Skip to main content

NICE’s latest consultation on hybrid closed loop

As part of its assessment of hybrid closed loop (HCL), the National Institute for Health and Care Excellence (NICE) has today published an additional consultation on its roll out.
21 August 2023

Illustration of the hybrid closed loop technology system, funded as part of treatment research for type 1 diabetes by JDRF.

The consultation document proposes a carefully controlled implementation period of five years. Technology Appraisals are normally required to be implemented after three months without any phased prioritisation. This can lead to inequity in access by those who have the greatest need. We anticipate this phased rollout period will help those with greatest need access HCL systems soonest – just as the phased Covid vaccination programme prioritised those who needed the most protection.

The final NICE appraisal document, detailing the exact criteria of who will be eligible for hybrid closed loop is due later this year. We will monitor this closely and provide comment separately if necessary.

Why is there a variation in the funding requirement?

The decision to extend the rollout period was driven by several factors:

Clinical Capacity: The extended rollout recognises the need for sufficient clinical capacity to ensure effective training and support for both healthcare staff and patients.

Specialist Support: The complex nature of insulin pumps, glucose monitors, and HCL systems requires specialised training and support for healthcare professionals. This extended period allows for the necessary investment in the workforce to provide comprehensive guidance and assistance to patients.

Variations in Access: Variations in the provision of continuous glucose monitors and insulin pumps across different healthcare centres have been acknowledged. This phased rollout will help ensure that you have access to the same standard of technology, no matter where you live.

Healthcare Inequalities: Access to technology can impact the uptake of HCL systems. The extended rollout aims to mitigate potential healthcare inequalities and ensure that the introduction of HCL does not increase existing inequalities.

Patient Benefit: The phased rollout is not expected to adversely affect patient outcomes. The National Diabetes Audit has highlighted improvements in glycaemic control for people with type 1 diabetes, and the effective implementation of HCL systems is poised to further enhance this progress.

Targeted Implementation: The proposed extended rollout will focus  where the demand is highest, starting with children, younger adults, pregnancy, existing pump users transitioning to HCL, gradually expanding to new pump users.

Procurement Process: The current variation in procurement of diabetes technology, including insulin pumps, will be addressed through the development of a new commercial framework via a formal procurement process by NHS England. This effort aims to ensure consistent access to cost-effective prices across different healthcare providers.


Advancements in type 1 technology have enabled people with the condition to live longer, healthier lives without fear, by reducing the risks of complications including heart failure, loss of limbs, kidney failure and sight loss. The roll out of HCL presents the chance for yet another significant leap in treatment progress for type 1 diabetes, with the potential to remove some of the burden and transform the lives of hundreds of thousands of people.

Our response

Speaking about the development, Rachael Chrisp, Head of Policy and Public Affairs at JDRF, commented: “This proposed extended rollout marks a step closer in our journey towards improving the lives of people with type 1 diabetes. By advocating for improved criteria and a comprehensive phased implementation, we are ensuring that HCL technology becomes accessible to those who need it the most.”

The consultation for the extended roll out period is now underway, and stakeholders from across the healthcare spectrum are invited to provide their input before the final guidance is published. With JDRF’s continued dedication and collaboration with NICE, the future holds promising prospects for everyone living with type 1 diabetes in England and Wales.

Related news

Read more
Nina Willer, who used hybrid closed loop technology through pregnancy, and her child.
Treatment research
7 November 2023

Hybrid closed loop technology set to be made available in England and Wales

The announcement is the biggest treatment breakthrough for type 1 diabetes since the discovery of insulin.

Read more
A young guy with type 1 diabetes dealing with exam stress and taking an exam
Policy and advocacy
4 October 2023

Letter to Gillian Keegan about the use of mobile phones in schools

We’ve written a letter to Gillian Keegan MP, Secretary of State for Education, asking her to make exemptions to the Government’s policy on banning mobile phones in schools. We thought you might like to read it.

Read more
A woman standing in a park using the Omnipod 5 system for type 1 diabetes
Type 1 technology
21 June 2023

Omnipod 5 becomes the latest hybrid closed loop system available in the UK

Insulet, the company who make Omnipod® products, has announced that their Omnipod® 5 hybrid closed loop (HCL) technology is now available in the UK.

Read more
A hybrid closed loop technology sensor
Type 1 technology
27 April 2023

Abbott, Ypsomed and CamDiab team up to offer hybrid closed loop with more affordable sensor technology

Abbott has announced that its FreeStyle Libre® 3 sensor is now authorised to work with Ypsomed’s mylife™ YpsoPump and CamDiab’s CamAPS FX mobile app.

Connect with us on social