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?

There are plenty of legal and safe online pharmacies where you could likely get it - do some research with products names - PM me if you want me to have a go for you .

Boots, lloyds , superdrug all have them

Similar with asthma meds. The preventer I and my gp know works is now no longer recommended. Try beclamethasine. IT really doesn't work for me. Ok try this other one. Two months in and my salbutamol use has doubled. So I'm back next week to no doubt get my original preventer.

Also 'hells' I would get a second opinion about your piles. They absolutely are treated on the NHS if clinically necessary- bleeding,itching and pain sounds pretty necessary to me

^ also check if you can register for GP at hand . All the doctors are super pragmatic

If it was really actually agonising though I would buy it OTC asap! As it was THAT horrendous and I couldn’t bear it anymore. Is that just me or maybe the condition isn’t as bad as that?!

I'm at wanting something more expensive most of us just want something that works...

I can assure you even when they are all basically the same they can still have different effects.

Even one tiny ingredient whether it's there or not can be the difference between bleeding in your very disrupted sleep or being ok.

Although rebecca will be pleased to k me I foot the bill for the special shampoo conditioner lotion deodorant washing powder and sunscreen she needs In order to not shred her legs.

vcree so now your condition has to be 'agonising' before the NHS will treat it? Bollocks.

It's certainly backfired in your individual case. Of course, the decision will have been made on the basis of all the people for whom the cream is or would have been prescribed, now and in the future. So it may well not backfire for the NHS as a whole, in which case there will be someone else who gets a treatment they otherwise wouldn't have got and who might see a return to the previous situation as backfiring on them.

vcrees6 you do realise that lots of people can't afford to just pop to the chemist to buy something for £40 per month

"If the person using the moisuriser and bath emollient thinks it's not worth the money though and won't buy it is it reasonable to expect other tax payers to pay for it? It's not a life saving cancer treatment, just a posh moisturiser."

Yes. The person has a medical condition and needs medication for it. The NHS isn't just for cancer and the moisturiser is for a medical condition.

OP, try writing to the papers and your elected representatives. The thing is, though, it might save money overall, even if not in your case.

I feel for you, OP. I have eczema and am currently prescribed emollients, Balneum bath oil and steroid creams.

They're absolutely not luxuries, but necessities to stop skin getting inflamed and infected.

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

and not to forget the quantities needed.
where a 500ml bottle of moisturiser/emoillent would last a couple of months or even longer for someone with normal skin, bad eczema means going through a bottle or more a week.

even 'cheap' own brand body lotion would get expensive at that rate.

"What happens, in many cases, is that the hospital specialist will prescribe and the medication/cream/whatever will be administered from the hospital pharmacy."

I've had that happen, but on another occasion I also had the consultant tell me she couldn't prescribe directly and had to write to my GP telling them to prescribe.

hells they do treat piles on the NHS. But they don't offer the most up-to-date procedures which have far fewer complications. But they can offer other treatments, especially if they are bleeding because that will also skew your bowel cancer screening results.

That sucks :( sorry you are suffering.

My “what a waste” story is from when I had GD. I put a request in asking if I could have more test strips in one prescription. NOT that I needed to use them any more quickly (always 4 a day) but simply to have more prescribed at once as otherwise I literally had to request as soon as I picked one lot up (surely a lot of admin for them as well as a PITA for me). They decided instead to give me a whole different brand of glucose monitor, as the strips were cheaper. I gave birth about a week later. Both monitors can’t be reused. Feels so wasteful.

also had the consultant tell me she couldn't prescribe directly and had to write to my GP telling them to prescribe.

I've had that as well - only for the gp to then say they can't prescribe as the computer says no...

7 years it took for us to get my son's eczema sorted out. 7 years and turning up at the GP with a copy of the NICE guidance. 7 years of repeated infections, impacting on sleep and school, scraping his back up and down walls and carpets to try and stop the itching and all we got from the GP was you're not putting enough cream on and it won't be allergies.

When we finally were referred to a dermatologist he went through blood tests, new treatment regimes and a diagnosis of a lot of allergies to environmental things that we have limited control over.

His eczema is largely under control now but this has taken so much time of experimenting with different medications to find the ones which don't make it worse and leave him crying in pain. His arms and back are scarred from infections. His eyebrows are only just starting to grow back from when he scratched his face so much because of the itching.

We pay for bedding, etc which is dust mite proof and hoover and damp dust everyday to reduce the allergens that he encounters but can't stop dustmites elsewhere, likewise all the pollens. He still has flare ups now and then but he's starting to catch up at school (because he couldn't concentrate before because of a combination of itching and the antihistamines that the GP insisted he take) and people have stopped saying that he has ebola, his confidence is starting to build up again.

It's not a bit of itchy dry skin and it's not fucking posh moisturiser. It's treatment for a medical condition which can be debilitating and using the wrong one resets everything. Anyone who thinks it's posh moisturiser has no fucking idea.

Sorry to hear this, never had excema before this winter and found it horrendous. There isn't much you can do, maybe start a petition to get it back the way it was? other than that you're stuck unless you can find a gp to prescribe it and that won't last long, they have to cut costs somewhere, very sad that people get ousted like this.

I’ve heard that carehomes just collect all these metal walking frames that the residents come in with as the NHS won’t take them back. Madness.

The cream I used is Aveeno, obviously different things work for different people but this is the only one that’s reliably kept my eczema under control for any length of time.

I did ask the GP if it was a surgery policy and he said it’s area wide (didn’t say CCG but that sounds like what he meant). I don’t want to complain to the practice as they’re usually really good, but I will find out where the decision has been made and if there’s any mechanism for me to complain there.

For the people saying I should buy it myself: If I could afford to then I would, as that would be preferable to my current situation. But, like most people, I don’t have £60 a month lying around. I’d hardly choose to be using potent steroids and antibiotics if I could pay for an alternative. I do pay for a prepayment certificate as I have other routine medication so it’s not about being able to afford the prescription charge, it’s about the GP no longer giving me a prescription.

A friend of mine has a similar issue with thyroid problems. They were well controlled by a prescribed banded product, but someone decided that that was too expensive for the NHS so insisted that everyone had to be put onto generic medications. As a result friend's thyroid went haywire, she became really quite seriously ill with her heart rate either manic or too slow, and had to be put on beta blockers - which cost way more than the branded thyroid medication. I really want to know who ever thought that was a good new initiative..

Definitely a lack of joined up thinking. DS’s needs daily cream, gp thought they’d cracked it because they’d found they could prescribe 1litre bottle which would keep us going for ages. Except the pharmacist wasn’t allowed to prescribe it for a child. So instead we get 4 250ml bottles. And every single time the pharmacist says they’ll phone the gp cause they can get a litre bottle.

What a waste of time for you , the GP and dermatologist! Guidelines are there to guide and your expertise in your condition should have been considered. I buy oilatum for my DC eczema and use this intermittently with oatmeal for baths 🛀

Definitely not about ‘posh moisturiser’ either, we are lucky that my DS has finally found a treatment regime that works after countless failures, but when he has a flare up he can’t bend his fingers, it has put him in hospital dangerously ill when he was little too. Agree even when products seem virtually the same there can be massive differences. We are just fortunate that the combination he needs is easily available