Can I get hybrid closed loop technology on the NHS?

This page is a summary of what is available on the NHS. Talk to your Diabetes Healthcare Team about what is available to you and how it might help.

If you have any questions about or issues with accessing technology, contact us.

The NHS in England and Wales

Hybrid closed loop is now available through the NHS in England and Wales for people who meet the criteria.

NICE released their new Technology Appraisal in December 2023, and plans are being laid to start everyone who wants the technology and who meets the criteria within five years. 

NICE now recommends hybrid closed loop technology as an option for people with type 1 diabetes who: 

• Have an HbA1c of 58 mmol/mol (7.5%) or more, or have disabling hypoglycaemia, despite best possible management with a pump, and/or real time CGM, and/or flash. 
• Are aged up to 18 years 
• Are pregnant or planning a pregnancy

If you are already using HCL through the NHS, you won’t be affected. You can continue to use your NHS-funded system as long as you and your NHS clinician consider it appropriate. 

People should only use HCL systems with the support of a trained clinical care team experienced in pump and CGM technology. You should be physically and psychologically able to use the system and competent in insulin dosing and adjustments. Your clinic should offer you structured education. 

What does ‘disabling hypos’ mean? 

When hypos occur frequently or without warning, making the person constantly anxious about having a hypo. 

What does ‘despite best possible management’ mean? 

Your diabetes clinic has worked with you to get the best possible results using a pump and/or flash and/or a CGM. This should not exclude anyone, as flash and prescribed CGM are now recommended for everyone with type 1. This is not about ‘how hard you are trying’ to manage your glucose but rather about whether you are being given the best treatment for your needs. 

Read our FAQs on the 2023 NICE Technology Appraisal to find out more about the guidelines.

The NHS in Northern Ireland

According to policy, HCL technology is available in Northern Ireland to people who meet the NICE criteria in England and Wales. However, in reality insulin pump therapy and CGM are not widely available and the political situation makes it unlikely to change soon. However, as flash glucose monitoring is widely available, some people have built a DIY hybrid closed loop. 

The NHS in Scotland

NHS Scotland has recommended that hybrid closed loop systems should be pro-actively discussed with all patients with type 1, particularly those who have:

• Suboptimal blood glucose management
• A high risk of severe hypoglycaemia
• Impaired awareness of hypoglycaemia
• Experience severe diabetes-related distress that adversely affects quality of life and is likely to be improved by using a closed loop system.

It also recommended that people already using both a CGM and an insulin pump should be offered a closed-loop system, but people managing well with should stay on that care plan.

Read the recommendations in full for more detail.

What is JDRF doing to widen access to hybrid closed loop technology on the NHS?

One of our main goals at JDRF is to make sure that everyone with type 1 diabetes who wants or needs a hybrid closed loop system is able to get one for free. Read more about our treatment advocacy work and how you can support us.