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834485
star this property registered interest false remove filter
star this property date remove maximum value filtermore like thismore than 2018-01-31
star this property answering body
Department of Health and Social Care more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health and Social Care more like this
star this property answering dept sort name Health and Social Care more like this
unstar this property hansard heading Liothyronine remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty's Government whether they intend to commission research to evaluate the impact on patients of reduced access to liothyronine (T3) for the treatment of thyroid disease. more like this
star this property tabling member printed
Lord Hunt of Kings Heath more like this
star this property uin HL5291 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2018-02-08more like thismore than 2018-02-08
star this property answer text <p>We understand that whilst it is recognised that some patients on levothyroxine remain symptomatic despite treatment leading to thyroid stimulating hormone levels in the therapeutic range, it is not possible to predict the number as the reasons for this are not fully understood; such patients should be under the care of an endocrinologist. Where clinical commissioning groups decide to implement recommendations in NHS England’s guidance, they are responsible for deciding whether further action is required, such as commissioning research, to monitor uptake and outcomes.</p> more like this
star this property answering member printed Lord O'Shaughnessy more like this
star this property grouped question UIN HL5226 more like this
star this property question first answered
less than 2018-02-08T15:11:48.057Zmore like thismore than 2018-02-08T15:11:48.057Z
star this property answering member
4545
star this property label Biography information for Lord O'Shaughnessy more like this
star this property tabling member
2024
star this property label Biography information for Lord Hunt of Kings Heath remove filter
833608
star this property registered interest false remove filter
star this property date less than 2018-01-30more like thismore than 2018-01-30
star this property answering body
Department of Health and Social Care more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health and Social Care more like this
star this property answering dept sort name Health and Social Care more like this
unstar this property hansard heading Liothyronine remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty's Government whether any Clinical Commissioning Groups refused to allow patients to be prescribed liothyronine (T3) before the consultation on Items which should not be routinely prescribed in primary care: Guidance for CCGs commenced; and if so, why. more like this
star this property tabling member printed
Lord Hunt of Kings Heath more like this
star this property uin HL5228 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2018-02-08more like thismore than 2018-02-08
star this property answer text <p>We understand that the British Thyroid Association (BTA) advises that a small proportion of patients treated with the most commonly used drug, levothyroxine, continue to suffer with symptoms despite adequate biochemical correction. In these circumstances, where levothyroxine has failed and in line with BTA guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months’ duration of liothyronine.</p><p>NHS England’s recommendations to clinical commissioning groups (CCGs) take account of those of the BTA and are to:</p><p>- Advise CCGs that prescribers in primary care should not initiate liothyronine for any new patient;</p><p> </p><p>- Advise CCGs that individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine where clinically appropriate; and</p><p> </p><p>- Advise CCGs that a local decision, involving the Area Prescribing Committee (or equivalent) informed by national guidance (e.g. from the National Institute for Health and Care Excellence or the Regional Medicines Optimisation Committee), should be made regarding arrangements for on-going prescribing of liothyronine. This should be for individuals who, in exceptional circumstances, have an on-going need for liothyronine as confirmed by a consultant National Health Service endocrinologist.</p><p>A number of CCGs had already created local policies on the prescribing of liothryronine before the national consultation started in July 2017.</p>
star this property answering member printed Lord O'Shaughnessy more like this
star this property grouped question UIN HL5225 more like this
star this property question first answered
less than 2018-02-08T15:03:07.447Zmore like thismore than 2018-02-08T15:03:07.447Z
star this property answering member
4545
star this property label Biography information for Lord O'Shaughnessy more like this
star this property tabling member
2024
star this property label Biography information for Lord Hunt of Kings Heath remove filter
832881
star this property registered interest false remove filter
star this property date less than 2018-01-29more like thismore than 2018-01-29
star this property answering body
Department of Health and Social Care more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health and Social Care more like this
star this property answering dept sort name Health and Social Care more like this
unstar this property hansard heading Liothyronine remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty's Government what assessment they have made of the degree to which the analysis contained in the NHS England document Items which should not be routinely prescribed in primary care: Guidance for CCGs justifies the advice given that prescribers in primary care should not prescribe liothyronine (T3) for any new patients. more like this
star this property tabling member printed
Lord Hunt of Kings Heath more like this
star this property uin HL5203 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2018-02-07more like thismore than 2018-02-07
star this property answer text <p>In November 2017 NHS England published commissioning guidance for clinical commissioning groups, entitled <em>Items which should not be routinely prescribed in primary care: A Consultation on guidance for CCGs, </em>following a three month consultation. A joint clinical working group comprised of clinical representatives reviewed the consultation findings and made evidence-based recommendations for consideration by the NHS England Board. Liothyronine attracted a significant number of responses and following detailed review, significant amendments to the original proposals were made before being published in the finalised guidance. NHS England’s recommendations are that National Health Service consultant endocrinologists may still initiate and recommend liothyronine for new patients, following audited individual trial periods of use, as recommended by the British Thyroid Association.</p><p> </p> more like this
star this property answering member printed Lord O'Shaughnessy more like this
star this property question first answered
less than 2018-02-07T12:11:38.85Zmore like thismore than 2018-02-07T12:11:38.85Z
star this property answering member
4545
star this property label Biography information for Lord O'Shaughnessy more like this
star this property tabling member
2024
star this property label Biography information for Lord Hunt of Kings Heath remove filter
833606
star this property registered interest false remove filter
star this property date less than 2018-01-30more like thismore than 2018-01-30
star this property answering body
Department of Health and Social Care more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health and Social Care more like this
star this property answering dept sort name Health and Social Care more like this
unstar this property hansard heading Liothyronine remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty's Government whether they have evidence showing that there are more cost-effective products available than liothyronine for the treatment of thyroid disease; and if so, whether they will publish that evidence. more like this
star this property tabling member printed
Lord Hunt of Kings Heath more like this
star this property uin HL5227 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2018-02-09more like thismore than 2018-02-09
star this property answer text <p>NHS England have sought advice from the leading clinical experts in this field. These are the Royal College of Physicians, the British Thyroid Association and the European Thyroid Association. These experts recommend that, for the vast majority of patients, levothyroxine alone is used in the treatment of hypothyroidism. They also advise that liothyronine should be considered in exceptional circumstances.</p> more like this
star this property answering member printed Lord O'Shaughnessy more like this
star this property question first answered
less than 2018-02-09T12:00:40.617Zmore like thismore than 2018-02-09T12:00:40.617Z
star this property answering member
4545
star this property label Biography information for Lord O'Shaughnessy more like this
star this property tabling member
2024
star this property label Biography information for Lord Hunt of Kings Heath remove filter
833609
star this property registered interest false remove filter
star this property date less than 2018-01-30more like thismore than 2018-01-30
star this property answering body
Department of Health and Social Care more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health and Social Care more like this
star this property answering dept sort name Health and Social Care more like this
unstar this property hansard heading Liothyronine remove filter
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty's Government what estimate they have made of (1) the additional workload, and (2) the added cost for secondary care providers resulting from the decisions that (a) individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine where clinically appropriate, and (b) individual patients with an ongoing need for liothyronine should have that confirmed by a consultant NHS endocrinologist. more like this
star this property tabling member printed
Lord Hunt of Kings Heath more like this
star this property uin HL5229 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2018-02-08more like thismore than 2018-02-08
star this property answer text <p>We have made no such estimate. However NHS England expects local clinical commissioning groups (CCGs) – who have responsibility for commissioning these services - to have regard to the guidance when determining their local prescribing decisions. As such, it will be for local CCGs, in conjunction with local providers to determine what is best for patients and as part of their decision making, the resources available to implement any change.</p><p>The Regional Medicines Optimisation Committee (South) has considered this issue in further detail and a statement will be issued by them in due course to support CCGs and secondary care providers in reviewing patients, in line with the recommendations made. Regional Medicines Optimisation Committees make recommendations, provide resources and co-ordinate activities to ensure the optimal use of medicines for the benefit of patients and the National Health Service.</p><p><strong> </strong></p> more like this
star this property answering member printed Lord O'Shaughnessy more like this
star this property question first answered
less than 2018-02-08T15:12:56.147Zmore like thismore than 2018-02-08T15:12:56.147Z
star this property answering member
4545
star this property label Biography information for Lord O'Shaughnessy more like this
star this property tabling member
2024
star this property label Biography information for Lord Hunt of Kings Heath remove filter