hi everyone I am looking for some advice please. Since the issue with my GP refusing to prescribe my T3 , my GP then referred me to my consultant on the NHS via Guys & St Thomas’s and I saw the endocrine team there who agreed I am stable on t3 and instructed my GP to continue the T3. The GP is still refusing for prescribe it they have said they can not prescribe it even though it is in black and what from the NHS Guys and St Thomas endocrine team is instructing them to continue it. They have said there is no shared care agreement in place and will no do it. I have spoke with the consultants in the NHS Team who have spoke with the pharmaceutical team and said No shared care need a to be in place they need to issue it. I have spoke to my GP prescribing team and told him I am being cared for by them not you, you have it in black and white that you are to continue the t3. The consultant is writing another letter instructing them to continue again. What more can I do I can not afford the cost of this medication! I’m so upset I don’t know what else or more I can do. Thanks so much everyone
GP refusing to prescribe T3: hi everyone I am... - Thyroid UK
GP refusing to prescribe T3
There is a requirement for a shared care agreement but it isn’t always followed up.
The Endocrine team have dx you as being in need of T3 but your GP wants to know who is accepting responsibility for your welfare on T3.
This isn’t always put in writing but some GPs feel they need it. Others just use the issue as an excuse for not prescribing.
When you read info in link below you can see why it’s needed
england.nhs.uk/wp-content/u...
Oh really is it a legal requirement or are they being hard work because the letter states I am stable and to continue the meds. Etc ! Ah it’s so exhausting this has been going on since 1 august when they got their letter and the whole process 10months
I believe that in London its notoriously difficult to get T3 prescribed on the NHS as the ICB's deter it. I'm sorry and I hope you can find a way forward very soon.
Thank you 🙏 what exactly is a shared care agreement is it simply a letter?
This would appear to be the shared care agreement. Ask if your Endo will sign it.
eastkentformulary.nhs.uk/me...
Oh wow thank u so much I will forward it to him . Thank you so much 😊
I think your GP needs to forward it - and not the East Kent one 🙈
Just ask your Endo team to sort it with your GP
ok thank you so much. So I can ask the GP to forward to shared agreement form to them honestly the hospital and the GP literally like talking to a brick wall, I said to them I’m sorry but it’s not for me to do your job it’s been nearly 2 months now trying to sort it and I ask them what is a share care and what needs to be done and they all reply Indont know 😂😂🫣 honestly it’s rediculous. But at least I know now that this needs to be done and it’s a simple form .
Your GP has to agree to it. (Hence ‘shared’ care). Read whole doc
So in essence does this mean GPs can veto any medicines prescribed by a hospital if they so choose?
And if so on what - medical - grounds?
In Britain, a GP can refuse a shared care agreement, but they should indicate refusal in 14 days by writing to the consultant. The consultant must take full responsibility for prescribing and any necessary monitoring. GPs are not legally obliged to take on shared care. The GMC has a lot of information about the obligation the refusing physician has to make sure someone is responsible for the patient’s ongoing care and monitoring. Any misbehaviour should be reported to both the GMC and your local PALS/PILS if not to outside advocates for the protection of others who should not experience the same bungling.
Thank you.
This kind of “heads you lose, tails you lose” interface between doctor and consultant is really dangerous for the patient. Only those who are born with a miniature microphone in their hand will be able to get over this hurdle - when GPs choose to put it up.
I hadn’t realised they could do this even when doing so means overruling someone medical with much more specialist knowledge than they.
which ICB area are you in
(use to be called CCG areas)
How much T3 and which brand are you taking
Over 63,000 prescriptions in England in last year
Search by ICB area
openprescribing.net/analyse...
Your GP is being especially obtuse
Hi slow dragon I think I am classed as Medway and Kent . They are being extremely awkward I said to them so when I’m unwell because ur refusing to give me the medication I am going to hold you liable ! Because u have it in black and what in the letter stating the patient is stable in her current medication 100mcg Levothyroxine and 10mcg twice a day if Liothyronine, please continue both Liothyronine and Levothyroxine medications. It’s so annoying because the team in Guys and St Thomas have said they are being awkward they have checked with there team and shared care is not necessary 😭😭😭.
I’m afraid it is. Someone has to take responsibility for your welfare when on T3. Your Endo has stated that it should be prescribed but he is not prescribing it. In law the prescriber takes responsibility
It’s the prescriber who takes legal responsibility. This is why the Shared Care Agreement is necessary. Your Endo and GP share responsibility in law.
Not really SD. Pedantic maybe. Obtuse no.
See link I gave to OP.
I thought as both parties endo team and GP are both NHS , ? in same ICB a shared care was not needed. I know I had to get one for Methylphenidate because I couldn't wait for NHS appointment with ADHD team and went private , so understood the need then.
They’re needed in both scenarios
I believe a shared care agreement is needed between Endo and GP, assuming the GP will be happy to prescribe if it is in place as the GP could still refuse I think. It’s their prerogative to both take and not to take responsibility.
I think you may have to find a way to source it until this is sorted.
Ah thank you, ok I will pressure them tomorrow. it’s actually disgusting how they treat patients with No thyroid. I can’t believe there isn’t a movement for this medication. 😭😭😭
I agree. I have no thyroid. Sadly you can’t beat the system. It’s only difficult if you have a stubborn GP
Yeah it’s not fair is it!! Mind boggling lol I even said to the GP 😂😂 you a very educated person it’s simple science the endocrine system, you are very educated and you know how the endocrine system works I have no Thyroid so I have no T3 it’s very simple and someone so educated I know u understand that 😂😂🙄
Never credit a doctor with knowing how the endocrine system works. Their ignorance is mind blowing!
Hi sorry to but in on this conversation but if you not got a thyroid are you saying we need T3 ? Besides our thyroxine?
Most people without thyroids do not do well on Levothyroxine monotherapy. Some do. However many of us fail without T3 and unfortunately it’s usually only after a long time that the need for T3 alongside Levothyroxine is identified
Exactly
“Shared care arrangements should be agreed and authorised by the local commissioner”
Is this 'shared care agreement ' specific to T3 prescriptions? Or other medicines?
I too am under G & T for a separate condition and was wondering if I could leverage it to get T3 prescribed via consultant at the same hospital, as my condition is aggravated by fluctuating thyroid hormone levels (it would be stretching it to be honest) But sounds like a lot of faff and bother in any case, or maybe your GP is just extremely rubber-necked?
But it IS good to know that they have reasonable endocrinology consultants at G&T.
Very interesting.
I have same issue since last year. The shared care agreement can be refused by your gp.
So my endo writes to gp with shared care agreement. I ask the gp for my prescription. It takes a month of me phoning to be refused. I go back to endo who sends me a 3 month script. Two months pass, I start phoning the surgery. A month later they refuse. I get another script from endo and so it goes on.
I’m coming up to my 4th attempt. Last time they said they were negotiating 🤷♀️. Wtaf? It’s truly pathetic.
I don’t use my prescription because the chemists fail to issue with any continuity of brands so I only keep it up to ensure that they have to deal with it and not give up on yet another thyroid sufferer.
I wish you the best of luck getting yours sorted. I’d rather deal with AI at primary care level. I haven’t met one that is fit to call themselves a medical professional. As for being triaged by a receptionist….!
Being triaged by reception staff seems to be a growing trend. Whether I fill in the online triage form or phone the surgery, the reception decides whether or not I’ll get an appt to see a doctor.
I can’t believe it’s happening 🙈
Your surgery has a computer and online forms…. WOW. This is a revelation , my surgery is still using leeches and quills. Can you tell I’m disillusioned. No f2f appointments, locum says cancer to me on the phone! Seven months later I’m waiting for abdominal scan but after research suspect Hashimoto Disease. I have another chronic AI condition of rheumatic type but last year became unwell and the posts here a godsend. Rant over.
Don’t be deceived by the online forms and the technology. They just make it easier for the practice to tell you to ‘go away’.
This reminds me of going to the doctors when I was a child (many moons ago!) when you turned up at the surgery, no appointments then, and had to get past the “dragon receptionist “ before being allowed to take a seat and wait to be called in to see the Doctor. The NHS is going backwards 🤬
I too do not have a thyroid, got tired of fighting. I see a private endocrinologist who prescribes T3. The last time the GP was refusing to prescribe t4 as he believes I am over medicated based on my TSH after a week on the lower dose I became so unwell. I alway get the blood test via the GP. I just call and say I am unwell and would like to have a blood test. So far this has been working. The good thing my GP always tests t3. Best of luck
Go to your Ombudsman's office ask for advice there, They will most likely tell you to complain to the GP Practice, my advice is go to the ombudsman first then take a friend as a witness, or call them and record them.
The problem is that the GP is just following the protocols. He might have his own prejudices and he might be an annoying old fart - but the fact remains that a) a shared agreement has to be in place and b) there is a section on the Shared Agreement Form where the GP can refuse.
Often, changing GP is the only option
Change your GP lovely. Period. The idiot is more concerned about his Surgeries budget, although they will never share this
Shared care, ICB, all red herrings….. make a formal complaint about FAILURE TO PROVIDE CONCORDANT PATIENT CENTRED CARE which you are entitled to under NHS charter etc. (you may have to make this complaint via local PALS for the Trust/ICB in the first instance) - then escalate to Ombudsman Office if response is unsatisfactory, also write to your GP practice manager in formal complaint mode telling them what you will do to follow the complaint through and asking them to specifically state the clinical reason for not prescribing).
Collect the evidence you need T3! Refer to it in your complaint. This would ideally include the Clinic Letter from the endocrinologist plus all blood tests showing TSH T4 &T3 each time together with symptom diary. If your fT3 is middle or upper lab range on T4 only you will be hard pressed to make your case UNLESS fT4 is in upper or over lab range, which is a known risk factor for additional cardiomyopathy (atrial fibrillation etc and should be avoided) and reducing higher range fT4 may only be possible WITH T3 replacement to avoid symptomatic hypothyroidism, whether your TSH/T4 is in lab range or not! Remember to stress that the LAB RANGE is too wide to indicate your personal healthy T4 T3 TSH levels and that all three MUST be considered together (with symptoms) and that NORMAL EUTHYROID levels are: TSH around 1-1.5 fT4 around 15 fT3 around 4.5. You may be different but that is a reasonable starting point together with symptom assessment. Also the argument that you need more than 5-10 mcg fT3 could be tricky since the healthy thyroid doesn’t give more than that!
Another strategy could be to consider buying T3 privately if you can for a while and supplementing your T4 with 5-10 mcg if this is within the dose advised by the endocrinologist - then monitor your bloods and symptoms to prove the effectiveness ?
Re your last paragraph - the endo will have done all this.
Re the convoluted process of complaining about failing to provide concordant patient care - the GP has final say and the process itself is very long winded and designed to dissuade patients from pursuing
PALS? You must be joking! The sooner patients realise that PALS exists only to swiftly dispose of complaints - by referring them back to the source of the complaint -the better. In spite of the clever acronym, PALS are not your friends.
well the complaint system works for me. And do you know for sure that her endocrinologist has covered all those bases? my endocrinology dept absolutely rubbish and their prescriptions way off; it's sometimes much easier to kick the GP into shape by providing the evidence in a patient centred approach. these people exist to serve us we are not just grist to their mill.
I’m glad everything has worked out for you.
‘Kicking a GP into shape’ is frequently counterproductive. The OP gives full information about her situation. Have you followed the discussion about ‘shared agreements’?
Sorry to inform you that the NHS Charter died a slow death owing to lack of interest and passed away 10 years ago. It was replaced by the NHS Constitution for England and is annually updated. It is non enforceable legislatively
I’ve just read the version updated 2023 with tears in my eyes. I haven’t read such a touching work of fiction since Lassie
gov.uk/government/publicati...
NB. The Handbook referred to in the constitution is separate document (downloadable). Below
Agree with you about that ( pals )
My niece was stepped down from ward work when she was ill and given a temporary desk job with PALS. She said that she spent all day sending emails to the ‘subject’ of complaints and copy/pasting replies into return emails to complainants. 🙈
I put a complaint in to them , I thought it a waste of time, when consultant just stopped my t3 no tapering down just stopped it told me to go back on thyroid dose I had been on , that was because gp weren’t going to prescribe, well that’s what I think anyway,
Hi, I’ve had a similar issue . Was taking T3 for years and suddenly my GP refused to prescribe any longer ( no amount of trying/ persuading would change their mind) Even refused Endo appointments at local hospital . Anyway very long story short I was told about Roseway Labs , contacted them , they needed proof paperwork from medical records etc. Telephone consultation, and I now have T3 on private prescription & not very expensive at all .
That's interesting I thought you need a private prescription to get it from roseway Labs do you mind IM me some details and do they do free from with little fillers ?
Roseway have a GP now who can prescribe privately. Its £30 for a consultation and prescription over the phone and Roseway will then dispense the medication and you pay for that as well. I get my LDN from them. They can prescribe NDT and T3. I've found them to be very good.
That's interesting I emailed them a while ago but they said you had to have a private prescription I will try again and see. I need a free from brand of T3 or NDT so I wonder what suppliers they use and if they can locate. How many months can you get on 1 prescription? What's LDN
I've never used them for thyroid, I think one of our other members does. I use LDN or low dose Naltrexone to help with Fibromyalgia symptoms such as pain, fatigue etc. I get 3 months worth on 1 prescription.
I know they offer Armour and Erfa NDT. The prescriber only works Wednesday afternoons and you can book online on the website. If you're seeking NDT or T3 they will need recent thyroid blood tests and you will need to submit a form they provide with your medical history.
Maybe start a new post about Roseway asking members for their experiences as this one is a little buried.
The actually quantities of "fillers" in all liothyronine tablets are very similar.
Basically, the entire tablet is excipients with the tiniest amount of active pharmaceutical ingredient. Approximating one single crystal of ordinary sugar.
However, I think Roseway can compound capsules with one of a small range of excipients. But that will cost more than tablets.
I get my T3 compounded by Roseway via a private prescription. Surprisingly, it works out much cheaper than any tablets I’ve been prescribed and with just one filler. It was Regenallotment who gave me the heads up that they have a Prescribing Pharmacist who can help you with a prescription after a consultation and necessary proof of your need for T3.
There are times I am very glad to be wrong!
Even if it had been the same price, that would have been more or less acceptable.
Can they do "odd" dosages like, say, 15 or 30 micrograms?
Yes I should think unusual quantities would be their bag. They offered to do me 2.5mcg but it was double the price of 5mcg. So maybe some additional cost for non standard. I pay £75 for 3 months supply at 5mcg and the prescriber endorses my splitting and making this last 6 months at 2.5mcg.
Do you take T3 and another supplement aswell?
Hey Merlio18 after a spell of over replacement or Hashi flare symptoms and over range blood tests I’m down to 75mcg Levo and 2.5mcg T3. That tiny T3 dose makes all the difference to my ability to function and work full time. But I will continue to monitor and may need to drop again or raise depending upon symptoms and future test results. 🌱
That's interesting that's probably the dose what I would function on too, I just stated having reactions to levothyroxine do they sell that to with reduced fillers? I am going to see what the endo comes back with as they should source the alternative really I was on 50 levo and 5 T3 and now I am just started taking an NDT again and taking some left 5 t3s I had to see how I get on how did you know your symptoms where hashimotos flare up?
As I never feel well Iam dragging myself though a 40hr shift week like a zombie with loads of symptoms still and the T3 doesn't make much of a difference just helps me a little but then I do have Lyme's positive/ fibromyalgia symptoms aswell so looking to start a good multivitamin again to boost my iron and d levels as might be that as there never optimal and see if my stomach can tolerate it as I get bad stomach too so hard to judge what I can take, roseway Labs sounds a good option to source the T3 tho! Glad you have found the right balance
Yes, they can do any amount you need, or, at least, the previous compounding company I used did 17.5 mcg T3 for me. The company I used then was PCCA “Customised4U” but the T3 was twice the price (not just the 17.5 mcg but all strengths). I haven’t tried any of the other compounding companies. It takes a lot of patience dealing with these companies but persistence pays off in the end 😁
That's good to new I will look into it. What do you have to send as proof ?
Roseway email you a form to fill in when you book a call appointment with them. The form includes lots of background info and they ask for recent blood test results. On the call you talk through your symptoms and what you want to try out and they discuss what they think would work based on their vast experience supporting many many thyroid patients with varying complications. They prescribe what is agreed by email with a payment link, you pay and the prescription arrives in the post. They ask for follow up blood test results at 3 months (you do this privately) and they issue a repeat if all is well, or as I did last time pay for another call if you aren’t sure. They also kindly wrote to my ago to explain what I’m being prescribed privately and why. GP was fine with this. 🌱
I know a nurse practitioner who said that she and colleagues (I think doctors included) used to be able to pick up the phone and call consultants, but now can’t. I wonder if anyone knows why this is?
I find that the relationship between GP and hospital is weaker than ever.
Sounds as if, though a frustrating journey to be on, you are nearly there. You have the answers and now need to push the GP over the last hurdle.
It could mean calling them every day / every other day, it might mean an email to the person in the practice who deals with complaints (and compliments) - but others here have all given excellent advice.
Hi - the situation is the same for me in the Midlands - GPs say they cannot prescribe.
Luckily, my Endocrinologist prescribes for me and issues me with a 3 month supply 4 times a year. Endo’s secretary sends me blood test forms twice a year, which I have done at local hospital, followed by a telephone consultation.
Could you ask Endo to prescribe until an agreement with GP is established at least?
Your GP should be prescribing it as you’re under the care (regardeless) of the Endocrine consultant. You’re stable on the T3 BECAUSE you are requiring it.
You’ve had some good reposes so far, follow those up.
If you’re not happy, you’re entitled to seek care from another GP. A letter to the practice of complaint wouldn’t go amiss either.
Endocrine is a specialist area, that of which GPs do not have in-depth knowledge.
I’ve had a similar fight and pushed to even get my GP to refer me to Endocrine. They now take charge of my thyroid management as GP mismanaged.
Hope you get somewhere soon.
I can remember a time not too long ago when it was standard practice for GPs to refuse to prescribe any drug which had been prescribed / recommended by a private practitioner.
The view was that if the non NHS consultant thought it was necessary, he could prescribe it. All very puerile
I live in Greater Manchester and my gp can't perscribe it. I have my perscriptions sent from Christies as I'm under their care. I also had lots of trouble getting the same brand medication as I seem to react when brands are changed, so Christies do that for me as well.Ask if the hospital can do your perscription
Hi I av been in the same situation. I av been waiting since April for a prescription but actually mine is from the hospital because I want a free from brand and no one had been in touch every time I have rang but previously they sourced it for me so I have a little bit stocked up I am taking with supplements.
It's the prescribers responsibility the hospital should be the one that is giving you a prescription not the GP I am afraid there just trying to look good saying they will prescribe it for you but really there not taking any ownership it's easy to just write in a letter they will prescribe so unfortunately you need to go back to the hospital and get them to write the prescription. GPS have no info on t3 and don't feel confident prescribing it anymore since it changed in 2018/2019 and they black listed it. That's why they will not agree to prescribing it as they have not had the consultation with you it should be the hospital that agrees and takes over prescribing. I have been in exactly the same situation as you for years now and paid for private for NDT untill the brand's stopped supplying it and it became to expensive and its very distressing but don't loose hope. T3 is not the only option but you need to battle this out with the hospital they probably don't want the cost of it coming out of there pot. Alternatively ask to be referred to another area that's what I did to get another appointment with another hospital as another consultant might take responsibility and agree to prescribe it my issue is I want a free from brand and first time the head of pharmacy got involved and sourced it and now I have no idea where my prescription is but no one has bothered to contact me since April, the GP doesn't take responsibility and the hospital don't reply or take responsibility so I have just managed on what I could source online as it's to much stress chasing it up and no one is taking any responsibility for my care and lots of other people like yourself are in a similar situation its an awful service by the NHS unfortunately.
GPs are getting increasingly frustrated about the workload and costs being offloaded on to them by acute hospitals - not just thyroid but many other meds - some expensive ones. And because T3 is more expensive the GPs are then being penalised for exceeding their prescribing budgets. It’s a consequence of a flawed system - welcome to back door nhs privatisation and fragmented providers same as it is in other walks of life such as grenfell with failures caused by multiple companies all wanting g to cut costs failing to take responsibility and buck passing.
I’m on new heart meds from an acute trust which should be closely monitored due to danger of life threatening arrthymias but Acute aren’t doing that monitoring- It’s not even been officially ‘handed over’ and GP is quite rightly frustrated that s/he is picking up the responsibility.
Sounds to me to be a matter of who pays. Stay calm I'm sure the GP practice will have to agree to pay. Have you spoken to the head of practice?
What a depressing state of affairs. ... I am so sad for you. ... Not being in the UK, I don't know what your options may be, but what you are going through seems totally dreadful. ... If the only thing you can do is "self medicate" you might want to look into getting Thyroid S. I take it and am doing welll.
My UK GP always refused to prescribe due to cost. I saw excellent NHS Endo every 3 months for prescription, what a waste of his time. Then the hospital didn't want to be responsible for the costs, so I had to fight for individual funding and all was sorted. I still had to go to Endo every 3 months as GP still refused. Not sure if individual funding still a thing?I moved to France 2019 no problems at all until this year. T3 now on elite athlete doping list according to cpam [our health agency] I am 62 and not an athlete, I certainly don't look like I am shredding fat to under 10% for competition!
My GP retired in April giving me a 12 month prescription and now I have to go through the whole procedure again with new Dr.
Life just shouldn't be this awkward.
I’ve heard a retired consultant (obstetrician) say the same about T3.
I’ve been given morphine in hospital before. It didn’t mean I was a down and out drug addict.
My aunt’s dog has the same heart medication as she does. That doesn’t make her a dog, or vice versa. He is also on epilepsy medication. He was already not fit to drive.
The same medicines have varying uses and abuses by different people. Surely this is in Y1 of medical school?
Hi how awful for you if a consultant says you need it should be prescribed I thought a consultant could do a script one of the brands of t3 is Roma I have a corn allergy so need a special medical board agreed to it in 2017 my g p refused to give me a prescription
I was with out med for 16 weeks took five months for I C B to agree for thyroxine they also said authorisation was needed for t3 good luck
So much knowledge here, love this group!
You need to speak to the practise manager and tell them that you are reporting it to PALS
Time's were better when we had CHCs with statutory powers to challenge healthcare commissioners/ providers poor practice or inequitable/illogical decision making. That's probably why the govt at the time (mrs t) disbanded them! Now there is no longer any public oversight and the public have even lost the 'right' to protest or even hold a placard up in public to highlight such decisions.
I had a similar problem. First of all, my NHS consultant refused to prescribe T3, telling me the hospital wouldn't allow it. He said he'd write to my GP and ask them to prescribe it. I told him that wasn't the protocol and wouldn't be allowed, and of course it wasn't.
Next appointment, he told me he'd had some good news, and had been allowed to prescribe for 3 months. Not at the full dose I was taking, but it was a start. I got my prescription, and he again wrote to the GP and asked them to take on the prescribing after 3 months.
I'll cut out a lot of the story here, but after 3 months, I contacted the surgery, and my prescription was refused due to funding. I had lots of back and forward conversations, and I ended up being called by my consultant who basically ranted that my GP surgery kept on contacting him to get him to continue to prescribe T3, and that I needed to get them to stop! Not exactly professional, but there you go.
I then composed an email to the practice manager at my GP surgery. It took me hours and included all the background of my situation, and as many links as I could find that would be useful to me, such as the prescribing rules for my county, how many prescriptions had been given in my county over the year, and lots and lots of other stuff. I also said how unwell levothyroxine had made me, and that the only way I had been able to function was by adding T3.
At the end of creating that email and sending it, I burst into tears, as I felt so emotionally 'done' with it all. The whole thing had been such a fight and I just felt like I couldn't fight any more.
We went off on holiday a week later, and whilst away I got a text asking if the surgery could use my email to send to the ICB. I of course replied that they could.
When I got back I found out that the ICB had agreed to funding my T3. I was staggered to be honest. That was last December, and so far so good.
I had a phone appointment with my endo in May. By this point I'd stopped levo completely (it had been 10 months since I'd last seen him) and upped my T3 quite considerably. I wasn't sure he'd agree to request this increase from my GP, but his only concern was who was funding it. As soon as I told him the GP had received funding from the ICB, he happily sent a letter to my GP asking for my dosage to be raised. I expected a little kickback, or to have to fight once more, but to their credit, they upped the prescription with no issue.
I have no idea how long the funding is for, whether they need to reapply or anything. I really hope not, as the whole thing was so stressful. However, reading people's experiences on here, I feel really lucky that I eventually got my prescription.
I am sorry to hear this. Can you fire this idiot GP and hire a different one? Can the consultants recommend a better GP? I still don't presume to understand medical processes in social medicine, except to be horrified by the majority of stories like yours regarding unbelievably crappy health care.
My favorite GP, sadly moved to another state. Later, this month I meet a new one. We shall see if she passes the interview.
Hi I’m Dawn. So sorry you are going through this nightmare you need to contact and schedule an appointment with your local MP
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