To think the CQC report on on ine prescribing services will only make life more difficult.

[ExConstance]

DH and I l both work long hours and struggle to get GP appointments. If we can get an appointment it invariably means taking time off work and then waiting and waiting for so long we have to book leave to cover it. We have found it very useful to use Treated.com for antibiotics and my HRT.

DH ascertained a while back that it is no good to go to GP with raging earache as they won't prescribe antibiotics, the only way you can get something that works is to use an on line service and say you have a dental abscess. I have needed a trimethoprim prescription for a UTI on the odd occasion, if I order on line I can get it the next day, having to wait a week to see GP for this sort of condition is nonsense. I need to go to my GP for HRT prescription once a year but at least the on line services mean I'm not subjected to the usual harassment and doom and gloom over this 4 x a year ( with consequent time off work) . Our bodies our choice, I really can't see if with informed decision making I want to order medication and that is checked ( as it is now) by a GP I should have to jump through additional hoops of proving who I am and allowing the GP who has no interest in me and can't even be bothered to have convenient surgery times to be notified. For many of us I suppose we will now just stock up on a plethora of medication while we can, buy abroad in future and - as my GP is of no practical use to me at all, de-register so there can be no unwanted snooping.

I wish you were a troll. Sadly, I know you're not. Antibiotic resistance is truly scary. The bacteria are becoming resistant to our very last antibiotics. No/very few new antibiotics are being made. We will see a situation where people start to die of common ailments in the next 10-15 years because we can't treat them effectively.

Why? Because people don't listen. Because they think 'you have a virus' is a fob off. They think the doctor isn't taking them seriously if they say they have a virus. Who knows why? Ebola is a virus - no-one would call that a minor ailment. But people don't want to hear virus. They want treatment. They want to walk out of the surgery with a green form in their hands. They want to be able to say "I'm really sick -the doctor put me on antibiotics."

Well, enjoy. Get your trimethoprim. Because one day, you'll need it and it will do nothing. You may as well get a packet of smarties and pour them down your throat.

The point here is that we can still use these services, which are very useful and take some pressure off GP's surgeries but we have extra hoops to jump through. Apart from DH's one lot of antibiotics for his ear (he is 62 this year so I don't think one lot of antibiotics obtained on the advice f a qualified GP is going to cause any problems) We have never had any antibiotics that a GP would not prescribe anyway. We live in the real world where sickness is closely monitored, where DH works it is the main basis for selecting for redundancy. I'd be very happy to pay something for GP services at point of use, maybe on the basis that those who get free prescriptions get free GP and the rest of us pay , say £40. If this would increase availability greatly. There are private GPs in two towns in this region, but with both being over 25 miles away it is still a lengthy excursion in a busy week.
I'm not sure why de-registering from a GP would be problematical longer term, I could always re-register if I wanted to at a later stage. Interestingly everyone who is unhappy with my views has chosen the antibiotic issue, not the HRT which is my major concern. I do find GPs very patronising about this issue. I think if they enabled well informed older women to avoid vaginal atrophy and the incontinence that comes with this then there would be less UTis amongst the older female population and less antibiotics needed.
I don't think DH and I will be self flagellating over one lot of antibiotics which worked very quickly for a raging ear ache.
Anyone complacent about antibiotic use in animals should read this - it is an NHS report here and start getting militant about the real issue. If more people stopped supporting the meat industry this would do far more to help the problem

The problem is if you get away with lying - how many other people less well informed are also doing so and how many are risking their health doing so.

I know GP aren't perfect - and I've experience my menstrual pain and bad reaction to hormonal contraceptives being dismissed but our current system has the acting as gate keepers between us and drugs that might harm us.

Certainly you should be able to choose to use HRT, as long, as you say, you are well informed about risks/benefits. Please don't forget that the grilling you perceive to get is likely just doctors covering themselves. There is a huge emphasis on information and consent, and complaints about "I wasn't told" can potentially lead to a lot of bother with the GMC. It is your body and your choice, but the doctor is responsible for the prescription and it's effects, so let them make sure for themselves that they are happy to do it.

I suspect that we will start to see the proliferation of more private GPs in the near future. The NHS at the moment is as unpleasant to work in as it is to use, and I suspect that healthcare professionals giving up on it and creating better working conditions for themselves will start to increase. You may well find a private GP closer to you sometime soon.

We have never had any antibiotics that a GP would not prescribe anyway

You are directly contradicting yourself now. Your DH lied about his medical problem to get the antibiotics because he knew a GP was unlikely to prescribe them for an ear infection.

And almost all ear infections clear up by themselves anyway. So the fact that it got better after the antibiotics means nothing.

No one is being complacent about antibiotic use in animals, do not use this to excuse your irresponsible, selfish behaviour.

I don't think one lot of antibiotics obtained on the advice of a qualified GP is going to cause any problems

Obtained on the advice of a qualified GP because of a lie. A lie your DH knowingly told to obtain them under false pretences.

Thank you sheep for that resistance map link! I'm quite put off going to India now...

OP - the overuse of antibiotics in agriculture is a major issue overseas (US and most developing nations), but is very tightly controlled in the UK and EU. Milk and meat containing antibiotics here have to be dumped, not fit for human consumption.

I've never had a sample taken before antibiotics were prescribed when I used to get UTIs, until I had a number in one year and they wanted to be sure I was getting an appropriate Ab (I was), and was prescribed trimethoprim to keep at home - but ear infections are far harder to confirm over the internet/phone.

I was going to say YANBU until you stated that you were lying to get antibiotics! That's ridiculous, and putting your own health at risk.

I use a combo of private GP and online UK pharmacies to get routine scrips like contraception, anti histamines, skin medications filled. I'd never dream of dealing with anything potentially serious via an online doctor.

Things like fenofexadine (Telfast) and Finacea gel are sold over the counter elsewhere in the world (like Australia), it wastes a lot of time having to get these prescribed.

Things like fenofexadine (Telfast) and Finacea gel are sold over the counter elsewhere in the world (like Australia), it wastes a lot of time having to get these prescribed

Lots of GPs would agree with you, ruby. The controls on Over The Counter prescribing are pretty arbitrary. Paracetamol, for example, is one of the drugs with the smallest difference between the recommended dose and the potentially deadly dose, yet you can buy it everywhere. By contrast, it's pretty hard to overdose on Finacea

But antibiotic prescribing needs to remain prescription-only because of idiots like the OP.

Is there a GP on here? DH was told by a GP who is our friend that he would not be prescribed antibiotics for earache because NHS would not pay for them and if he went to our GP he would be advised to go back the following week. He was advised that a private GP would prescribe because the cost considerations would not apply but that the best route would be to go online and get them, saying it was a dental abscess as the same type of antibiotics would be required. DH was in extreme pain so he got the antibiotics on line. Why am I an Idiot. GPs happy to hand out "just in case" prescriptions of Trimothoprim if you ask anyway. I do wish people would actually read the posts instead of just wading in.

There is a whole debate to be had here, about the amount of control GPs should have over the way we can acquire medication for pretty routine conditions when their resources could perhaps be better used. On line prescribing is surely the way to go, but if we have to comply with too many restrictions it is very off putting. If someone wants to be untruthful about their situation for whatever reasons the you can do this face to face with your GP anyway.

I am a GP. Antibiotics like amoxicillin are as cheap as chips. It's not cost that stops us prescribing, it's that they don't work if the infection is viral - which most ear infection is. In fact, most people with ear pain don't even have an ear infection - the pain is caused by snot-like gunk in the sinuses causing back pressure in the ears. Even if it's bacterial, antibiotics often make no difference to the average time for a condition to clear.

If you take antibiotics, you are 13 times less likely to respond if you need the a similar type of antibiotic again. It doesn't even have to be exactly the same antibiotic. So, by taking them when you don't need them, you are putting yourself at risk as well as fucking over everyone in the community who might be at real risk from bacterial infections - which includes babies, new mothers, anyone who has had surgery and people with cancer.

I'm a GP. I think abusing the system by lying about your condition is remarkably stupid. However there is a lot to be said for online services, and many of my patients do use them, appropriately and mostly safely. One problem arises with communication, which is generally very poor, so the registered GP is not always informed about prescriptions supplied online. Due to this a patient died in my area recently because of a fatal drug interaction; the online GP did not know what medications they were already on, and had only the patient's word about allergies etc.

HRT is a difficult one. Again the risks, while usually small, can be very serious. I would rather someone was monitoring my HRT, if I ever decide to take it, more carefully than an online service can possibly manage...

And what shinynewusername said

My DH is a dentist. He is very interested to hear what doctor is prescribing for dental abcesses and what doctor advised lying about one to get a script

Doctors should not be prescribing for dental abscesses. They do not have the requisite knowledge. Many patients at present with "abcesses" and have a totally different issue anyway.

In addition antibiotics are not always the appropriate remedy for an abscess and a patient should always be examined to check what the issue is and whether antibiotics are appropriate by a properly trained professional. Neither of which this GP who is apparently sanctioning these prescriptions is?! The NICE guidelines and the provisions of indemnity insurance are very clear.

The on line services insist you see your GP once a year for HRT and will then prescribe 3 monthly in between. I don't mind that but I do mind photo id and insisting your GP is contacted. It only leads to more badgering to give up. GPs never seem to take into account that some people ( one particular friend comes to mind) would rather have, at age 60, a few more years of drinking, smoking and HRT than 30 more years where the last 10 deliver zero quality of life. They are totally risk averse to any life enhancing medication or lifestyle choices that might mean a short life but a merry one.

Do you understand how prescribing works? That the person prescribing has a duty of care and can only prescribe responsibly, even if it's a private prescription?

Are you honestly saying that you think you should be able to buy any drug off the shelf and self administer? Can you see the possible issues around abuse of that?

a few more years of drinking, smoking and HRT than 30 more years where the last 10 deliver zero quality of life

I have had many patients say that when healthy. Not many still hold that opinion once they have actually had the blood clot, cancer or stroke.

You sound remarkably ignorant of the risks of HRT: it doesn't conveniently kill you stone dead after your 10 years of good quality life. If you are unlucky enough to get the side -effects, you are likely to have years of poor health and disability before also dying early. It is a broadly safe and effective drug for many patients, but not everyone and smoking significantly increases the risks.

GPs balance the risks and benefits of every prescription and, as Gobbolino says, we are still responsible for ensuring that every drug is appropriate for the patient, even if the patient says they are happy to take a risk.

I would suggest that your GP friend is utterly clueless and probably needs reporting to the GMC if that's exactly what he said to your DH.

If you want to drink, smoke and medicate yourself into a stroke, heart disease or early grave then that's your call. But don't expect your GP to facilitate that with inappropriate and potentially dangerous prescribing that risks their professional registration and livelihood.

I do wish people would read my posts properly before commenting. I have a healthy lifestyle and don't smoke and drink very little ( and I'm vegetarian) I don't expect HRT to necessarily kill me though there may be increase risk of strokes and breast cancer depending on which study you rely on. My comment was about the desire to extend human life at all costs without thinking through the fact that my grandparent's generation tended to die around 80 - 85 after a funny turn and a few days in hospital. My Parents generation are now 90 -95 and, when still alive contending with falls, incontinence, poor mobility , swollen legs, skin problems, Parkinsons and Dementia. I don't suppose people ever want to die but my mother is not too impressed with life at 90 and osteoporosis and heart failure, she says she has lived too long.

*my grandparent's generation tended to die around 80 - 85 after a funny turn and a few days in hospital.

Yet more total crap. People died younger but had more years of ill-health.

The longer you live, the fewer total years of ill-health you experience, on average. And you are wrong about the prevalence of chronic disease in our grandparents' generation. When I first qualified as a doctor in the 90s, we saw huge numbers of patients with massive haemorrhage strokes, acute heart failure and disabling COPD- all conditions that are rarer or better controlled now. Rates of diseases like dementia are actually falling, thanks to our healthier lifestyles (obesity excepted) and preventative medicine. Other diseases like type 2 diabetes are increasing in prevalence but we have better ways to control them to prevent disabling side-effects. Most people under 70 now can look forward to a much healthier old age than the parents or grandparents.

I'm not sure I agree with this, shineynewusername.
Paternal Grandmother - active life until fall in garden, got hypothermia and died 84
Maternal Grandmother - active life if a bit forgetful, had stroke died 2 day slater - aged 84
Maternal grandfather - died aged 78 in hospital after admission for heart problem.
DH's grandfather - had fall in street aged 89, went to hospital died a week later of pneumonia.
DH's grandmother - died late 80's fit and well until a week before she died.
My mother - 90 has a miserable life of her own admission, heart failure and osteoporosis, on mountains of medication, continually not well.
DH's mother nearly 90 in care home with poor mobility and Alzheimer's.
Local friend of family - 88, had one stroke, made poor recovery, had another and had loads of medical interventions, now zero mobility, cannot speak.
Yes, it is only us and it is anecdotal but when my old school friends gather it is a topic on which we can all come up with similar examples.

The plural of anecdote is not data.

Yes, it is only us and it is anecdotal

Exactly. As shiny says, actual evidence (as opposed to you and your mates) shows that people who live longer also experience fewer years of ill health and a better quality of life.

You sound either really poorly educated, or just genuinely stupid and/or selfish.

The plural of anecdote is not data

That is brilliant, I must remember that!

I quite agree, maybe it is just my family, but whether it is a widespread experience or not - and my experience is that it is common, I see, in my work in the care sector large numbers of very ( 90+) people who probably wouldn't have been alive now without modern medical interventions who have very poor quality of life. Time and time again they fall, go into hospital, get sent home, and spend their days in abject misery. I suppose that most of us would prefer not to have to go through that. Yes, the statistics may show that many people are living longer with better health but for a great many the last 15 years or so are not only pretty grim but a cycle of one intervention after another.