Rubbish -Leave liothyronine alone, Julie Woods and Simon Stevens should resign

[Airmed]

Julie Woods chief Exec NHSCC and Simon Stevens should resign on this statement alone. How dare they suggest there are more cost effective products available than liothyronine. Unless they are referring to T4 of course, which is absolutele pug wash. This article just goes to show their lack of knowledge and yet still employed within the NHS. These statements can only be made with information/data they have on Liothyronine which is hearsay and theorists accounts passed around by high ranking self serving idiots in the NHS. Maybe if the pair of them directed their huge resources and efforts into securing liothyronine from a cheaper source, close the loophole that a second company are now exploiting and remove the monopoly that Concordia now enjoy the NHS would be in a better place. Huge, huge cost savings just do the job you are paid to do simples.

"Julie Woods, chief executive of NHSCC, said the financial challenges the NHS faces at the moment are “unprecedented”.

“This is not about cutting essential services or restricting access for patients to services they need, it is about allowing local clinical leaders to make the best and most efficient use of the money CCGs have available to spend,” Ms Wood said.

Simon Stevens, chief executive of NHS England, spoke about the plans in an interview with the Daily Mail today, in which he stressed the need to tackle “inefficiency and waste” in the health service.

“There’s £114m being spent on medicines for upset tummies, haemorrhoids, travel sickness and indigestion. That’s even before you get on to the £22m-plus on gluten-free that you can also now get at Morrisons, Lidl or Tesco,” Mr Stevens told the newspaper.

RPS "surprised" at homeopathy omission

In response to the prescribing review, Royal Pharmaceutical Society English pharmacy board chair Sandra Gidley said the announcement could be “interpreted as a attack” on the principle of providing treatment free at the point of use.

“We are concerned [about] how a blanket ban of products to treat life-long conditions such as coeliac disease and chronic pain could have unintended consequences.”

However, Ms Gidley acknowledged the need for the NHS to be cost-effective.

“We are surprised that homeopathy – which has no scientific evidence – is not on the list for review," Ms Gidley added.

What could the NHS stop funding and why?

Source: NHS Clinical Commissioners

1) Low clinical effectiveness

Co-proxamol. In 2005, the Medicines and Healthcare products Regulatory Agency (MHRA) decided to withdraw the analgesic over a phased period – until the end of 2007 – to enable patients to move to suitable alternatives. However, there remains some prescribing of the imported product at an inflated price, NHSCC said.

Omega 3 and fish oils. These are licensed for elevated triglycerides, but the evidence is "weak", according to NHSCC. Nice recommends against prescribing them for primary prevention of cardiovascular events. There are additional potential savings in terms of reduced GP appointments, it added.

Lidocaine plasters. These are licensed for treatment of post-herpetic neuralgia. But there is “limited evidence”, said NHSCC, which pointed out that Nice does not recommend this product.

Rubefacients. The evidence available does not support the use of topical rubefacients (rubs and ointments) in acute or chronic musculoskeletal pain, NHSCC said. There are additional potential savings in terms of reduced GP appointments, it added.

2) More cost-effective products available

Liothyronine. This is used to treat underactive thyroid, but is costly and there is limited evidence of its effectiveness, NHSCC claimed. The vast majority of patients are controlled on the much cheaper levothyroxine, it added.

Tadalafil. An expensive alternative to sildenafil (Viagra), but with no evidence of superior effectiveness, NHSCC said. It is also licensed for treating lower urinary tract symptoms in men – but this is not recommended by Nice, except for clinical trials.

Doxazosin MR. A fourth-line drug for hypertension. The modified-release version is more expensive than the standard release, NHSCC explained.

Fentanyl. Typically used for breakthrough pain in palliative care, there is limited evidence of its superiority compared to morphine – even though it is much more expensive, NHSCC said.

3) Low priority for NHS funding

Some gluten-free foods. The range of gluten-free foods readily and inexpensively available in supermarkets is now much greater than when prescribing of the food on the NHS was introduced in the 1960s, NHSCC stressed. Many carbohydrate foods are naturally gluten-free – such as potatoes, rice and some noodles – and the cost to the NHS is greater than if bought direct by consumers, it claimed.

Travel vaccines. Only a small number of vaccines are allowed on the NHS, but many practices still prescribe them, NHSCC said."

[Hidden]

I've been thinking about this for the past few days, re why the NHS don't want us to be prescribed T3. They make a lot of noise about expense. However I think there's another part to this, and I've not seen anyone mention it (they might have and I missed it, of course!).

T3 isn't as 'simple' for a patient to take as T4. You can shove a packet of T4 at someone, tell them to take one per day for the next few weeks (and eventually, years), testing annually, 'oh you're normal', rinse and repeat, or bump it up a little and so on. It's a mindless and simple option for us hypothyroid sufferers, never mind how we feel. But, prescribe some of us T3... that is going to be a lot more time-intensive for GPs and Endos to manage. Given the short half-life of T3, and how it's usually beneficial to divide doses, watch and observe symptoms, and so on - and isn't as easy to test for, Heaven help us, TSH will be 0 in most cases! To me that screams 'this is way too much trouble for us to manage', especially given the numbers of people who are likely to require it.

I'm going to add T3 in to my Levo (conversion issues) shortly and am very motivated and am reading a lot and planning how to manage it all (whilst being aware it could take quite awhile to get sorted, and also realising even THAT might not be the right path). Now, factor in people who are very ill and probably, through no fault of their own, not as motivated and suffering brain fog etc. That's a big ask - they need a LOT of doctor support to get their dosage figured out. Right now GPs have ridiculous workloads and very limited patient-time. Imagine if so many more of us require the extra supervision and appointments required to sort out T3 dosages!

I do believe this 'time saving' factor is heavily involved in the decision to just say T4 is 'all you need', not just the 'expense'. I think the 'cost' is cited as the main 'reason' but in fact, it's all about the time and energy required by the medical profession to manage the numbers of people involved.

That's my two-penneth on the subject, anyway! But I still wish we could get T3 prescribed in the UK for a lower cost and that doctors weren't so... dismally educated.

[Marz in reply to Hidden]

I think it is even more sinister - keep everyone sick and prescribe all those other sweeties to bolster the bank balances of BIG Pharma. Most officials are on the payroll of Big Pharma and have to fall in line. GP's afraid to step outside the box for fear of losing their licence to practice - the whole thing is a b***** mess.

[greygoose in reply to Marz]

Exactly! That's the thing, we might actually get well! T3 isn't that difficult to manage, I've been taking it for years, self-treating, it's not a problem if you know what you're doing. But, of course, doctors don't know what they're doing, do they. And that's why we're having all these problems.

[Airmed in reply to Hidden]

I can only speak from my own experience now. I take T3 only. To be honest I only go once a year for a blood test and that's only because I won't get my script otherwise I wouldn't bother. Maybe I'm just lucky. Who knows we are all different.

[Clutter in reply to Hidden]

Jadzhia,

I don't buy that T3 is any more difficult to manage than T4. After thyroidectomy I was told to take 20mcg T3 x three times daily so that's what I did. I was under the care of surgeon and oncologist. My GP has never been involved in management of my thyroid or thyroid management.

[Hidden in reply to Clutter]

Perhaps it's because I'm currently reading Paul Robinson's book 'Recovering with T3' where he describes his own journey and attempts to find the best T3 dosing system. Has made me think it's a lot more complex than taking T4. But if that's the exception, not the rule, that's good to hear.

[Airmed in reply to Hidden]

Hi, I too have got his books and they were really interesting and sent me on my own research mission. I started out religiously on the circadian method he describes. Now I just take two larger doses and a third dose 8 hours apart. I often forget doses and take two together etc have had no ill effects. I know some people on this site have mentioned taking their whole dose all at once. Sadly their are few guidelines other than advice and experience we glean from others on our forum.

[Rapunzel]

Hope you've made your voice heard here, Airmed

engage.england.nhs.uk/consu...

There's a pinned post about the consultation, too.

[Airmed in reply to Rapunzel]

Heard, heard you say I'm surprised you can't hear me, I am jumping off the ceiling at the moment. I have just sent my "T3 file" to Dr Sarah Wollaston MP (excellent bed time reading😜) and have an appointment to see her on 8 September.

[Airmed in reply to Rapunzel]

yes of course. 3 replies!

[Bluecat101]

That Simon Stevens is bound to be trouble - he is American. Why on earth was He employed in OUR Nhs. Homeopathy has already been slated which works well in the right circumstances and Practitioner; dont know if He had a hand in that. After all the Royals always use it and have done for years. l suspect that Stevens will be taking any occasion to promote US Pharma! And could be in the pay of them.

[Airmed in reply to Bluecat101]

They probably need a cut and slash, sadly in the wrong departments. Should start will all NHS hangers on, departments managed by self service over paid idiots (and I've heard a few) that do not add value just divert money away from patient care. That's what I'd do with an "I'm in charge badge".

[Bluecat101]

l gather there is a lot wrong as friend was Manager in NHS and nearly driven mad! She says needs dismantling and starting again, so much is wrong. i know they pay more for bulk photocopy paper than you and l cd buy one packet up the road. Here they have closed excellent Hospital Audiology dept which l used; put it out to Scrivens who are hopeless and Specsavers not much better - all latter are concerned with is 'profit'.

Foreign speakers have taken a franchise of 'one or two branches' and staff are not native speakers. So when you have lost a hearing aid and cant hear, you then have to struggle further with talking to a foreign speaker on the phone- who l cant even hear. l complained strongly about idiot in store left to programme Aids - not knowing what she was doing and being cut short on appointment with good Audio guy. Was rung up by someone called Pedro - which my friend said she thought was the name of a donkey! And it seems you cant go back to any branch - only those owned by the franchise holder. And so on.

In US the Drug companies got on the Boards of Medical schools offering help way back - and then with bribery got rid of all the Herbal and Homeopathic Colleges, but they seem to be reviving there thank goodness

[Airmed in reply to Bluecat101]

Sorry to hear about your friend but she is right in my opinion. It is now a £100 billion white elephant. Which has been so badly mismanaged for so long that it is barely glued together. As you say wastage from general supplies right through the organisation. Sadly it doesn't matter how much more money any government chuck at a poorly managed system it will fail. My company had at leanest a 3 layer management structure that included the CEO!

Who suffers in all of this. The patients and the people who do the real work. Cause, simple, too many chiefs and not enough Indians .

[Bluecat101]

Absolutely, dont know how we get it to change.My friend has retired now. Do you remember there was that guy was his name Geoffrey Robinson - sent in some years ago on TV to make change. l think he gave up, but normally cd do most things