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I think allowing GPs a get out clause disadvantages a lot of T1s. I'd like to to know how many T1s really should be treated differently from the NICE guideline and what % of the T1 population do they represent? I'd put money on them being a minority.
Hello there.
I'm unsure I really understand your post. Do you mean that only a minority of T1s would benefit from their GPs treating them outside NICE guideline?
There's no judgement in me asking my question. I just not sure I see which way you feel.
Sounds perfectly reasonable to me. I think doctors are trained in medical school to take this approach, ie use their knowledge, the guidelines, research, and the patient's circumstances and wishes to recommend a course of action.The following was published today on GP Online, so I thought I'd copy it into here.
The following article was published today on GP Online. Interesting...........
GPs and patients must choose when to ignore NICE advice, says Haslam
By David Millett on the 13 October 2015 Be the First to Comment
NICE guidance 'may not be appropriate' for every patient, and it is important that GPs talk through treatment options with patients, NICE chairman Professor David Haslam has said.
Speaking at the NICE annual conference in Liverpool on Tuesday, Professor Haslam told delegates that although NICE guidance represents the ‘gold standard’ of treatment, it is not meant to be prescriptive and should not replace a doctor’s clinical judgment.
He said the health and social care system in the UK had changed ‘significantly’ since NICE was founded in 1999. Doctors of today are facing new challenges as multimorbidity and long-term conditions become rife in the population, he said.
NICE will play a pivotal role in helping doctors tackle these issues, with new guidance on multimorbidity due next year.
Professor Haslam said: ‘NICE guidelines give a population-level steer on what the most clinically and cost-effective ways are to treat different diseases and conditions. Nationally, the guidance helps the NHS make sure that it’s getting the best value for taxpayers’ money.
NICE GP guidance
‘But it is essential to remember that on an individual level, our recommendations might not always be appropriate for individual patients. The guidance is not intended to replace a doctor’s clinical judgment or the joint decisions they make with their patients about their specific and individual needs.
‘Our job at NICE is to ensure clinicians and social care professionals are supported to give the very best care to people.
‘Equally we understand that each discussion between a patient and their clinician is unique.
‘NICE guidance is a gold-standard which professionals should take very seriously. But the role of the clinician is to interpret our guidance together with their training and experience in the interests of the patient before them.’
The article url is: http://www.gponline.com/gps-patients-choose-when-ignore-nice-advice-says-haslam/article/1368070
I feel that only a small number of T1s might actually require treatment outside what NICE recommends. 'Allowing' GPs to vary treatment outside the guideline introduces inconsistencies to T1s treatment resulting in a lot of T1s not getting the treatment which results in better outcomes, eg lower HBA1C, less hypos, etc.
I have been a T1 for 24 years and every GP and specialist I have had had different ways of treating and explaining the treatment to me. Yes I have always had the target of lowering my BGL but 'how' was always the question with which I could not get (in my mind) a consistent answer. Fortunately I do have it I do have it know after attending DAFNE program, mentioned in the guidelines, 12 months ago.
David
A pleasure.Thanks for clarifying.
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