Despite NICE recommendations for pump use, which will include some people in every diabetes clinic across the UK, pump services are still patchy and lack uniformity. If you are less familiar with using pumps but wish to set up a service, there are many considerations, and the more planning you do, the easier it will be to set up the service in the way that you desire. These considerations are discussed here, and if you want more in-depth information, it can be found in our book 'Using Insulin Pumps in Diabetes'.
Firstly, deciding how your team want to approach pump therapy is important. This includes what your overall team philosophy is about using pumps (which can sometimes be difficult to agree on but helps to avoid inequality later on!), as well as what level of service will be provided by your team and when people will be referred to another service. Even if a minimal pump service is provided, clear lines of referral should be established.
Funding pathways are important and most usefully should be determined at the outset, although may change over time. Also how the service will be provided, which includes who will be involved, how people will be assessed, and how pump services will be integrated into existing services. This is particularly important if only some of the diabetes team staff deal with pumps, because those who are more experienced are, as they gain confidence, more likely to think of using a pump earlier than those who have less experience.
There are many other aspects of pump therapy that will need to be planned and agreed. These include ongoing support and access to emergency care for pump users, staff training, which pumps to use, how to provide objective information to your clinic population, what educational materials to use, what records to keep, and also, becoming more important in today's NHS, how to measure the success and effectiveness of your service. And across all of these, the thoughts, wishes and opinions of people with diabetes, both those using pumps and those not using pumps, should be sought to help you ensure your service meets their needs.