Letter template to CCG regarding T3

[Airmed]

Below is a letter template I have copied from a Facebook posting by Kitti Voltair

CONTACT YOUR CCG

Have your CCG withdrawn your T3 already ?

Concerned about the way CCG are riding rough shot over doctors before the consultation has finished ?

Please use our template letter to take your CCG to task.

Since this document was created, it has come to our attention to request this information under the freedom of information act. It means you will get a reply in 20 days max

​​​​​​​​​​Address

Date

Dear ...

I am writing regarding your current position on the prescribing Liothyronine.

I request a copy of the Health Impact Assessment of the proposed changes and the Equality Impact Assessment.

Please answer the following questions for me.

1. What process did you go through to consult patients, and the public in this matter? Specifically, were patients taking liothyronine consulted about the proposed local changes to prescribing policy? If not, why not?

2. Why are you going through your process when there is a consultation by NHS England, that is still ongoing?

3. How much is this local process costing and is it a good use of NHS resources at a time when the NHS is in a difficult position financially ?

4. What will you do if the consultation process reaches different conclusions and recommendations to the local process? Will you carry on with your local process or will you comply with the recommendations?

5. Have other CCG’s & The NHS England taken steps to procure cheaper supplies of liothyronine?

6. Are you aware of the BTA stance on this issue? -

“The BTA Executive Committee have been made aware of recent difficulties encountered by patients in obtaining Liothyronine (L-T3). In some instances, patients who have long been established on L-T3 have had their treatment abruptly withdrawn and some clinicians have received requests from local health authorities to switch patients from L-T3 to levothyroxine (L-T4). We are concerned that these actions are driven by cost considerations rather than clinical need and that the BTA position statement on the management of hypothyroidism is being inappropriately cited to support this requests. The BTA does not support the sudden withdrawal of L-T3 therapy and this practice does not in any way reflect our position statement.

For patients who are established on L-T3 and are considered to be stable, a change to L-T4 monotherapy should not be implemented without discussion with the patient. In such cases change of treatment may result in significant instability of thyroid status and potentially undesirable clinical outcomes, which may prove more costly than continuation with L-T3 therapy.

For patients with hypothyroidism who are not on L-T3 but wish to be treated with LT3, the principles in decision-making should follow those outlined in the BTA statement and in line with the best principles of good medical practice [3]. Combination treatments of L-T3 and L-T4 should only be initiated and supervised by accredited endocrinologists [3]”

british-thyroid-association...

By going against these recommendations you are violating recommended medical practice.

Whilst changes to prescribing policies for over the counter medicines may be popular with some doctors. May I point out that does not change the fact that you do not have the legal power to limit prescribing by GP or endocrinologists ,and that this power lies with the Department of Health.

gponline.com/gpc-warning-ig...

In addition to this I would also copy to your MP and Jeremy Hunt.

In fact I am going to copy this to my MP, Dr Wollaston as part of my bundle in preparation for our meeting

I look forward to your reply

[shaws Administrator]

It is a good letter but I think we could individualise it slightly, so they don't think we've just copied and pasted an original.

I have read that a face-to-face appointment with your GP may be better than a letter. If there are several people in your area, you could all go to the one appointment and place your concerns before him/her.

[shaws Administrator]

I have just read TUK's Summer issue of Harmony - the quarterly magazine that keeps us up-to-date with what's going on.

The page is No.12 and is headed 'Thyroid UK T3 Campaign so even if we were unaware of it, things are going on behind scenes.

It is suggested in this that we actually visit GPs as many MPs as we can throughout the country. Not just in one area.

Patients who have written to their MPs are just receiving more or less a word for word reply with no action being taken.

It would be worth becoming a member of TUK as the 'more' members the stronger voice we have. £20 per year for four quarterly magazines and updates on what is happening/going on/ is great value.

Also in September is the Conference:

thyroiduk.org.uk/tuk/member...

[Clutter]

Airmed,

A member of the ITT Campaign has been advised by NHS England that the decision to withdraw Liothyronine has already been made.

I emailed NHS England asking for confirmation that Liothyronine has been withdrawn during the consultation and was referred to my local CCG. I have emailed back:

Your reply referring me to my local CCG does not answer my questions.

My local CCG did not initiate the consultation and will not be able

to answer questions about NHS England actions and decisions.

Please refer to the questions in my email which your reply does not address.

1. Is the consultation still open to 21st October?

2. Has NHS England decided to deprescribe Liothyronine?

3. What date was the decision to deprescribe made?

4. When will deprescribing Liothyronine become effective?

5. How can patients and clinicians appeal a blanket ban?

Yours sincerely,

[Airmed in reply to Clutter]

$€$€€€>^**+ lots of swearing. Should I do the same. Very disappointing if correct.

[Clutter in reply to Airmed]

Airmed,

I've seen the email sent to the ITT member and Kitti followed up with a phone call which confirmed the email was correct.

If I don't get a proper answer to my email I'll make a FOI request.

[Airmed in reply to Clutter]

What does FOI mean

[Clutter in reply to Airmed]

Freedom of Information. Public bodies are obliged to respond within 20 days of receiving a request.