If I make a complaint about my GP refusing to prescribe medication

On the subject of GPs being asked to prescribe medication by consultants - hospital specialists know a huge amount about a small range of conditions and drugs. GPs know a smaller amount about a huge range of conditions and drugs.

Many drugs have been around for ever, and all GPs will have experience of the risks, benefits, side effects etc. Newer drugs won’t be as well known. Or they might have been around a while, but only very recently been licensed for certain conditions.

GPs need to be confident that they can manage any problems that may arise after they prescribe a drug, and also that they have the expertise to defend themselves in court and justify their actions, if things go wrong.

If a GP refuses to prescribe a drug after a request from a consultant, it’ll be because their guidelines prohibit them doing it. Or because they don’t have the confidence or expertise.

You wouldn’t want the pilot of your Boeing 747 to be someone who’d only ever flown Cessna light aircraft would you!

I’m on Topiramate @Sconesandgravy. I couldn’t cope without it tbh. My migraines were absolutely horrendous and I had them almost everyday. I’ve been on it for around 10yrs or more, I’d say.

At no point have I been told never to get pregnant. I’m not planning to because my pelvis was severely damaged when I was pregnant with DS2, which had resulted in 8 major surgeries. My husband has had a vasectomy, too. I’m post menopause now, so that ship has sailed, but it’s strange how absolutely no one warned me.

I would just caution you that you're likely to wait a year for another opinion on the NHS......topiramate perfectly reasonable option for migraine

and I do agree the communication could have been better. I tend to just pick up the phone to the patient in situations like this.

Great response OP, but this is mumsnet, you're not allowed to read the replies, digest them, and then use them to be completely reasonable and realise where the fault lies. that's not how this works!! ;-)

Yeah. GPs love patients who just think they are being bloody minded when they actually have genuine safety concerns. Makes us much more likely to go above and beyond for that patient next time......

Yep, that makes sense. One of several reasons I’m sure. I was challenging to OP to reflect on why the GP might be refusing, because she seemed certain it was pure bloody mindedness.

Absolutely! have fun......

it's not valproate

You're definitely NBU OP but I'd also be very wary of topiramate. Both my sister and I tried it for chronic migraine and whilst it helped (reduced my attacks by about 50% and DSis by about 75%), the side effects just can't be overstated.

I had pretty much all the side effects they warn you about (numbness, tingling, memory and speech issues, extreme fatigue, constant nausea and dizziness) plus quite a few others they don't mention. I dug around and did some research and found that there is growing evidence to suggest Topiramate causes serious mental health issues. My DSis became actively suicidal on it (no previous history of MH issues aside from PND 25 years ago) and I developed extremely poor judgement and was engaging in all kinds of not-typical-for-me risky behaviors. Both of us recovered from these issues within 2-6 weeks of stopping Topiramate.

Believe it or not, the migraine relief made me stick with the Topiramate in spite of the MH and other problems it was causing for me (I was in denial about it being the cause TBF) - I eventually stopped taking it because my hair started falling out (oh vanity).

By all means try it - I know the horror of life with migraine - but be prepared for the side effects and make sure your DH is looking out for behavioral/personality changes. My DH still talk about the "medication that turned me into a different person" and I stopped taking it 8 years ago. I'm not exaggerating when I say it almost ended my marriage. Oh, and HCPs will tell you the behavioral stuff isn't related - I can guarantee it is.

Cheers for that information. I now know what to do for the next time he tries to fob me off 🤗

You basically have a choice between what, to you, is the least worst option: accepting the prescription and then just not taking the pills until your appointment with the GP, even though that's wasteful, or carrying on with the migraines. To me it seems to be a no-brainer - go for the first option every time.

Is there any chance of seeing a different GP within the practice?

Yep, see MHRA website and guidance. You need to be on a PPP (pregnancy prevention programme) but you should be ok to get it in your situation, a risk assessment form will just need completed with your arrangements documented. Speak to your GP and Neurologist, they should be able to sort it out between them for you.

https://www.gov.uk/government/news/valproate-banned-without-the-pregnancy-prevention-programme

I remember when I was younger, a specialist said I wasn't responding to the standard treatments well, but there was one thing left to try that could work. However, as I was of child-bearing age, he wouldn't prescribe it.

Dear Reader, I was 14. I wasn't sexually active. I didn't want children. The twat didn't believe me.

I thought I was being dismissed because of my age, but three decades on, people (mostly men) still tell me I'll change my mind about having children.

Medicine is not designed with women and girls in mind.

I had a couple of really rough years but thankfully my condition got better with age. If I'd been medicated, I could have avoided those years of hell.

I'll never know for sure though. Because I couldn't get the treatment I needed. Because I was female.

Incidentally, I was told I couldn't have the medicine by myself because I was Gillick competent. The thing is, yes, I was old enough to make decisions about my healthcare and I didn't need a parent in the room. But I wasn't old enough to know what to do if my decision was overruled.

Yes it's part of the hospital contract to give enough from clinic until the gp can reasonably take over and what the trust is being paid includes this.

Wow, that’s interesting. Since 2009 my neurologist has always sent my scripts to the G.P. Are you saying this is illegal? It once took months for me to get a certain medication because the G.P wasn’t happy prescribing it, but the consultant stuck them out. It was like a tennis match, absolutely ridiculous. I gave in in the end, just couldn’t be arsed.

Like I’ve pointed out in another thread, he told me it can come out of the G.Ps budget! 😳

OP, what would the GP’s motivation for not prescribing it be?

Not feeling confident with an area of clinical practise which he had purposefully passed to a specialist due to a lack of knowledge?

So presumably you've made a formal written complaint about your neurologist to PALS? What a shit. Please do.

My neurologist has never once given me a prescription, he always sends it to the G.P. This means trying to get another feckin appointment, I have M.S so life can be pretty shitty, and to top it all he says “It can come out of their budget” What a complete knob, I swear he’s on the autistic spectrum, he’s bloody hard work!

Ffs. Wrong thread sorry. Bring a lasagne to you GP ?

So your consultant hasn't fulfilled their contractual obligations for which their Trust is being paid, in nine years. Fancy reporting them for fraud?

If the lasagne really is that big I would cut it into squares and freeze. If it's too big for the freezer , could you blitz the remaining and make a savory stock pots to freeze in plastic bags ?

I don't think you've addressed the issue that you're angry with the wrong doctor. @Sconesandgravy

Your neurologist and the trust that they work for are under a contractual obligation to give you as much medicine as you need until the GP is happy to take over, and to request, not demand that the GP prescribes.

Why didn't your neurologist give you a script? And why aren't you raging against them?