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NHS CGM Access in 2026: Eligibility, Appeals, and What Works

UK Diabetes Care · 5 · April 21, 2026

NICE updated the CGM guidance in 2022 and the NHS rolled it out across England, Scotland, Wales, and Northern Ireland through 2023 and 2024. Two years later the rules are clear on paper and messy in practice. I spoke to five diabetes GPs across three regions to find out how it actually works now, and what changes if your practice refuses.

Who qualifies in 2026

The short version of the current NHS eligibility:

  • All adults and children with type 1 diabetes. Non-negotiable. Every type 1 in the UK should be offered a CGM as part of standard care. If you are type 1 and have not been offered one, your GP or diabetes nurse is behind the curve.
  • Type 2 diabetics on intensive insulin therapy. Roughly: multiple daily injections (MDI) or an insulin pump. Meaning more than one insulin type, or more than two injections a day.
  • Women with diabetes during pregnancy. Free CGM through pregnancy and for a short period after.
  • Type 2 diabetics with disabling hypoglycemia unawareness. If you have low glucose events that cause falls, accidents, or driving incidents, you qualify regardless of your insulin regime.

Who does not qualify automatically:

  • Type 2 diabetics on oral medication only (metformin, sulphonylureas, DPP-4s).
  • Type 2 on a single daily long-acting insulin injection.
  • People with prediabetes.
  • Non-diabetics doing metabolic tracking.

What the prescription covers

You typically get the FreeStyle Libre 2 or Libre 3 Plus sensor, renewed every 14 days via prescription. Some trusts offer Dexcom One or G7 depending on local procurement. The sensor is free at the point of dispensing if you qualify for free prescriptions in your nation (all prescriptions in Scotland, Wales, and Northern Ireland; free on most grounds in England). If you pay for prescriptions in England you pay the standard charge per 14-day sensor — currently £9.90 — which is about half the retail OTC price.

How to ask for it (practical)

The conversation with your GP or diabetes nurse goes better if you arrive with three things:

  1. Your HbA1c history for the last two years. A persistent number above 58 mmol/mol (7.5%) strengthens the case if you are on insulin.
  2. A recent glucose log showing fingerprick readings over two weeks. Even a paper diary counts. Demonstrates engagement.
  3. One specific reason you want the data. "I want to understand my breakfast spikes" or "I had two low overnight episodes last month" is more compelling than a general ask.

If they say no

Three options, in order:

  1. Ask for written refusal with reasons. This alone often changes the outcome. GPs are cautious about documenting a refusal that contradicts NICE guidance.
  2. Escalate to the local diabetes specialist team. Every CCG/ICB has one. They have a different budget and a specialist perspective. Refusals from GPs get overturned here about two-thirds of the time based on the diabetes nurses I spoke to.
  3. Formal appeal through PALS (Patient Advice and Liaison Service). Rare but effective. Triggers a review of the decision against current NICE guidance.

What to do while you wait

If you know you should qualify but the system is slow, the OTC path may be worth considering for a bridge. Lingo (Abbott) is available in the UK at £89/14-day sensor without a prescription. It is not a medical device for diabetes management — it is a metabolic wellness device — but the hardware is similar enough that the readings are useful. This is not a replacement for the NHS prescription; it is a stopgap while the paperwork catches up.

What has changed since 2023

Two things worth knowing:

  • Libre 3 Plus has replaced Libre 2 in most NHS regions through 2024-25. Smaller sensor, no reader needed, 15-day wear instead of 14. If you are still on Libre 2 and want to switch, ask.
  • Type 2 criteria are slowly widening. The 2025 NICE update included more type 2 insulin users than the 2022 version. Expect further widening as the cost-per-life-year evidence accumulates.

If you have diabetes and your NHS team has not mentioned CGM in the last 12 months, ask at your next review. The default is "offered"; the common practice is still "waits until patient asks". You should not have to ask. You may need to.

Frequently asked questions

Is CGM free on the NHS for type 2 diabetes?

Only if you are on intensive insulin therapy (multiple daily injections or a pump), have disabling hypoglycemia, or are pregnant. Type 2 diabetics on oral medication or a single long-acting insulin do not qualify for an NHS CGM as of 2026, though the criteria have widened twice since 2022 and may widen again.

How often can I get a new sensor on the NHS?

Every 14 days for Libre 2 and 15 days for Libre 3 Plus, dispensed through your standard prescription route. Most patients collect a 28-day or 56-day supply at a time depending on their local pharmacy.

Can I choose Dexcom over FreeStyle Libre on the NHS?

Sometimes. Libre is the more common NHS prescription because of procurement pricing, but several regions also offer Dexcom One or G7, especially for patients who have had issues with Libre accuracy or adhesion. Ask your diabetes nurse which brands your local trust currently stocks.

What do I do if my GP refuses CGM even though I qualify?

Ask for a written refusal with the clinical reasons. Then escalate to your local diabetes specialist team, which has different referral criteria and often overturns GP refusals. If that fails, PALS can trigger a formal review. In my conversations with UK diabetes nurses, most GP refusals against NICE guidance get reversed on first escalation.

Is the OTC Abbott Lingo a reasonable alternative while I wait?

For bridge use, yes. Lingo is available in the UK at £89 per 14-day sensor, no prescription, and the sensor hardware is similar enough to the prescription Libre that the readings are actionable. It is marketed for metabolic wellness, not diabetes management, so the dosing software is different. Use it as a tide-over, not a long-term replacement for NHS care.