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<p>NHS England is working closely with clinical commissioning groups (CCGs) on the
prescribing of liothyronine to support them with the implementation of guidance for
CCGs on items which should not be routinely prescribed in primary care. The Department
has not had specific discussions with NHS England or made an assessment on these issues.</p><p>CCGs
are expected to have regard to national guidance, and are responsible for developing
their own local approaches to its implementation taking into account local priorities
and needs. CCGs set the policy which governs what hospitals and trusts implement,
therefore the prescription of liothyronine at University Hospital Bristol and Musgrove
Park Hospital in Taunton is a matter for those CCGs.</p><p>This guidance for CCGs
on items which should not be routinely prescribed in primary care includes recommendations
on the use of liothyronine in line with the British Thyroid Association, who advise
that a small proportion of patients treated with levothyroxine continue to suffer
with symptoms despite adequate biochemical correction. In these circumstances,</p><p>where
levothyroxine has failed and in line with this guidance, endocrinologists providing
NHS services may recommend liothyronine for individual patients after a carefully
audited trial of at least three months duration of the drug.</p><p>Further guidance
on the prescribing of liothyronine has been published by the Regional Medicines Optimisation
Committee. The aim of the guidance is to make best practice on the prescribing of
liothyronine clearer. A copy of <em>Guidance – Prescribing of Liothyronine</em> is
attached.</p>
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