To think this GP policy is backfiring?

[ConfusedYetAgain]

I’ve had eczema pretty much my whole life. After years of dermatology appointments and lots of trial and error with different emollients and steroid creams me and my GP (sadly now retired) finally found a combination of stuff that keeps it generally under control.

Until a couple of months ago I requested my prescription as usual and when I went to collect it I was told my usual emollient cream and bath emollient are no longer available for cost reasons. Instead I’ve been given a different emollient cream and no bath emollient. I asked the receptionist how I could request this is reconsidered given my history and she said to make a GP appointment.

So, GP appointment 1 I explain my concerns, GP says I need to try the alternative cream, even though I’ve used it before and it wasn’t suitable. Also told me that if I had my heart set on the original emollient I could buy it myself. Not sure who has their heart set on a product they use to treat a medical problem (!) but I asked at the pharmacy how much it would cost and for the amount I need to use the emollient cream alone would cost me around £40 a month which is just impossible. I took GPs advice and tried the new emollient and went without the bath emollient as per her advice.

I was hoping it’d be okay but within a short time my eczema had really flared up and the mild steroid cream I normally use wasn’t helping. Cue GP appointment 2 GP is sympathetic but says there’s nothing they can do. Prescribes potent steroid cream, alternative emollient cream and aqueous cream to use instead of bath emollient. Advises me to come back if no improvement in 10-14 days.

Eczema continues to be worse so I make GP appointment number 3 GP again very sympathetic. Says that he’d prefer to just prescribe the emollient that has helped for years but he’s not allowed to. Instead prescribes potent steroid and antibiotic cream. Advises to return if no improvement in 7 days.

A week later, GP appointment 4 Same GP says he’s going to refer me to dermatology again as eczema not responding to usual treatment. I say this seems ridiculous when it was well controlled with my original emollient cream and bath emollient. GP agrees and says it’s possible dermatology will just recommend the original emollient and that the GP can then prescribe it as it’ll be on specialist advice.

So, the original cost cutting exercise has now led to this extra cost:
4 GP appointments
1 dermatology appointment
2 potent steroid prescriptions, 1 antibiotic prescription, several prescriptions for emollients that were only half used due to my skin reacting badly

I can’t help thinking that all of this must dwarf the saving they’d make by switching me to a cheaper emollient cream and banning prescriptions for bath emollients. AIBU to think it all seems massively counterproductive?

An emollient is a moisturiser

YANBU. Frustrating. As a fellow sufferer you have my sympathies.

But can your try another you haven’t tried before and see it it works again?

I’ve found over the years the skin changes and different creams suit different phases/seasons/age

For example I used to swear by Diprobase. Now Aveeno is best. Also Fucidine Steriod cream word for years, now a better solution is a milder one.

I think it’s alsi good practice to check in with a dermatologist every few years to keep up to date with best practice & research.

It’s not posh moisturiser. Eczema is a real medical condition.

YANBU but my GP surgery (and the area in general) has a policy of no longer prescribing any OTC drugs.

OK I'm prepared to get flamed for this but why can't you just buy the cream and bath gel that works for you? I appreciate you have a skin condition but if you have found what works why can't you pay for it?

I agree eczema is a medical condition but emollient and moisturiser are synonyms.

Ps sometimes Amazon do larger sizes cheaper than prescription (if you pay for prescription that is. I used to get Cetroben like as could get big vats of it rather than little tubes from the local chemist).

It's shit, and at least in your case, an utterly pointless, silly, false economy. I would complain to your CCG, and explain how their policy is actually costing more money.

At the poster who thinks it's a 'posh' moisturiser. You've never had eczema, have you? Emollients for eczema are bland, scentless creams and ointments that come in industrial-looking containers. They're not Jo Malone body creams....

It does seem total madness but may have been cheaper to buy the cream you have successfully used as prescriptions at nearly a tenner a go are not fun either especially as they didn't work

People are taking exception at the 'posh', 2rebecca

Nothing says luxury like a giant tub of diprobase

Well, lost, why not just make everyone pay for their medications? It's not a choice to have medication for eczema- without emollients the skin becomes cracked and infected. The op has clearly stated the emollient alone would cost her £40 a month which which she cannot afford. We live in a society where our medications are subsidised in the form of NHS prescriptions so that everyone can have them whether they are rich or poor. That's how are fair society works. 'Just pay for it! Indeed.

It’s also cheaper than Jo Malone

The derm will trump the Gp in what they can prescribe. I've been forced to try cheaper products but my consultant insisted I got the original despite what the ccg recommended.

expensive then if people don't like posh. Most NHS areas now have formularies with evidence based emollients/ moisturisers classified as light medium or heavy weight according to how greasy they are. There are usually 1st and 2nd line preparations and if people want something more expensive they have the option of buying it from a pharmacy.
If the person using it doesn't think it's worth the money then why should other people fund it? "The NHS" is just other tax payers.

It is madness. We have this with my DD's narcolepsy medication on a regular basis. For some reason the generic/alternative version of her tablets just don't work as well. It's a genuine thing as she is not the only person that has had this issue.

So every now and again they change the prescription. then her narcolepsy becomes less controlled so they refer her back to the specialist (meanwhile she's missing more school and getting more injuries while it's not controlled). The specialist sees her and writes to the GP saying "Prescribe X brand tablets". Then we get back under control again for a year or so until someone decides to just prescribe Y tablet rather than specifying the brand and the circle begins again.

Just a thought but could you afford a medical exemption certificate or whatever they are called £100 for prescriptions for a year?
I get free prescriptions at the moment as I have an underactive thyroid (I hope they don’t change that).
On another note I went to the doctor about something else recently and mentioned my piles which I have had for years. They are massive now very sore after a poo, frequently bleed and are extremely painful and itchy at night. The GP had a quick look and said they don’t remove piles on the NHS now as it’s looked upon as a cosmetic procedure....seriously!

Lostlemon, OP has explained she cannot afford this. RTFT 1st post...

OP, I am really sorry but this is down to the CCG, the pharma team will be looking to save money. Your GPs are under the cosh from both sides. And you are caught in the cross fire, which means you have two choices. Either play along with Dermatology appointments or involve your MP. Whilst the latter will create heaps more work for all concerned, it will definitely expedite things.

Just trying to read through before I reply to everyone, but Rebecca - I think it would be worth every penny but I’m not in a position to spend £40 a month on emollient creams and £20 a month on emollient bath oils. If I were rich enough to do so I would have done that already rather than feeling as ill as I currently do with a crappy eczema flare up!

Giles

Seriously, though, to those saying why doesn't she buy it, why should she? Eczema is a medical condition like any other. We all pay into the NHS and pay prescription charges so that we can get the medicines we need. If the NHS is short of cash (which it is) then the govt needs to have the balls to either raise more cash to spend on it, or spend less elsewhere, or re-organise (if possible). Not deny people essential medicines.

hells a prepayment certificate wouldn't help- the GP is refusing to prescribe the cream that works and suggesting she just buys it over the counter instead- at a cost of £40 per month

You have my sympathy. YANBU. I hope the dermatologist recommends the products that work for you. I think there is a lack of understanding of skin conditions eg how difficult they can be to treat, the long term nature of many of them, and the effect they can have an individual's life and mental health.

How ridiculous. I have this issue with one of my medications. There are two versions. One works for me, one doesn't. Guess which one is cheaper? I have to your the local pharmacies to find out which one they have in stock each month. No-one has a consistent supply and it's getting harder to find the functional version.

Without it, I require steroids. If I worked, I'd have to have time off. (I'm a SAHM). The pennies they save, it's not worth it.

The cheap brand is widely regarded as being next to useless by a lot of people with my condition, it's not just me.

@SluttyButty actually a GP cannot be forced to prescribe something, although some can be persuaded. What happens, in many cases, is that the hospital specialist will prescribe and the medication/cream/whatever will be administered from the hospital pharmacy.

Hellsbells the OP doesn't have a prescription, her GP won't give her one got the stuff she wants so she would need to buy at over the counter prices.