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This might reduce the number of requests…… Exclusive: Patient choice is not key to improving performance, says Hunt<http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCMQqQIwAA&url=http%3A%2F%2Fwww.hsj.co.uk%2Fnews%2Facute-care%2Fexclusive-patient-choice-is-not-key-to-improving-performance-says-hunt%2F5077051.article&ei=Vud1VNSQHIzsO9nugagF&usg=AFQjCNEKk1Iq4iBRpd_TLMdnrakwSUXvJA&sig2=fh0o8TZNHOJO_noXG3ks6w&bvm=bv.80642063,d.ZWU> Health Service Journal - 8 hours ago Patient choice is no longer fundamental to improving NHS performance, the health secretary has declared, marking a major break from a policy favoured by Conservative and Labour governments. ... I wonder if this is a prelude to announcing the closure of swathes of smaller DGH’s?? BW John From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JONES Stuart (Pathology) (RF4) BHR Hospitals Sent: 26 November 2014 14:22 To: [log in to unmask] Subject: Re: NICE: "Vitamin D: increasing supplement use among at-risk groups" Shame the BBC article neglects to mention the recommendation on testing! From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Colley, Michael Sent: 26 November 2014 14:08 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: NICE: "Vitamin D: increasing supplement use among at-risk groups" which is what is implied in the letter from the Chief Medical Officers’ letter of 2012 (and NICE 2012) neither of which mentions measuring VitD M. Dr. C . M. Colley Consultant Chemical Pathologist Great Western Hospital Swindon SN3 6BB From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Salter Simon (ROYAL FREE LONDON NHS FOUNDATION TRUST) Sent: 26 November 2014 14:00 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: NICE: "Vitamin D: increasing supplement use among at-risk groups" --- This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within. The identified sender is [log in to unmask]<mailto:[log in to unmask]> --- c) are we to wait until a child develops rickets or an elderly person develops irreversible bone deterioration before taking preventative action? No. Just treat those who are at risk and don’t waste time and money on measuring it. Simon From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Nick Miller Sent: 26 November 2014 13:36 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: NICE: "Vitamin D: increasing supplement use among at-risk groups" Right, NICE has done its usual job again. The problem with all that is that: a) the symptoms of vitamin D deficiency are multifarious and cannot all be diagnosed clinically, b) if you live somewhere like Manchester you will never have enough exposure to sunlight to make vitamin D in your skin - it will all have to be derived from dietary intake, c) are we to wait until a child develops rickets or an elderly person develops irreversible bone deterioration before taking preventative action? Nick Miller London On 26 November 2014 at 11:57, Jonathan Kay <[log in to unmask]<mailto:[log in to unmask]>> wrote: http://www.nice.org.uk/guidance/ph56/resources/guidance-vitamind-increasing-supplement-use-among-atrisk-groups-pdf includes: Recommendation 7 Only test vitamin D status if someone has symptoms of deficiency or is at very high risk Health professionals should not routinely test people's vitamin D status unless: • they have symptoms of deficiency • they are considered to be at particularly high risk of deficiency (for example, they have very low exposure to sunlight) • there is a clinical reason to do so (for example, they have osteomalacia or have had a fall). Jonathan ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. 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