The original conversation I had was taken in the context of Did Not Attends (DNAs). Subjectively* it seems that at my local hospital pump users are not turning up for their regular clinics. The “contract” is a proposal being mooted to force patients to turn up.
* the stats seem to be vague, so it’s probably difficult to get an objective measure of whether pump users are actually worse than other patients when other factors – such as age – are taken into consideration.