To ask if you've ever successfully challenged a GP refusal to prescribe under a shared care agreement

Have you read the thread? Because a one-off paid for consultation where you’re given hope but no follow up is not the same as being prescribed and stabilised for 3-6 months on a medication and then asking the GP to take over, if they feel able to. With monitoring and contact with the private doctor. What happens when you develop side effects? The private doctor won’t see you if you don’t pay. People always look for blame and compo and it will fall on the hapless GP.

Not all icbs forbid it, so plenty are allowed, and regularly do.

GP's are not allowed to prescribe under Shared Care Agreements from Private Consultant's. This is standard across all ICB's who set the guidelines for this, so is not a case of GPs choosing to not prescribe. It is in their contracts not to accept private SCA's. There are many reasons, but essentially this is to stop GPs being left prescribing medications which need monitoring but the patient stops seeing a private consultant especially when a patient moves areas.

Why else would they deny it if it's a standard treatment, same consultant? Why would they make that rule in the icb?

OP, it’s not cost saving. GPs will prescribe medication worth ££ if it’s through the usual channels. It really isn’t cost saving.

But this has nothing to do with shared care as such. More with formulary policies. In any case, if it’s actually standard and according to NICE protocol, I can’t see why this would be an issue. In any case, if you want to rant, rant away, yes, NHS is fucked and not fit for purpose. If you want solutions, see my earlier post. I think you are unlucky with your GP practice/NHS trusts. Many trusts do actually allow consultants to add their private patients to their NHS lists and 5 year wait is rare.

Gosh that is so unfair and frustrating. It makes so sense to me why the "rules" aren't blanket. It shouldn't be a bloody postcode lottery it's ridiculous

@prescribingmum the issue I'm having is GP'S can't prescribe these drugs not under NHS guidelines. They maybe able to do in years to come but not currently as they are so new. So unless the consultant will prescribe them, I will have to pay privately for them as my hospital says they have no funding.

That's after a diagnosis and access to a hospital clinic and me failing all other treatment options. Go our wonderful NHS. They are paying for this treatment in other NHS areas, just my luck not mine. Actually it's not just this area but just my luck got stuck in one that isn't currently funding this treatment.

OP, if you want problem solving you might be better off posting in health with a specific condition/medication. I imagine there are many in your position and if the condition is chronic and debilitating people would have developed life hacks how to navigate the health system.

Disregarding a private opinion. Well, depends. A GP may feel uncomfortable and decline puberty blockers, but be ok with a strong steroid cream etc. Bottom line is, it’s their registration on the line. You can’t force anyone to share care. The specialist can refer you to their own NHS list, or someone else’s. Then you’ll be happy to be under both specialist and NHS care and not pay for treatment.

Beat the system? You mean try to get healthy and live a full life?

What do you mean here by baby boomer? Why not go private if he can afford it?

@MigGril in my experience, the NHS does interact with private consultants and does accept their diagnosis but whether they continue treatment depends on how specialised it is, funding and restrictions (as you are experiencing). They need to feel comfortable prescribing it, monitoring and dealing with any issues that may arise.

I have had one of my DC diagnosed with a common condition privately due to excessive NHS waits for a paediatrician and the GP had absolutely no qualms initiating recommended treatment following a confirmed diagnosis because it is a drug which they commonly give to children.

No it doesn't?

Op is likely still on that waiting list. She isn't an additional person.

She's the same person she'd be if she'd waited on the list.

I have found tho a lot of services will still make you wait to be seen again, to get the same diagnosis, again. It's a waste of NHS time and money.

What do you propose people actually do? Simply die waiting?

@StormingNorman
Why can’t the NHS interact with private consultants. It’s ridiculous that a GP can disregard the opinion of a specialist who you only see because the GP doesn’t know how to treat you!!!

Actually it's often that the GP'S aren't allowed to prescribe certain medication. I've been trying to get access to some fairly new medication recently. Currently though in the NHS only consultants can prescribe it, so I either have to wait on and an NHS area who keeps telling me they have no funding for this drug or go private. If only the consultant would initiate the prescription (which would come out of their funding) then the GP could issue it. But the GP can't prescribe it as it's a consultant prescribe drug only, even though my GP would happily give it to me if she could.

In that case do compare costs with multiple pharmacies but also, have you had a look at the shared care agreement yourself? Does it cover the drugs you are taking? Are you still seeing your private consultant?

There is a chance you could get the GP to reconsider/see another one or change practice if you are currently under the care of a private consultant who is overseeing the treatment and it is exactly what the NHS would have offered and is covered by shared care guidance. Did your private consultant sign the document and send to the GP?

But most of us go private in desperation, for speed, to be seen and helped. We wait and wait on the NHS, get nowhere and then in desperation go private

Which given the waiting lists, just extend them further. It’s like ordering two drinks at the bar because it’s packed, just increases waiting times.

I think you thought you could queue jump, it doesn’t work like that. Don’t blame the NHS blame the government. Blame awful working conditions, blame entitles patients who shout at doctors and nurses, blame people who sit in A&E for non emergency treatment.

I saw this coming and was shot down last year. I see more and more friends taking private health care policies or making use of the ones they have - it’ll get worse before it gets better.

Also, shop around!! Ime items cost differently per pharmacy (idk what drug it is but I've had a few private scrips for stuff cost different amounts)

If that's the case then I wouldn't expect them to accept it. I assumed she was on meds because I've never (in my limited personal experience!) Known an sca to be suggested before that point anyway? I took it from "made a plan " so I can understand why they wouldn't take that on.

I feel sorry for op regardless as well, because it really is a shit system, and tbh re diagnosing her with whatever is a complete waste of time, money and nhs resources and it drives me insane.

My own gp told me a right to choose diagnosis "isn't real" and honestly I despair. Its no wonder the nhs is up shit creek.

Op - have you spoken to pharmacies to see how much a prescription would actually cost? It may not be as bad as you think, especially if it’s an inexpensive medicine.

My interpretation is that she’s seen a specialist as one off who has diagnosed and given a treatment plan but not initiated yet (she said she can’t afford the private prescription). She also said she stretched herself financially for this appointment which implies she’s not under the specialists care on an ongoing basis until she moves to top of NHS list.

So I can understand why GP is not prepared to prescribe in this circumstance.

I do have a lot of sympathy for OP and the sorry state of our NHS. She should definitely not need to pay all her savings just to get a diagnosis and no wait for a specialist should be as long as she’s being expected to stay on the list. It is diabolical

Yes and no. The consultant should oversee care etc. However, if the gp writes a prescription, they are legally responsible for the medication, not the consultant.