NHS Sheffield Clinical Commissioning Group

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Readers' Panel feedback - Vitamin D materials

Readers' Panel feedback - Vitamin D materials

Thank you so much to everybody who took the time to review our materials for Vitamin D prescribing. Your valuable contributions have once again helped us to produce better information for the public of Sheffield.

Vitamin D information resources

Vitamin D is important for bone health. It is needed to absorb calcium and other nutrients from our diet and helps to keep bones strong and healthy. Taking vitamin D supplements is recommended for people who may not get enough vitamin D or who have been identified as having low levels of vitamin D from a blood test.

The decision to remove these supplements from people who are at risk, but do not have active disease, was made due to the current financial pressures within the NHS. Working with limited NHS resources has meant that some difficult decisions have had, and will continue, to be made. Further engagement about these wider issues will be happening in the coming months.

Over the counter vitamin D supplements are only advised for those who are at risk, but do not have active disease. General health advice and guidelines are in place to ensure those with active disease get the treatment they need on the NHS.

I would like to share the general feedback that we received and highlight where we have made changes as a result, and explain why we have been unable to make some changes.

Feedback

Outcome

Pregnancy and breast feeding

There is already a targeted leaflet for pregnancy and breast feeding which will be sent to any patients identified as being pregnant or breast feeding. Overall, the messages are the same so we feel that generic advice will be appropriate for the majority of patients.

Both documents have too many difficult terms

We have replaced some complex words and terms with easier to understand alternatives where suitable.

Be more direct with the message that these supplements can be bought cheaper over the counter than on prescription

We have been more explicit about this message.

Make it clearer that the action being taken by the patient's doctor is part of a common change taking place across the whole area

We have added more context to City wide initiatives.

It would be helpful for the typical cost of a month’s supply of supplements across the counter to be shown

We have included an example of how much an alternative, over the counter supplement would cost. We hope that this will better inform patients when they receive the letter.

Not all people will understand the term practice, should change to your GP practice

We recognise that just referring to practice is not helpful, so have changed accordingly.

Should state “This does not mean that the medical advice you have previously been given has changed.”

We have added in this more explicit line.

More detail about portion sizes for recommended daily intake of calcium

Unfortunately, there is limited room on the leaflet to discuss calcium, hence we have included the link to an online calcium calculator for more information.

Simpler message about sun exposure advice and sun cream

Guidance from NICE has been checked regarding sun cream and exposure and amendments made

Languages and learning disabilities

It is a complex message and the intention is to get leaflet in other languages and an easy read version once approved.  All our information is designed to support healthcare professionals to have conversations with their patients, this would include advocates for people with learning disabilities or communication difficulties.

Further advice

The letter advises discussing with a healthcare professional if there are any concerns.

Impact on those who don’t pay for their prescriptions. What is happening to support them?

We have worked with the community pharmacy Sheffield to encourage pharmacies and other outlets selling food supplements (such as supermarkets) to stock the lowest cost vitamin D supplements. This information has been included in the letter.

Blank design / branding

The letter will come from practices on their own headed paper.

Weblinks

Hyperlinks to websites and the calcium calculator will help certain patients but we acknowledge this will not suitable for all. We hope that those who would like more information would be able to ask relevant healthcare professionals for answers to any extra questions they may have.

The vitamin D rich foods will not be familiar to the older adults in the population

These food options are based on NHS choices advice. We have tried to clarify some of the options as healthier versions of these foods.

Healthy start information

We have clarified the information regarding eligibility for healthy start vitamins and included this in the letter. This section will only be included to pregnant or breastfeeding women.

NHS Sheffield Clinical Commissioning Group

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