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>
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>
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>
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>
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 Guidance \u2013 Prescribing of Liothyronine<\/em> is attached.<\/p>"}
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, "title" : "RMOC liothyronine guidance"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
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], "questionText" : "To ask Her Majesty's Government what action they plan to take to lift the ban on the prescription of liothyronine (T3) by University Hospital Bristol in contradiction of the advice given by NHS England.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
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], "answer" : {"_about" : "http://data.parliament.uk/resources/1037606/answer", "answerText" : {"_value" : " The Department engaged with 79 organisations as part of the process of reviewing of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 and received 57 formal responses. Of these, 22 case studies included instances where individuals were required to make advance payment for treatment that the Department has concluded was arguably, on proper analysis, immediately necessary and/or urgent.<\/p> The common issue in these cases is that clinicians have not fully taken into account the date at which those seeking treatment have been expected to leave the United Kingdom, something that national guidance is clear must be taken into consideration when making a decision as to whether or not treatment is considered urgent. To mitigate this risk and help ensure the regulations are applied as intended the Department has updated its guidance, published on 24 December 2018, and is planning further updates to relevant training material and case studies in early 2019 to ensure all relevant circumstances are considered when deciding if a treatment is to be considered immediately necessary, urgent or non-urgent.<\/p>"}
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], "questionText" : "To ask Her Majesty's Government how many written submissions they have received as part of the review of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017; how many case studies were submitted to the review where urgent care was withheld; and what assessment they have made of the number of case studies submitted where urgent care was, or may have, been incorrectly withheld.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
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