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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

217 replies

OptimismvsRealism · 31/07/2024 17:23

Debilitating illness - NHS consultant waiting list 5 years - used up significant savings and went to a private doctor who set up a plan - GP says no it's got to come from the NHS and no they won't take your diagnosis and adopt it you go back to day 1 on a 5 year waiting list. The same private consultant btw works on the NHS team that would make the diagnosis.

Cost of the medication to NHS is actually not that much but cost to an ordinary individual on private prescription isn't within realms of possibility.

Is there any alternative?

Oh and the aibu, aibu to despair that the NHS seems to actively want people to suffer?

OP posts:
StewardsEnquiry · 31/07/2024 19:49

Do you understand what a shared care agreement is, OP? Have you read your copy of it?

There are outline shared care agreements on the Internet, so anyone who is interested in looking can take a look at what one involves.

It is not just a case of the GP agreeing to take over your prescription. The consultant also needs to agree to their part of ongoing monitoring of your medication. And you, the patient, need to agree and understand that if the medication needs swapping or the dose changing it will be the consultant, not the GP who does that for you.

If you have gone privately as a one-off, it's really not clear that this sort of standard shared care agreement is suitable for your circumstances. Could you definitely afford to see the consultant again repeatedly if needed? If there is a problem?

I can't say I blame GPs who decline to enter into shared care agreements with private consultants.

prescribingmum · 31/07/2024 19:49

Shared care agreements vary around the country depending on the local commissioning arrangements. All agreements I have dealt with involve the specialist initiating the medication, stabilising the patient and then the GP taking over prescribing. The patient still remains under the consultant for ongoing dose reviews, GPs usually just prescribe and monitor blood results (where required).

The situation you are describing does not fit into this arrangement as the specialist has not started treatment. GPs will (quite rightly imo) not take on responsibility for something that is outside their area of expertise if there is no ongoing specialist guidance

wombat15 · 31/07/2024 19:48

OptimismvsRealism · 31/07/2024 17:23

Debilitating illness - NHS consultant waiting list 5 years - used up significant savings and went to a private doctor who set up a plan - GP says no it's got to come from the NHS and no they won't take your diagnosis and adopt it you go back to day 1 on a 5 year waiting list. The same private consultant btw works on the NHS team that would make the diagnosis.

Cost of the medication to NHS is actually not that much but cost to an ordinary individual on private prescription isn't within realms of possibility.

Is there any alternative?

Oh and the aibu, aibu to despair that the NHS seems to actively want people to suffer?

How do you know what the cost to the nhs is? If it is very expensive on a private prescription it very probably will be to the nhs too,

Dreamsofcruise · 31/07/2024 19:46

OP Im guessing but forgive me if I’m wrong that its ADHD meds? GP’s are often reluctant to initiate these as many people cannot tolerate them ( and some can become really quite ill) and initiating them safety requires a lot of monitoring.
NHS services will do all this initial work until such time a patient is stable on meds, but usually private clinics won’t, and won’t provide any ongoing advise to GP’s along the way, and so there is no ‘shared care’. In addition GP’s are under absolutely no obligation to prescribe any medication at all if they chose not to for a defensible reason.
your best bet may be to enquire to other GP’s as to what their stance on this is.

wombat15 · 31/07/2024 19:45

Floralnomad · 31/07/2024 19:36

But do they ? After my brush with death and expensive private care we joined Benenden Health and although they are like a half way house between the NHS & private care the NHS is happy to use all the Benenden test results etc and that is both GPs and NHS consultants.

They aren't prescribing under a shared care agreement though.

wombat15 · 31/07/2024 19:44

They don't have to agree to shared care with nhs consultants let alone private ones so you have no chance. The consultant knows this.

Floralnomad · 31/07/2024 19:42

@StormingNorman must just be different GPs then , ours is more than happy to work with them , how annoying .

StormingNorman · 31/07/2024 19:38

Floralnomad · 31/07/2024 19:36

But do they ? After my brush with death and expensive private care we joined Benenden Health and although they are like a half way house between the NHS & private care the NHS is happy to use all the Benenden test results etc and that is both GPs and NHS consultants.

I’m with Benenden and my practice are still digging their heels in about following the consultant’s recommendation.

Floralnomad · 31/07/2024 19:36

nocoolnamesleft · 31/07/2024 19:24

Surely the problem is that is isn't under a shared care agreement, as GPs only have those with NHS teams?

But do they ? After my brush with death and expensive private care we joined Benenden Health and although they are like a half way house between the NHS & private care the NHS is happy to use all the Benenden test results etc and that is both GPs and NHS consultants.

StormingNorman · 31/07/2024 19:35

I’m having the same problem. Chronic illness for 30 years has never been properly managed by the nhs. Lost my career to it!

Had a private consultation, paid for my first prescription privately (apparently this is nhs policy) and my GP doesn’t want to issue repeats.

It’s only been a couple of weeks but this medication has literally given me back my life. I never thought there would be a day when I wasn’t in pain but now I feel like I can rely on my body not to let me down from one day to the next.

Not having the medication would destroy me. If it comes to it I’ll need to pay privately (I know I’m lucky in that sense) but it stinks.

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!!!

Pebbles16 · 31/07/2024 19:30

The NHS don't want people to suffer, but there are protocols and care pathways. The medics' hands are frequently tied.
Sorry you are in this position, you either need to continue with private healthcare (it's usually under insurance so there are very few pathways in place for one off private care and medication)

nocoolnamesleft · 31/07/2024 19:24

Surely the problem is that is isn't under a shared care agreement, as GPs only have those with NHS teams?

Tomorrowillbeachicken · 31/07/2024 19:16

GP won’t generally prescribe consultant medications anyhow. When I was under a psychiatrist all my meds came through them and GP never did repeats. Same with my meds post eye surgery

bakebeans · 31/07/2024 19:13

If you have seen a private doctor who has set up a plan. The prescription needs to come from him or he needs to transfer you to his NHS waiting list.
I work in the NHs but had private treatment due to waiting and the consultant was the one to the write the prescription. He didn’t ask the GP.

Floralnomad · 31/07/2024 17:44

Have you asked the consultant to continue your care on the NHS in which case he might be open to getting his secretary to write to the GP in his NHS guise . I went private several years ago to see an endocrinologist having been failed by our local NHS trust and my GP was only too happy to prescribe my medication and even suggested that he refer me for the blood tests (SST) that I was going to be paying for to save me money - I declined because I’d already got it booked and wanted it over with .

thebluebeyond · 31/07/2024 17:41

depends on the diagnosis. Did you not realise before hand that this might happen?

Waynettaaa · 31/07/2024 17:39

I had to wait to see the same consultant on the nhs, as they wouldn't accept that I'd seen them privately first. Such a waste of nhs time and money.