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c/glp1uk·posted 1 year ago by u/solene_ilunga

[Discussion] the tier 3 advice in here is 3 years out of date

Discussion The Quiet One ×4 Slow Clap ×3 Receipts ×2

The title is the argument: the tier 3 advice in here is 3 years out of date. Here is the rest of it.

Pulling the figures out of the title: 3 years. All of it is written down as it happened rather than reconstructed.

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.

Why the monthly pricing tracker works, and the rule that makes it work.

Members post the pharmacy, the product, the month and the price they actually paid — not an advertised offer, not a first-month discount. No links of any kind are permitted, which removes the entire incentive to post anything other than what happened.

The result is that the spread between pharmacies in a given month is visible, and it is consistently larger than people expect. That single table has saved members here more money than every other thread on the board combined, and it survives only because the no-links rule is enforced without exception.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

4,866 up / 270 down95% upvoted23 commentsid 7363d71 Jan 2025

23 comments

17 in this archive, depth 4

best — the order this archive was captured in

u/viktor_kirchner694 points·1 year ago

A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.

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[removed]493 points·1 year ago

[removed by moderator]

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u/solene_ilungaOP365 points·1 year ago

NHS pathway or private prescription?

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u/solene_ilungaOP195 points·1 year ago

How long have you been on the list, and from what date?

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u/ipamorelin_i475 points·1 year ago

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.

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u/kavya_kravchenko287 points·1 year ago

specialist service, not GP, for tier 3 in most of England

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u/tomas_broberg334 points·1 year ago

keep every letter, the dates matter later

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u/helga_vermeulen234 points·1 year ago

Same. My ICB threshold was different from the neighbouring one and nobody could tell me why.

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u/elise_ramos673 points·1 year ago

Not convinced — the US threads are a different system entirely and importing their advice here does real harm.

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u/boots_or_bust557 points·1 year ago

Push back: a private prescription is a separate route, not a shortcut through the NHS queue.

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u/camila_marchand499 points·1 year ago

discharge at goal back to the GP is where a lot of people fall over

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u/lane_watcherMOD356 points·1 year ago·edited

Left up. It names a nation and an ICB, which is all we ask of a pathway post.

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u/solene_ilungaOP221 points·1 year ago

the price difference between pharmacies this month is genuinely large

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u/zaid_balogun303 points·1 year ago

GP said no in the spring, specialist said yes eighteen months later. Same person, same numbers.

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u/elise_ramos178 points·1 year ago

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.

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u/blunt_coldbox29145 points·1 year ago

Cosigning on discharge at goal. It catches people who have done everything right and did not know it was coming.

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u/jonas_eriksen37 points·1 year ago

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.

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UK-specific access: NHS tier-3 and specialist weight-management pathways, the two-year waiting-list reality, private prescription routes and their monthly cost, pharmacy stock, MHRA supply notices, and how the UK rules differ from the US conversation that dominates most of the internet.

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