbrake impacting the use of the devices has now emerged: the NDSS outlines that only health professionals for whom diabetes is their ‘usual scope of their practice’ are able to certify the access forms.
These include credentialled diabetes educators (CDEs), endocrinologist/diabetologists, nurse practitioners, physicians, and paediatricians, but specifically exclude GPs.
RACGP President Adjunct Professor Karen Price has written to the Department of Health (DoH) to voice the college’s frustration at the restriction, which she believes is ‘nonsensical’.
‘Clearly this policy decision needs to be reviewed and rectified right away,’ she said.
‘There is no logical explanation for why other members of a healthcare team are able to sign a form approving this device, but hardworking GPs are excluded.
‘Not only is it insulting to GPs, it creates an unnecessary barrier to patient access for something that could make a real difference in managing their health.’
An estimated 130,000 people have type 1 diabetes in Australia, and Professor Price says those living in rural and remote areas will be especially disadvantaged by the restriction, as they rely more on GPs for their overall healthcare needs.
‘Telehealth and electronic form transmission may be helpful for some but Medicare rebates for longer phone consultations were removed at the start of this month – something else we are trying to fix,’ she said.
‘There is no point crying over spilt milk. The RACGP calls on the Government to reconsider and recognise that managing patients with diabetes within a specialist team falls squarely within the job description of GPs.
‘GPs are there for our patients managing their diabetes, and the Government needs to be there for us. Let’s chart a new course on approving glucose monitors and ensure that the role of general practice is always kept front of mind.’
The DoH has said the decision to exclude GPs from the authorised certifier group is based on advice from the Australian Diabetes Society (ADS) and the Australian Diabetes Educators Association.
ADS CEO Associate Professor Sof Andrikopoulos has defended the advice, telling The Guardian that type 1 diabetes is a complex condition that requires the use of insulin, a potentially dangerous medication, as well as education and upskilling or specialist care.
‘Diabetes technology, which supports the delivery of insulin, is rapidly evolving, complex and requires considerable training and experience to stay up to date,’ he said.
‘This can be very challenging, even for specialised diabetes health professionals, which is why we advised that the training and support to commence using diabetes technology should be provided by specialised diabetes health professionals – endocrinologists and credentialled diabetes educators.
‘A GP chronic disease management plan provides five Medicare-subsidised visits to allied health professionals, including CDEs.’
Meanwhile, Diabetes Australia’s group CEO Justine Cain told the same publication that anyone having trouble getting an appointment with a specialised diabetes health professional should contact the NDSS Helpline on 1800 637 700.
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