It is certainly possible where I live to get NDT from a nearby NHS hospital ( the Royal Liverpool ) if you complain to your GP long and hard enough and therefore are issued with a referral. A consultant there, who is surprisingly NOT an endocrinologist, has been given the authority to issue hypothyroid patients who are referred to her with NDT on a PRIVATE prescription. The cost is, however, considerably more than sourcing a similar product from abroad (eg Thyroid-S) when you take into account the smaller quantities involved, the pharmacy's charges and the premium cost of Armour.
I suspect this responsibility has been set up to fob off consistent complainers like myself, and to a non-endocrinologist as my local CCG insists that NDT can only be supplied on an NHS prescription on the advice of a genuine endocrinologist.
Liothyronine was a legal "drug" for many years for the treatment of hypothyroidism but some CCG's insist that it has been withdrawn purely due to cost even to existing patients when that contradicts the rules set out by the appropriate medical body. On the basis of the above situation re NDT, I can see no logical reason why the patient cannot therefore insist that liothyronine be supplied on a private prescription. The cost involved would be significant, but the supply would be guaranteed.
I can take this even further by stating that one reason NDT is not licensed is that it has not been subject to appropriate modern trials. The West Lancashire CCG states that liothyronine has also not been subject to similar appropriate trials. The MHRA has stated this to me: "For the following licenses [Activis, Teva and Mercury] we have searched our records (including our archived paper
records) for the details of clinical studies submitted with the applications, however we have been unable to obtain this information."
To achieve consistency and credibility it is therefore logical to either remove this rule for NDT and Liothyronine or BAN Levothyroxine for the very same reason unless the results of the appropriate trials are supplied to the public. Many people have strong beliefs that this evidence does not actually exist even though the NHS's Special Pharmacy Service (SPS) in its November 2018 statement regarding the use of NDT state that numerous medical bodies " recommend that synthetic levothyroxine (tetra-iodothyronine, or T4) monotherapy is the standard treatment for hypothyroidism, due to the robust evidence supporting its use."
If appropriate action is not taken by the NHS, logically to remove this rule for NDT and liothyronine, they really are hypocrites.