UK — 2 things I got wrong before I got it right
Thinking out loud about this: UK — 2 things I got wrong before I got it right.
Scotland, Wales and Northern Ireland have their own arrangements. An answer that begins with "in England" should say so, and most of the confusion here comes from answers that do not.
Concentrations can differ between products and between pharmacies. Switching mid-titration means redoing the arithmetic rather than carrying the old unit count across.
Two years and four months on a tier 3 list. Referral date and every letter kept, which turned out to matter when the service reorganised.
I will update this if the picture changes rather than quietly leaving it up.
best — the order this archive was captured in
In England, specialist weight management services are commissioned locally, so eligibility criteria and waiting times differ by ICB. There is no single national threshold to quote.
England, Scotland, Wales and Northern Ireland are four different pathways
Which pharmacy, and what did they quote for the month rather than the first month?
the MHRA supply notices are published, read them before the panic threads
the Irish scheme cap is the single most useful fact in this board
GP said no in the spring, specialist said yes eighteen months later. Same person, same numbers.
private and NHS pathways are not a ladder, they are separate routes
Pharmacy pricing on a private prescription is set by the pharmacy. The spread between them in a given month is routinely substantial, which is why a tracker built from member reports is more useful than any headline.
Agreed. The ICB variation is the thing that makes national advice useless here.
Discharge at goal, which nobody warns people about.
Specialist services in England are commissioned to deliver a defined intervention. Reaching goal is a successful outcome and it typically ends with discharge back to primary care. Whether prescribing continues after that is a local decision that varies, and plenty of members here have discovered it at the point of discharge rather than at the start.
The useful thing to do is ask early: what happens when I finish, and does prescribing continue in primary care in this area. Ask it in writing, keep the answer, and you will at least know which conversation you are heading for.
The scheme cap in Ireland was the single most useful thing I learned in a year of reading this board.
Correction: that threshold is your ICB’s, not a national one. They differ and they change by year.
Have you seen the current threshold published by your ICB?
A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.
Supply notices from the regulator describe expected availability at a national level. They do not predict what any individual pharmacy has on the shelf next week.
Discharge from a specialist service at goal is a normal end point of that pathway. Whether prescribing continues in primary care afterwards is a local decision and is worth asking about at the start rather than at the end.
Read the MHRA notice rather than the news coverage and the actual scope was much narrower than the panic threads suggested.
Small fix — that is the Scottish pathway. The post is asking about England and the answer is different.
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What did the referral letter actually say?