NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework. The framework sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

NHS England has welcomed the Health Services Safety Investigations Body’s report and is developing a detailed response in line with the recommendation, in discussion with other healthcare partners.

The Department is aware of supply issues with some insulin presentations. However, a variety of alternative insulin products remain available, some of which are also suitable alternatives to those affected by shortages or discontinuations. We continue to work closely with the suppliers to ensure alternative insulin products can continue to support increased demand. We have issued comprehensive management guidance to the National Health Service, including all general practitioners and community pharmacists.

The resilience of United Kingdom supply chains is a key priority, and the Department and NHS England are committed to helping to build long-term supply chain resilience for medicines. We are continually learning and seeking to further improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and strengthen our resilience. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver solutions. However, medicine shortages are a complex and global issue and everyone in the supply chain has a role to play in addressing them, and any action will require a collaborative approach. The Government is also enhancing domestic manufacturing capability alongside strengthening international partnerships to build long-term supply resilience and help ensure patients can access the medical products they need.

We are not aware of any current plans to increase domestic production of insulin specifically, but we continue to engage with the pharmaceutical industry and other stakeholders to ensure continuity of supply.

NHS England is considering the Health Services Safety Investigations Body’s report and will respond to the recommendation in the report in due course.

To reduce insulin related harm, the NHS Getting It Right First Time (GIRFT) programme published guidance in April 2025 to support trusts to establish Diabetes Safety Boards. GIRFT is also undertaking a pilot across 20 integrated care systems as part of a Community and District Nurse Insulin Programme, which works to empower community diabetes nurses and district nursing teams to support patients at home requiring insulin administration.

To further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

NHS England is considering the Health Services Safety Investigations Body’s report and will respond to the recommendation in the report in due course.

To reduce insulin related harm, the NHS Getting It Right First Time (GIRFT) programme published guidance in April 2025 to support trusts to establish Diabetes Safety Boards. GIRFT is also undertaking a pilot across 20 integrated care systems as part of a Community and District Nurse Insulin Programme, which works to empower community diabetes nurses and district nursing teams to support patients at home requiring insulin administration.

To further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

The Government is committed to ensuring that people with Type 1 Diabetes and Disordered Eating (T1DE) receive support and care which meets their needs. NHS England will continue to work closely with the National Institute for Health and Care Excellence (NICE) to understand emerging areas for consideration in national guidance and has committed to share the current T1DE pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

To reduce insulin related harm, the National Health Service’s Getting It Right First Time (GIRFT) programme published guidance in April 2025 to support trusts to establish Diabetes Safety Boards, with more information available at the following link:

https://gettingitrightfirsttime.co.uk/supporting-hospital-teams-with-safe-inpatient-diabetes-care/

GIRFT is also undertaking a pilot across 20 integrated care systems as part of a Community and District Nurse Insulin Programme which works to empower community diabetes nurses and district nursing teams to support patients at home requiring insulin administration.

To further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework. The framework sets out how services must effectively assess, plan and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

Improving the integration between community mental health services and other physical health services and meeting the holistic needs of people with severe mental health problems is a priority, as set out in the Community Mental Health Framework.

Recognising the continued need to further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, which sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

The Health Services Safety Investigation Body recently published a report Insulin: supporting safe self-administration for patients in the community with a mental health problem, which recommended that NHS England and the Department develop a strategy for improving collaboration between mental health teams and specialist diabetes services. A formal response to this recommendation will be published in May 2026.

Improving the integration between community mental health services and other physical health services and meeting the holistic needs of people with severe mental health problems is a priority, as set out in the Community Mental Health Framework.

Recognising the continued need to further support services to provide high quality personalised care for all patients needing secondary mental health services, including those with diabetes, NHS England has shared new draft guidance with systems, the Mental Health Personalised Care Framework, which sets out how services must effectively assess, plan, and manage people's care in collaboration with all relevant teams, including how they assess safety and risks of harm.

The Health Services Safety Investigation Body recently published a report Insulin: supporting safe self-administration for patients in the community with a mental health problem, which recommended that NHS England and the Department develop a strategy for improving collaboration between mental health teams and specialist diabetes services. A formal response to this recommendation will be published in May 2026.

The Department is aware of the global discontinuation of insulin porcine vials, including Hypurin Porcine Isophane, Hypurin Porcine Neutral, and Hypurin Porcine 30/70 Mix vials, by Wockhardt. We have issued comprehensive management guidance to the National Health Service, including all general practitioners (GPs) and community pharmacists, on 23 July 2025. This management guidance contains information on alternative licensed medicines including Hypurin Porcine cartridges.

Hypurin Porcine Isophane and Hypurin Porcine Neutral cartridges remain available. Following a short-term supply issue from 1 January 2026, Hypurin Porcine 30/70 Mix cartridges will be available from the week closing on 19 January 2026.

Patients and/or patient representatives should speak to their GP on the most appropriate treatment option.

Insulin pumps were recommended for certain groups of the type 1 diabetes population in 2008 via the National Institute for Health and Care Excellence’s (NICE) Technology Appraisal TA151.

The National Health Service is legally obliged to fund and resource medicines and other treatments recommended by NICE’s Technology Appraisals, and commissioners are required to meet the costs. Local integrated care board leaders should already have plans in place, and budgets identified, to meet the needs of their populations who meet the recommended eligibility criteria of TA151, in accordance with the NHS Constitution.

A national contribution is available to meet 75% of the additional costs of the requirements of NICE TA943 on hybrid closed loop (HCL) systems, as a funding variation was agreed with NICE. Insulin pumps are one of the components of HCL systems.

We are aware of supply issues with a limited number of insulin products, some of which are affected globally, including the discontinuation of Levemir pens and cartridges. We are working intensively with manufacturers of alternative insulin products to help mitigate these issues, including expediting deliveries where possible and ensuring there are sufficient volumes of alternative products to support the market during this time. We have issued communications to National Health Service healthcare professionals, providing comprehensive management guidance and information to allow them to support their patients as well as advise on alternative recommended insulin products. We are continuing to closely monitor the insulin market to ensure access to insulin for patients who need it.

The production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Medicine supply problems can occur for a number of reasons, for example due to manufacturing difficulties, regulatory problems, problems with the supply of raw materials, sudden demand spikes, or from issues which are related to the distribution of the product.

While we can’t always prevent supply issues from occurring, we have a range of well-established processes and tools to manage them when they arise, to mitigate risks to patients. These include close and regular engagement with suppliers, use of alternative strengths or forms of a medicine to allow patients to remain on the same product, expediting regulatory procedures, adding products to the restricted exports and hoarding list, and issuing NHS communications to provide management advice and information on the issue to healthcare professionals including general practitioners and pharmacists, so they can advise and support their patients.