Here's the Proof your GP can prescribe T3, NDT,... - Thyroid UK

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Here's the Proof your GP can prescribe T3, NDT, Whiskey...

juliat profile image
11 Replies

 For anyone being told by their GP " I'm not allowed to prescribe......"

Read and print this off and slam it on their desk ( well not actually! but you know what I mean!)

    "Any medicinal product not in the ‘Blacklist’ can be prescribed on the NHS. For example, whisky is not on the blacklist, so a prescription for this item would be passed for payment by NHS Prescription Services. The prescriber may however be questioned by their CCG about the appropriateness of prescribing this item at NHS expense.

    likewise a doctor cannot prescribe an item that appears in Part XVIIIA of the Drug Tariff"

    psnc.org.uk/dispensing-supp...

    here is Part XV111A Liothyronnine and NDT are not there.

    drugtariff.nhsbsa.nhs.uk/#/... XVIIIA Products K-L

    the following link I think covers prescriptions on a named basis

    nhsbsa.nhs.uk/PrescriptionS...

    "A doctor cannot prescribe an item that appears in Part XVIIIA of the Drug Tariff and will also be in breach of their 'Terms of Service'. Contractors may, however, be able to dispense a Schedule 1item if the doctor has ordered it by an "approved name" i.e. a generic item with a monograph in a recognised formulary (BP, BAN etc) so long as the "approved name" is not included in Part XVIIIA."

    A Doctor has a legal duty to care for his patients and they can be held accountable in law if they do not. Nowhere can I find any legislation that takes away this sacrosanct right. in fact it is re-iterated on numerous occassions. EVEN in a CCG refussal of Individual Funding Application letter.

    You cannot give a doctor the right to precribe as he sees fit for the good of his patient and hold him accountable in Law and then force restrictions on him that makes it impossible for him to do just that.

    Here is an excert from a CCG refussal letter

    "The complainant was given assurance that as with any drug, doctors in (county) retain their clinical freedom. Where the CCG does not consider the specialist recommendation to be a cost effective use of NHS resources then the CCG would not normally support the commissioning of the drug and the doctors would be supported in making a different prescribing choice ( there is no other choice for our sub-group) to the specialist recommendation.

    (county) CCG is fully supportive of doctors addressing clinical need ...."no guidance was given to cease treatment." and they stated they 'expected' endos to convert patients over to T4

    As far as I'm concerned they can expect away till the cows come home.

    Their fancy 'traffic light' colouring system is all smoke and mirrors, don't take what they say as fact.

 

Juliat    

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11 Replies
helvella profile image
helvellaAdministratorThyroid UK

There have been a few posts over the years which point this out. For example:

healthunlocked.com/thyroidu...

I know I have posted about it but the search mechanism can be so cranky it is almost impossible to find some things.

juliat profile image
juliat in reply to helvella

thanks xx

dolphin5 profile image
dolphin5

At my GP surgery, T3 is "grey-listed", but the doctors interpret this to mean, that "in effect, it is black-listed".  They are obviously not prepared to take any risks - or responsibility.  They would rather I take the risk and order from goodness knows where, online, at absolutely no risk to them, and of course at no cost to the NHS.

Life is obviously pretty straightforward for GPs and thyroid treatment - just follow the very simple protocol, and leave it at that.  The rest is entirely up to the patients, and whatever goes on in their heads.  Then move on to the next patient ...........

juliat profile image
juliat in reply to dolphin5

Hi dolphin5

What they say is 'in effect' nonsense.

The question you need to answer is...WHAT YOU GONNA DO ABOUT IT?

You write like it's a done deal! and you are just a victim.....

It ain't gonna change unless we as individuals decide to act.

The Black List is from NHS ( not CCG) Docs Cannot prescribe whats on here - fair enough, long as I can still get my whiskey ;-)

The 'Traffic light drugs list' - Red, Amber, Green is from CCG formularly it is 'guidance' which they 'expect' GP's and Endos to comply with. MANY DO NOT WANT TO as they know it will harm patients but 'feel' their hands are tied.

We need to

EMPATHISE with them about that - BUT TELL THEM YOU DO NOT ACCEPT IT

EDUCATE THEM about T3, NDT and flag up the hard to treat hypo Thyroid patients that need more than T4 and the options available. ( well covered in BTA 2015 statement on treating primary hypothyroidism)

HAMMER HOME the huge potential cost to the NHS and to the COUNTRY of tests, treatment and disability benefits which will undoubtable occur from people returning to or NOT RECOVERING FROM Hypo Thyroid without the appropriate treatment FOR THEM. Not to mention the personal suffering of patients and their families...and depression etc

REMIND THEM that they have a responsibility in law to care for our clinical needs

REASSURE THEM that they can take the responsibility for treatment ( with an endo or even without one ).....

BEACAUSE WE can be told about any supposed potential 'risks' and accept that risk for ourselves ( section 12 BTA 2015 statement on treating primary hypothyroidism)

HOLD THEM ACCOUNTABLE FOR OUR PRIMARY CARE

Be helpful and nice about it :-)

IF WE KEEP ROLLING OVER IT WILL COMPOUND THE SITUATION.

IF ENOUGH GP'S STAND UP TO THE CCG'S BECAUSE THEY WANT TO SLEEP AT NIGHT AND DO A DECENT JOB AND BECAUSE THEY DON'T WANT TO BE SUED - IT WILL MAKE A DIFFERENCE.

Let me know what you decide

kind regards

Juliat

juliat profile image
juliat

Hi dolphin5

What they say is 'in effect' nonsense.

The question you need to answer is...WHAT YOU GONNA DO ABOUT IT?

You write like it's a done deal! and you are just a victim.....

It ain't gonna change unless we as individuals decide to act.

The Black List is from NHS ( not CCG) Docs Cannot prescribe whats on here - fair enough, long as I can still get my whiskey ;-)

The 'Traffic light drugs list' - Red, Amber, Green is from CCG formularly it is 'guidance' which they 'expect' GP's and Endos to comply with. MANY DO NOT WANT TO as they know it will harm patients but 'feel' their hands are tied.

We need to

EMPATHISE with them about that - BUT TELL THEM YOU DO NOT ACCEPT IT

EDUCATE THEM about T3, NDT and flag up the hard to treat hypo Thyroid patients that need more than T4 and the options available. ( well covered in BTA 2015 statement on treating primary hypothyroidism)

HAMMER HOME the huge potential cost to the NHS and to the COUNTRY of tests, treatment and disability benefits which will undoubtable occur from people returning to or NOT RECOVERING FROM Hypo Thyroid without the appropriate treatment FOR THEM. Not to mention the personal suffering of patients and their families...and depression etc

REMIND THEM that they have a responsibility in law to care for our clinical needs

REASSURE THEM that they can take the responsibility for treatment ( with an endo or even without one ).....

BEACAUSE WE can be told about any supposed potential 'risks' and accept that risk for ourselves ( section 12 BTA 2015 statement on treating primary hypothyroidism)

HOLD THEM ACCOUNTABLE FOR OUR PRIMARY CARE

Be helpful and nice about it :-)

IF WE KEEP ROLLING OVER IT WILL COMPOUND THE SITUATION.

IF ENOUGH GP'S STAND UP TO THE CCG'S BECAUSE THEY WANT TO SLEEP AT NIGHT AND DO A DECENT JOB AND BECAUSE THEY DON'T WANT TO BE SUED - IT WILL MAKE A DIFFERENCE.

Let me know what you decide

kind regards

Juliat

greygoose profile image
greygoose in reply to juliat

Juliat, Dolphin5 may not see that response because you didn't slick on the reply button at the bottom of her post. :)

juliat profile image
juliat in reply to greygoose

Thanks! I did not know that! doh

dolphin5 profile image
dolphin5 in reply to juliat

Phew!!!!! I didn't expect all of that!

I've been through 3 years of discussion and battles with a series of GPs and one endocrinologist, and I take every opportunity to educate them. I will also continue to do this for as long as it takes to see a difference.

My endocrinologist is receptive and learning, and I finally have a GP who is very pleasantly accepting of the things I tell him, so I'm making progress.

Are you?

juliat profile image
juliat in reply to dolphin5

Hiya

Sounds like you going great guns, well done x

Yep we're Ok thanks. Just got GP to re-instate T3 on our prescriptions after they were knocked off because of CCg nonsense.

No offence meant x

Juliat

Julesb02 profile image
Julesb02 in reply to juliat

What is BTA 2015 statement please? Looking for evidence for my Dr to be treated properly! Thank you, Julesb02

juliat profile image
juliat

First link is original 2015 British Thyroid Paper ( very usefu;l stuff)

second link is a supplementary guidelines. (even more helpful)

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

For more bits of info I've posted that may help you click on my 'image' and wade through

all the best

Juliat

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