To be fed up of doctors doing this

[Catlady1976]

I have a couple of long term medical conditions and I get items on a repeat prescription. Ever 6 months I have to make an appointment for a review and they are reissued. All good.
However a couple of times now an item has been removed from my repeat without consultation. It is a bath additive for a skin condition I have.
The last time it happened I queried it and they put it back on.
Maybe the rules have changed and I can no longer get this on prescription. (NHS under pressure etc etc).
However I still think that if they are going to remove it they should consult with me first to check how severe my symptoms are.
AIBU

Felicia my pharmacy manages my repeats, and every month when I collect they ask do I want all three items next time. I say no, just those 2 and not that one, and next month there they are again. They seem to complete the selection on a screen...

I don't always look in the bag when I collect, I'm normally rushing! It will get used, just much more slowly than the rate they are dispensing at, and there will be spells when we get it back under control and I can use up my supply.

I get asked to go in and review my prescriptions once a year. My GPs are accessible via phone appointments if I just want to discuss meds. Everything on repeat is issued once a month, they'd notice if I was stockpiling.

You're only allowed to buy 32 painkillers at a time OTC, I'm meant to take the equivalent of 8 paracetamols a day so they soon go down, but I'd rather not have a huge pack of paracetamols hanging around.

When a doctor signs a prescription they are taking clinical responsibility for it - its effects, its risks, any monitoring it may need, the indications for prescribing it, the dose etc. Part of that responsibility is to physically see patients regularly, which can be monthly, weekly, annually - depending on the drug. It would be negligent to dish out drugs, year in year out, without actually checking the patient face-to-face. That's why you get called for review.

Drugs get removed from lists of repeats if they are deemed inappropriate to prescribe (such as bath oil) . Patients aren't necessarily informed about this, because they'll find out soon enough wheh they ask for it, it's not life and death, and it costs 50p to send a letter out (it can get ridiculously expensive).

Money is everything now sadly. I'm a GP and at my surgery we've each taken a 7k pay cut in the past year.

I can understand bread and bath stuff not being provided on prescription - baths and sandwiches are not essential for health, and the NHS exists to provide health care, not help people save on their groceries.

DP is a dentist and sometimes gets patients asking him to prescribe toothpaste, toothbrushes or mouthwash - not because they need a special one, but because they want it 'free.' He usually just directs them to the Poundland over the road, or gives them a heap of free samples if he has any kicking around.

I have a lifelong condition and am prescribed a very specific drug for it which can only be bought OTC with difficulty - you have to be grilled by pharmacists to 'prove' you have the condition, before being issued with a slip of paper that you then have to produce every time you need to buy the medication. Even then I'm routinely given the third degree if I try to buy it OTC, am asked why I don't see my GP to get it prescribed, etc etc (answer: sometimes I need the medication as an emergency and don't have any with me, sometimes I'm away from home and need it, etc etc).

I have it on a repeat prescription but I don't stockpile so when I need it I really do need it. Last week when I went online to order it I found it had been removed. No consultation with me, no call to ask if I still needed it.

I was pretty unhappy about that tbh.

Its all very well people saying that anything available OTC shouldn't be given on prescription but I couldn't afford the £26 per month OTC for my eczema lotion. Over thirty years I have tried lots of different ones. None apart from the one I'm prescribed do the job. If I am diligent about applying my prescribed lotion it saves doctors visits, steroid creams, light therapy etc.

Its a bit different to a bottle of calpol or a bottle of cheaper eczema lotions (I buy my own E45 which I use in between the prescribed lotion applications because I can afford to.)

Diabetes does not get cured and I'm not aware that anyone has found a way to get off on insulin so these medication reviews are just daft and a waste of an appointment for them as well as me.

As mintychoc1 says it would be negligent to dish out drugs, year in year out, without actually checking the patient face-to-face. That's why you get called for review.

The review is not necessarily about whether you need the medication-in the case of insulin you obviously do. It's also an opportunity to review your diabetes control, review the dose of medication, review whether you're having hypos or hyperglycaemia, check for diabetes complications (e.g. Checking your urine, feet etc) and review other risk factors e.g. Checking your blood pressure and BMI.

By requesting you to attend theses reviews they're trying to help you and prevent any avoidable complications from your diabetes, but I'm sorry you feel that's a waste of everybody's time.

It is fairly essential to clean intimate area though Especially when they become itchy during a flare up with a subsequent risk of infection if the skin breaks.
I have been advised not to even wash my hair in the shower due to the risk of irritation.
Anyway thank you to the doctors who have explained the reasoning behind the move.

Its ok saying that you can buy paracetomol for 16p but no pharmacist will sell you the equivelent of 8 per day. I'm sure many people would he more than happy to pay for them but they would have to go out almost daily to get them which may be near impossible if they are on constant pain killers.

What WOULD be sensible is instead of a prescription a "ticket" is issued that gives you the ability to buy large amounts of paracetomol yourself

You can buy 32 paracetamol/ibuprofen in one go from any supermarket or aldi/Wilkins. Why would you pay pharmacy prices? We get ours as part of a weekly shop.

The quantity thing is hard with the painkillers, but at 19p a pack....hardly bank breaking? 16 per pack divided by say 250? Is that about £2.56 a month?

You can only buy 32 at a time so that's 4 days worth. I'm disabled, in severe pain and housebound the vast majority of time. DH works 50 miles away, leaving the house at 5:30 am and returns home at 6:30 pm. We live at least 6 miles from the nearest shop that sells painkillers.

In theory DH could go to the supermarket every 3 to 4 days to buy paracetamol, but in practice he really couldn't. Once he's home he helps with dinner, sorts the pets, helps with my massage and therapy and gets me ready for bed. By the time he's sorted everything out it's almost 9pm so he has an hour to watch the TV before bed.

We really can't manage without getting my paracetamol once a month from the dispensary at the doctors surgery.

My mil has a vast collection of tablets. Water tablets, tablets for brittle bones, tablets for blood pressure, tablets for arthritis......
many, many tablets.They are delivered to her door, monthly,
on repeat prescription from her local chemist.

She hardly ever takes the bloody things! Last time I was there, she had about 2 years worth of medication backlogged! Next time I visit I will be having words.

My psoriasis has been so bad I was once hospitalised for six weeks.

I'm under consultant care. My GP prescribes Balneum Bath Lotion as part of my preventative treatment. So yes, some people do need 'baths'. Psoriasis is a fucking awful condition for which there is no cure, just treatment plans. Sticking to a proven treatment plan - that'll be one agreed with a consultant dermatologist - keeps me out of hospital.

Ive got a cupboard that's my own mini pharmacy. My joints have decided to really play up of late which is annoying as I took methotrexate & sulfasalazine & plaquenil fine, no problems. I'm hoping it's a cold weather thing, but that combo treats several of my autoimmune issues.
I've even got anti biotics on repeat, max of 4 times a year for UTI's. I would have gone to the chemist to get tx but this one day, every pharmacy I tried the designated pharmacist wasn't there. I looked such a tit carrying around my sample in a plastic container & having to explain. If the yummy cranberry stuff worked I wouldn't be taking my sample out like a pet. Luckily we have loads of Tupperware and other containers from when we ate Chinese so I could just bin it.
When we were weaning DS & DD we bought a load of smaller containers, so we could make up something and then pop it in the fridge / freezer. But with DD it was more baby led weaning, unlike DS where I was trying to not use jars, which I presume MN'ers hate, even if organic
Going off on a tangent, our GP does online prescriptions. I was given stuff for my skin that was a cream, could be used as soap and a bath emollient. But as a cream it's thick as anything.
I feel lucky to be exempt, but slightly annoyed that other countries in the Uzk prescriptions are free as standard. Doesn't seem fair that we have to shell out so much. I'm lucky that 2 of my conditions mean I get a health cert for prescriptions. But surely people who have heart/lung conditions should get stuff free too since their condition can be life threatening at times.
I would never ask for paracetamol or ibropufen on script, we just grab a pack of each when either of us nips in supermarket, plus on the online shop. One thing I wasn't sure to ask my GP about was this anti reflux med I take. Although omeprazole had no effect on the reflux so these tablets and Rennie (shop own brand) are the next best thing to try and help.
Usually we're lucky that you can speak to GP on phone and he'll send script to pharmacy who also deliver. So saves some time if you're in during the day.
There was a woman the other day saying her DH had trapped / bulging discs and they wouldn't even prescribe codeine to him. I've been on stronger meds for years though as codeine & tramadol werent cutting it. Even with current pain killers I'm still in a lot of pain. But don't want to raise dose and don't want to be on gabapentin or pregablin as its just
I think they can tell generally when you're in pain, I refuse to go to GP generally. If I need to see one I'm on the doorstep at 7:55 to grab an appointment for 8:30. It seems like common sense if you need to see a GP that badly, over playing telephone roulette.

FairyCaravan sorry to hear you're in so much pain, I'm pretty much the same and just don't go out at all if I can help it, as its too much off a faff and energy wise just going out for a short time will knacker me for 2+ days, even though I don't have ME, but from multiple conditions I get bad fatigue.
How do you get your DH to massage you? I'm so desperate at times if trying myself doesn't work, like rubbing my back on the corner of a wall, I try to image a sexy masseuse doing it. For me it would be Indian Head Massages. I should talk DH into training at college for massage & Indian head massage. That would be a treat.
How do you cope being housebound? Do people come and visit, or are you mostly supine and by yourself? I hope you get direct payments from SS so someone comes in to help.

My GP surgery does this.
I order repeat meds - am drug dependent due to a series of reasons - once a quarter I go to grab the script and they have decided they cannot issue an item without seeing me.
Obviously I then need an appt which has to be arranged etc with no meds.
Spoke to the two consultants I'm under and they wrote stiffly worded letters regarding how utterly ridiculous the policy was..
No difference - it is the practice manager's policy which illness, necessity and consultant led care cannot override.

That's why a getting a good GP is mandatory with Chronic Illness, as some GP's have been known to kick you off their books, just for needing expensive treatments. The one time an old GP tried to cost cut I ended up having a bad reaction, as the cheapie version just didn't suit me at all.
How do you get quarterly prescriptions?

earl grey - as you will see from my post (and is is contained in NICE guidelines) I am under consultant care for diabetes. GP is regularly updated by the hospital on that care. My experience of GP knowledge of diabetes is that it is very limited indeed (for example I am not asked what my ratios of insulin to carbs are, I am asked what my 'dose is for breakfast time' which is a completely irrelevant and uninformed question to ask). My hba1cs, retinopathy and neuropathy screenings etc etc are carried out by specialists so YES I do think it is a waste of time to call me in 2-3 times a year for a pointless check.

However what I am actually more concerned about is the lack of communication. Just not bothering to fill a request for insulin and holding me to ransom until I drop everything to come in is outrageous, especially as there is no communication to that effect (except on a piece of paper which I no longer see due to following the surgery's preferred method of request).

Singing - for Utis the nice tasting cranberry stuff is useless as it contains sugar and only about 10% cranberry juice. Mine came back every time I had my period until I discovered 100% pure cranberry juice. The real stuff tastes disgusting but it does work. You can get it off the Internet. Drink some a couple of times a day. You don't need that much of it to work so a 750ml bottle for around £10 will last you maybe 10 days. Then after a month, maybe reduce to a maintenance dosage for a while.

Quite often Gp practices removed items that haven't been prescribed for some time. I work in healthcare and now our local GP practice routinely remove things if not ordered god six months. If the patient then needs it they can fill in a request form at the surgery. It's to stop waste or people ordering thinks they no longer need or want

MrsNucky - I'm in a similar position and completely agree. My gp actually has no input into my diabetes mgt, I see specialist doctors/nurses/Dietician's at the hospital for that.

I also get regular calls from the gp to attend diabetes reviews and I decline them each time. In the past they've been with the diabetes nurse whose knowledge is nowhere near that of the hospital staff and who asks similar questions to those you describe. I think this may be helpful for elderly patients, or those with type 2 controlled by diet or some meds etc but certainly not in our cases.

In the end this nurse left and a new one joined. I met her when I went for my child's immunisations. I mentioned in passing that I kept getting requests to see her and how I declined as I was seen at the hospital at as a result it was a duplication of effort. She was great, went into the system where she found my latest test results from the hospital and told me that next time I came up on their system as needing a review she'd do the same. Result

MrsNucky the electronic prescription has a box for your GP to write a 'message to the patient' which your Pharmacist should read you, although sometimes they don't. Perhaps your GP writes and asks you to come in several times and you aren't being given the message. Stopping your insulin is obviously dangerous, can your GP have a planned yearly review with you instead?.

If the GP is prescribing your medicine they are legally responsible for it, and they may not be receiving full and clear communication from your hospital about your monitoring, letters can be sent very late or not at all, or not contain all the relevant info. Sometimes hospital clinics decide to prescribe a drug themselves rather than asking the GP to do it, obviously your clinic has chosen to not do this and ask your gp to do it, in which case the GP will need to be satisfied with signing the prescription.

It's a silly system, GPs so rarely manage type 1 diabetes that their knowledge becomes v out of date, and yet they are responsible for the prescribing.

We have to pay for our open borders somehow! Stop moaning about your NHS that you paid for because you need to share it widely with everyone. That no one had a cost for.

It is a shame that the government doesn't invest more in the NHS and follow Bevans principles.

Catlady, you've explained why you need the product, but you haven't explained why you think the NHS should waste money supplying it to you.