Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they are satisfied that the NHS Dorset Integrated Care Board is following national guidelines in prescribing T3 to patients who do not respond to Levothyroxine monotherapy.

The NHS Dorset Integrated Care Board (ICB) recognises the importance of ensuring that local prescribing policies and formulary guidance are consistent with relevant national guidance, including NHS England's advice for prescribers for liothyronine, also known as T3, from August 2023, and the National Institute for Health and Care Excellence’s guideline Thyroid disease: assessment and management, reference code NG145. NHS England's guidance recognises that while levothyroxine remains the standard treatment for hypothyroidism, a small proportion of patients who continue to experience symptoms despite adequate levothyroxine treatment may be considered for liothyronine following specialist assessment by a National Health Service consultant endocrinologist.

The ICB has previously acknowledged the need for local formulary wording to be clear and aligned with NHS England guidance and has undertaken review work to ensure that local guidance appropriately reflects the role of specialist assessment, individualised clinical decision-making, and shared care arrangements where clinically appropriate.

NHS Dorset continues to review prescribing arrangements to ensure they are informed by specialist endocrinology advice and seek to support safe, evidence-based, and patient-centred care. Prescribing decisions for individual patients are made by appropriately qualified clinicians based on clinical need, specialist advice, patient preference, and the available evidence. NHS Dorset supports clinicians in exercising professional judgement.