JISCMail - ACB-CLIN-CHEM-GEN Archives

This might reduce the number of requests……

Exclusive: Patient choice is not key to improving performance, says Hunt

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]
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

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]
Subject: Re: NICE: "Vitamin D: increasing supplement use among at-risk groups"

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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]
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]> 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

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