how much of what we believe about tier 3 actually comes from NHS threads
Genuine question, and the title is the question: how much of what we believe about tier 3 actually comes from NHS threads.
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.
A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.
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.
Ask me anything specific. Anything general I will probably get wrong.
best — the order this archive was captured in
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.
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That is the first-month offer price, not the ongoing monthly cost. The tracker records the second one.
Correction: that threshold is your ICB’s, not a national one. They differ and they change by year.
Disagree. That is the pathway in one ICB and it does not generalise even to the next one over.
Cosigning on discharge at goal. It catches people who have done everything right and did not know it was coming.
ask the pharmacy for the price list, not the headline offer
How long have you been on the list, and from what date?
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.
Yes — the consultation that asks nothing tells you what kind of service it is.
tier 3 waiting lists are measured in years, not months
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.
This. The monthly pricing tracker is the most useful thing on this board and it works because nobody is allowed to link anything.
Agreed on keeping letters. Dates are what make an appeal or a re-referral possible.
the price difference between pharmacies this month is genuinely large
Switched pharmacies mid-titration and had to restart the ladder because the concentrations did not line up.
GP said no in the spring, specialist said yes eighteen months later. Same person, same numbers.
Concentrations can differ between products and between pharmacies. Switching mid-titration means redoing the arithmetic rather than carrying the old unit count across.
the MHRA supply notices are published, read them before the panic threads
the MHRA supply notices are published, read them before the panic threads
Agreed — and keeping the letters with dates is what makes any later challenge possible.
Same. My ICB threshold was different from the neighbouring one and nobody could tell me why.
- 1Discharge at goal, which nobody warns people about. Specialist services in…10 comments in this branch · started by u/units_not_mg
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