[Meta] the tier 3 rule is doing its job and people should stop complaining
the tier 3 rule is doing its job and people should stop complaining, and it will stay as it is unless somebody makes the case to change it.
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.
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.
Tell me where this is wrong. That is the useful part of posting it.
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.
In England, specialist weight management services are commissioned locally, so eligibility criteria and waiting times differ by ICB.
Disagreeing with this line: that is the arrangement in one nation and the question is about another.
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.
A private prescription is an independent route: it does not affect NHS list position, and it is not a step in the same pathway.
Discharged at goal back to the GP, who would not continue it. Nobody had mentioned that this was how it ends.
Disagree. That is the pathway in one ICB and it does not generalise even to the next one over.
Added a nation tag — the answers to this question differ across the four.
the price difference between pharmacies this month is genuinely large
Same. My ICB threshold was different from the neighbouring one and nobody could tell me why.
Cosigning on discharge at goal. It catches people who have done everything right and did not know it was coming.
That is Scotland’s arrangement and the post is asking about England.
Four pharmacies, four prices, same product, same month. The spread was larger than I expected and none of them were the headline offer.
Correction: that threshold is your ICB’s, not a national one. They differ and they change by year.
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.
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.
Switched pharmacies mid-titration and had to restart the ladder because the concentrations did not line up.
the Irish scheme cap is the single most useful fact in this board
Yes — four nations, four pathways, and threads that ignore that give people the wrong answer confidently.
The scheme cap in Ireland was the single most useful thing I learned in a year of reading this board.
Read the MHRA notice rather than the news coverage and the actual scope was much narrower than the panic threads suggested.
I would not read a supply notice as a shortage in your pharmacy tomorrow. They are not the same thing.
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.
the MHRA supply notices are published, read them before the panic threads
discharge at goal back to the GP is where a lot of people fall over
Which pharmacy, and what did they quote for the month rather than the first month?
BMI thresholds vary by ICB and by year
Not convinced — the US threads are a different system entirely and importing their advice here does real harm.
Not convinced — the US threads are a different system entirely and importing their advice here does real harm.
emil_okwuosa is right that the two routes are separate. A private prescription does not move you up the list.
The two routes, described separately, because mixing them is where most of the confusion here starts.
The NHS route in England runs through specialist weight management services commissioned by your ICB. Criteria, waiting times and what happens at discharge are all local decisions, which is why a confident answer from somebody in a different area may be wrong for you.
The private route is an independent transaction: a consultation, a prescription and a pharmacy price. It does not affect your position on any NHS list and it is not a shortcut through one. Both are legitimate; they are simply not the same pathway and they do not connect.
- 1A private prescription is an independent route: it does not affect NHS list…8 comments in this branch · started by u/ines_lindqvist
- 2Scotland, Wales and Northern Ireland have their own arrangements. An answer…8 comments in this branch · started by u/hsa_math