Pippa52, could you not ask for 100s instead and then cut them in half? That would be much cheaper than loads of 25s.

sheila, will answer your questions about Newson...
>can anyone give me an indication or ongoing costs? £100 every time I want to tweak it?
The non-negotiable is the £230 (or is it £270) annual review appointment to stay registered with them. The letter to your GP is included in that. Hopefully your GP will then provide all meds on the NHS - mine was, although now we have the Estradot shortage so I am buying that via Newson at the moment.
If they prescribe you something and it's totally wrong and you want to change product then it's £100 for a phone consult to get that change done. However, they are generous in what they initially prescribe to help you avoid this. For eg - my doctor there gave me 25s, 50s, 75s and 100s at my first appointment, with advice to begin at half a 25 patch and gradually increase if I felt I needed it and if symptoms continued. They didn't give me just one dose. (This was 3 years ago.)
This year I trialled Sandrena when I couldn't absorb more Oestrogel. This was a disaster and all my symptoms came back, so I had to pay £100 for the phone consult and got switched to gel and patch combo which is working. But that's the only time I've needed to pay that £100. If you have a good idea of what products work for you and what doses, it's unlikely you're going to find yourself in that situation. If you just need more meds, you just put through a request direct to the pharmacy as long as it's within a year of your consult.
>How often bloods required?
Only before each annual review appointment. And you can decide where to get them done - as long as they are venous (no finger prick tests). They will accept NHS bloods too. I usually use Randox Health who have a Female Hormones test which you can do at home using the 'Tasso' special collection device on your shoulder, so it doesn't get contaminated like finger prick tests. It's only £45. Otherwise, Medichecks or Lola Health. I've never used Newson's own tests as they are more expensive.
>How much is estradot from their pharmacy?
I just got Estradot 100s, 48 patches, for £140.
>How long before they write to my gp so I can (hopefully) get it on the nhs?
This is usually within a few days of your appointment, you will be sent a copy of the letter. (Their letters to my GP always go missing, so I actually print out the letter and take it in myself personally and hand it to my GP's receptionist. That way I know it is definitely there.)
>Will I need an annual newson appointment?
Yes, if you want to stay registered with them and be able to access meds via their pharmacy.
>Given that have a mirena and can test levels myself are they likely to add expertise or is the advantage really just the hoped for nhs prescription?
It depends what your situation is? If you are just desperately in need of Estradot but totally know what dose you need and everything is fine/no symptoms, then I guess it would be a way to access Estradots now during this shortage and then you could just not renew next year.
My experience with the expertise side of things has been mainly that they will support you, with what you want to do. And they are very willing to give higher than licensed doses of estrogen. I agree with what someone else said, that there is some variability of doctors there. I see Dr Jane Robertson and recommend her.
Personally, I don't trust the NHS continuing to prescribe me the HRT I need and Newson is a safety net for me. If I get a sh*tty NHS GP who refuses to prescribe, I have them to go to. If there are products out of stock (Oestrogel, utrogestan and now Estradots), they will typically always still be able to get them.
I spoke to their admin team about the Estradot situation last week and they said that their pharmacy, CloudRX, has not notified them of any shortages with Estradots and continues to be able to source them. Maybe they are importing them via a different route or from a country which still has them, no idea....