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

[Catlady1976]

I have taken on board the views of the doctors in here and I have said I will now buy it.
I

[atheistmantis]

I think it's not unreasonable for the surgery to take them off repeat if they have been reviewed by a doctor, often people have things on prescription that they could buy cheaply. One of my DCs had a generic equivalent of calpol on prescription because they are allergic to the additives in it but I got them onto the tablets ASAP as it saves the NHS money.
We all need to take responsibility for helping the NHS save money.

[Catlady1976]

Incidentallypremier the NHS is quite happy 'to waste money' prescribing 4 different creams / soap substitutes to a friend who just happens to go to a different surgery including aveeno. Her condition is different but the principle is the same.

[Catlady1976]

Cheaply is relative though I guess. We can afford to buy it and will do noe but £10 is alot say for someone earning just above the free prescription threshold with perhaps other conditions which require the purchase of prescriptions.
I also think that if it was an issue than it could have been discussed at my regular prescription review.

[MrsMurf]

To those in here bemoaning & minimising my need to get aveeno cream and emollient was prescribed as part of my severe psoriasis treatment, like to explain how a condition that can make me feel in pain, as though I'm burnt from head to foot is not serious enough to be prescribed? I understand it's available over the counter, but I simply cannot afford to buy it several times a month, rather than pay £10 for a pre payment prescription. Should I just waste time & money on Drs appts, and depression medication whilst not having the confidence to step out of the house?

[Sirzy]

It needs to be taken on a case by case basis really looking at the condition and the impact stopping it could have.

Ds gets an antihistamine on prescription- it is part of his overall treatement for severe asthma so is taken daily.

After discussion with his pead we found the best multivitamin to provide what he needs is an Asda kids one taken in double dose - so I buy them when doing my weekly shop. He is prescribed another supplement to make up for something he gets nothing of in his diet.

[Catlady1976]

I absolutely believe you should be prescribed them. Mrsm and I am glad you do. I have seen people hospitalized on the TV for portraits.
Your need is definitely greater than mine.

[Catlady1976]

Damn auto-correct.

[Catlady1976]

I agree to a case by case basis and discussed upon review.

[Catlady1976]

Sorry Mrsm my post about waste was in response to premier.
I don't believe NHS money is being wasted prescribing the 4 treatments my friend receives.

[Catlady1976]

Her condition is no way near as severe as your Mrsm* and is fairly localized like mine.

[MrsMurf]

Sorry cat lady I wasn't having a go at you! It's just a really sensitive subject for me. I know there are people who abuse the system, but equally there are others who actually NEED it. A case by case review seems to be one solution, but then you'd have to weigh that up against the Drs time I guess. Difficult one.

[TrickyD]

I get our repeats by ringing our local chemist who gets them from the GP, we pick them up a couple of days later. I thought this system was used everywhere.
Every few months we get GP's letters asking us to come in for a check up on each condition, to make sure the prescriptions are up to date.

[PlayOnWurtz]

Our surgery removed my dc''s inhalers off their repeat. I was not impressed given they've ended up on hospital a number of times due to their asthma

[Catlady1976]

I know your weren't. I just felt my post was a bit insensitive in the circumstances.
Hope your condition remains stable.
I do think it's up to the GP to decide whether a prescription is a waste of NHS money but strangers over the internet.
But this decision should not be as a result of a blanket ban or on the whim of a GP who has made it clear that they feel very little should be prescribed. Certainly not without consultation with the patient during their regular review. It wouldn't surprise me if it was removed before even checking if I had a condition which requires it.

[Catlady1976]

play that is terribly.

[Fallonjamie]

Whatever GPs prescribe are paid for by the surgery budget so that's why it varies from surgery to surgery.

[Sirzy]

Locally they are stopping pharmacies being able to order repeats for you due to the amount of waste. Now the individual/their carer has to order them directly from the GP

[HopelesslydevotedtoGu]

Medication prescribed by GP comes from the CCG budget not the surgery budget Fallon

[Didiplanthis]

Fallon - the cost of drugs come out the CCG budget not the individual practices but the CCG set guidelines within which practices have to work so the individual practices have little or no control over many aspects of this ie monthly prescribing, certain medications being changed to cheaper ones or not being prescribable. There are medicine management teams at the CCG that govern all of this and will come into practices to do bulk changes. I get its annoying but it's not individual GPS fault. With regards to repeats taken off pretty much all the computerised systems remove meds that have not been used for 6 months. You can't turn it off and your gp won't even know it has been taken off until you ask for it.

[Fallonjamie]

Didiplanis - that's interesting. I'm currently in a stand-off with a GP refusing to prescribe a certain medication and citing budgetary concerns despite the fact we have a shared care agreement for the drug with that CCG.

Thank you!

[TrickyD]

Gosh, Sirzy, that would be a nuisance. Hope it doesn't happen here.

[maddon]

Can I just point out to the self-righteous 'you are wasting the NHS's resources' that those resources are paid for by all of us already in the form of National Insurance Contributions ££££ on my last salary slip

I'm not advocating waste, but when you suffer a chronic condition hassle over prescriptions is the last thing you need on top of the pain itself and can push you over the edge of coping or not.

[Musicaltheatremum]

A lot of the diktats on drugs come from above. We used to do a system of switching drugs to the cheaper formulations. Fine for some but I have some patients for whom the expensive drugs do work better. Aveeno is an example much better than some of the others and one of my patients has horrendous psoriasis and goes through bucket loads of it. She also cannot tolerate peptac for her indigestion and needs the more expensive gaviscon advance.
Quite often pharmacists come into practices to do the drug switches. We refused to do them this year. It takes up so much time and although the pharmacy teams support us with this I do need to see patients too.
We also do like to see people for medication reviews. Even if just to say yes continue. I always hate opening a set of notes and seeing lots of medications prescribed but no GP visit. It just looks bad and if anything happened the GMC would come down on us like a ton of bricks and put cautions on our registrations and even fine us. So we do need to see you.

That being said I was doing a repeat prescription for a patient yesterday and realised she hadn't been in for a while despite being asked. I was about to refuse her meds but you know what, we have no appointments, we have 2 GPs off sick and one leaving in a month so I gave her a small amount and will get the staff to phone her to book an appointment.

English GPs have it worse than us and they have more rigorous and in my mind fussier inspections citing rules and regulations for which there is no evidence base. So the GPs are more cautious.

[IvorHughJarrs]

Catlady I think you may live near to me (did you have a name that was similar but younger?) and I can confirm that the CCG in our area has issued an instruction to remove all bath additives from prescription as they are of no clinical value. While this is done to save money, clinical evidence is showing that the effect they have when put in bathwater is negligible as it mostly goes down the plughole. If you are using it for washing there are other emollient products you could use to wash instead
Ask to speak to the practice pharmacist, every practice has one even if part time, and they can recommend an alternative if one is needed. They are unlikely to continue it as the CCGs are monitoring practice prescribing figures

Can I ask those people complaining about pharmacies over-ordering to ring, inform the surgeries and ask for those items to be stopped. CCGs are discussing schemes that could stop any ordering by pharmacies because of the huge scale and cost involved even though it is a minority of them doing this and wasting NHS resources to enrich themselves. This would inconvenience many patients and responsible pharmacies