GP told off by the CCG for writing a private prescription for T3

[Suesews]

I have just come back from an appt with my GP, she told me that she could no longer let me have a private prescription for T3 and that she got a telling off from the CCG!! She tried to explain to the CCG that it meant I could purchase it from a reputable source, but was told that private prescriptions for T3 can only be issued by and Endo. I also told her about the dossier and current media coverage re T3, but said that although she was sympathetic her hands were tied.

[SlowDragon Administrator]

Then she needs to refer you to an endocrinologist

Email Dionne at Thyroid UK for list of recommended thyroid specialists, some are NHS and will/may prescribe T3

[e-mail]

[holyshedballs]

If were in your position I would make a formal complaint to the CCG advising them of the BTA's advice regarding T3 here is the link to the BTA's advicebritish-thyroid-association...

In my formal complaint I would also submit the NHS England recommendations regarding T3 england.nhs.uk/wp-content/u...

as well as forwarding the dossier regarding CCGs not following NHS and BTA recommendations.

I would request that my T3 is reinstated not as a private prescription but as a NHS prescription, in line with the guidance.

This not only affects your health but also the health of other patients.

[Hidden]

Hello Suesews

I have included a link to the Thyroid Patient Advocacy Website which has some information you may find helpful:

tpauk.com/main/article/stra...

I have also copied it here in case the link does not work:

Published on 15th November 2013 00:27 Updated 1st May 2014 Number of Views: 956

Because I could not find the definitive source within the Department of Health for the statements below on the 2 February 2013 I wrote direct to The Rt. Hon Sir Jeremy Hunt MP (Secretary of State for Health in the UK)

Please keep the DoH response safe.

Show it to your GP/Endocrinologist if they insist they cannot prescribe anything other than levothyroxine-only and/or cannot prescribe unlicenced drugs.

Show it to those doctors who state they are not allowed to follow other thyroid guidelines other than the RCP’s policy statement.

Show it to those doctors who claim they are not allowed to diagnose if blood results are within the reference range – and help further their education.

________________________

Dear Jeremy Hunt

I am founder/Chair of Thyroid Patient Advocacy (TPA) tpauk.com.

There are no official guidelines for the diagnosis and treatment of hypothyroidism or guidelines for those suffering from peripheral thyroid hormone deficiency and I wondered what the situation is for medical practitioners when all they have as guidance is a policy statement issued by the Royal College of Physicians.

Are doctors allowed to follow guidance/guidelines of their choice whoever has written them and choose guidelines even if they are from a different country? TPA has thousands of members of their Online Thyroid Support Forum many saying their doctor has told them that they are not allowed to diagnose or treat outside of the RCP policy statement. I would be grateful for a definitive answer to this question please.

Kind regards

Sheila Turner (Chair)

______________________

Dear Mrs Turner

Thank you for your email of 4 February to Jeremy Hunt about hypothyroidism treatment. I have been asked to reply.

I should explain that the Royal College of Physicians (RCP) and the British Thyroid Association (BTA) are independent of the Government. The Department of Health has no plans to ask the RCP to withdraw its clinical guidelines for the treatment of this medical condition. Nor does the Department have any plans to produce guidance on the diagnosis or treatment of hypothyroidism. UK Guidelines for the use of Thyroid Function Tests are published jointly by the Association for Clinical Biochemistry and the BTA.

Doctors are encouraged not to rely too heavily on the results of blood tests but to use their clinical knowledge and an assessment of the symptoms experienced by individual patients in making a diagnosis for thyroid treatment. Doctors are free to use whatever guidance they feel is appropriate when making a diagnosis. This includes guidance published in other countries.

I should add that under their terms of service GPs are allowed to prescribe any product including any unlicensed product or product not licensed for a particular indication that they consider to be a medicine necessary for the treatment of their patients under the NHS. This is subject to two provisos which are:

– the product is not included in Schedules 1 or 2 of the NHS General Medical Services Contracts (Prescription of Drugs etc) Regulations 2004 otherwise known as the Selected List Scheme; and

– GPs are prepared to justify any challenges to their prescribing by their primary care trust.

It is the responsibility of health professionals to decide on the most appropriate treatment for their patients. If a person has any concerns over their treatment or the drugs they are prescribed they should raise these concerns with their GP or consultant.

I hope this reply is helpful in clarifying the Departments position.

Yours sincerely

Peter Wozniak

Ministerial Correspondence and Public Enquiries

Department of Health

The Secretary of State for Health states doctors can use other thyroid hormones other than levothyroxine - only; they can prescribe unlicensed drugs; they can follow whatever guidelines they wish even if they are from another country.

Hope this helps you

Good Luck

CatPaws🐾

[helvella Administrator in reply to Hidden]

UK Guidelines for the use of Thyroid Function Tests

Those guidelines were published many years ago and have a recommendation they be reviewed after a few years. That time also passed years ago.

In my view, ANY guideline-type document must have a review date. And if it is not reviewed, the document should thereafter have zero status. (I'd understand, for example, NICE looking at it as part of their collected evidence. But not its use in a clinical context.)

I know for an absolute fact that there is a significant typo in the document which I have tried to get corrected - and can't.

[EbonyEvans]

This is a first. As it’s not a financial burden on the NHS the CCG May be wrong. Sounds like they (CCG) got the details incorrect. Did you get a reason other than above? Or did your gp not ask?