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?

Oh daily, I really feel for your DS. Eczema is awful, you’re right that people dismiss it as just a bit of dry skin and itching but it’s really so much more. I hope the improvement continues and he’s able to manage better at school too. My first GP was so dismissive as well, I remember her telling my mum that she just needed to tell me to put my moisturiser on when I was at school and that would solve it all. Of course it didn’t. I hope things get better for your DS and you find a GP who knows more about eczema.

It's ridiculous. You must be so frustrated, OP.

For those who don't seem to realise, there is really nothing glamorous or luxurious about eczema cream. And eczema is a proper medical condition that can cause serious problems if neglected.

OP, we have the same issue with our GP. My dd used to have a prescription for one cream that worked really well, but now she can only get the cheaper alternative on the NHS, which doesn't seem to work nearly as well. We're in the fortunate position of being able to pay for the old cream over the counter, but it's not cheap and I can completely see why this would be impossible for some people. I probably spend in the region of £60 per month on dd's eczema - not great, given that she is supposedly entitled to free prescriptions!

I suddenly developed eczema in my forties. I'd never had it before. It flared to the extent I was getting dressings changed twice a week. I was crunchy and oozing. It was grim. I ended up with cellulitis. I cut out gluten and it settled down. It took time, and it takes time to die down every time someone things I'm choosing no gluten for lifestyle reasons and I get a flare up because of contamination, but it's never been so bad. I have never been diagnosed with gluten intolerance

It may or may not help. I feel for you. I feel my life is now ruled by my skin condition. And it is almost certainly not as bad as your issues. I don't bother with the GP's emollient, btw, but use the red topped E45 cream which is often on offer at Tesco. It seems to do better for me, but that may be because I have a lesser case than you. I hope you can get something sorted out - preferably getting a prescription for medication that actually, provably works.

And it’s easy to spot the folk on this thread who have no idea what living with eczma is like.
This times a thousand! My last serious infected outbreak saw me off work for four weeks (in hospital for the last week). I am lucky, I have a very sympathetic GP who has prescribed different things and asked me "what works?"

Sorry for misunderstanding I feel for you having mild excema and severe dry itchy skin it must be so difficult for you.

I think it would be better if GPS were allowed to try a couple of alternatives but if they didn’t work as they haven’t in your case OP they should be allowed to use their discretion. Would it help if you write to the Practice Manager and you MP?

vcrees6

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?!

Your argument makes no sense. It’s like saying if someone has a life threatening illness and the NHS has a waiting list then the person should pay for private treatment and if they don’t it can’t really be life threatening.

I would gladly buy the products I need if I could afford to but I can’t. Do you think anyone would choose to be in pain and having to use potent steroid creams with long term effects if they had any choice.

Really annoying op - hope the consultant sorts it out.

I've got asthma and I always get the patronising pharmacist tell me I should drop down to a lower dose of my steroid inhaler (I have 3 preventers). I now tell them that's fine as long as they pay my mortgage while I'm off work being nebulised in hospital.

Thanks for trying to help hells :-)

meckity sorry to hear how much you’re suffering. People really underestimate how much skin problems affect your life. I’ve never managed to identify any dietary triggers for my eczema, but I have heard gluten can be quite common as a trigger. I’d ask about allergy testing but I suspect that’d be a non starter at the moment!

Aveeno is amazing stuff!

Confused - if you can ever afford it, have a water softener installed.
I suffered with eczema for fifty years; tried every cream, scrub, lotion going. We had a water softener installed five years ago and the eczema was completely gone within three months. And it has stayed gone. I can wear wool, do the dishes, go out in winter with no gloves. Wish I’d had one years ago and if it breaks tomorrow I’ll beg or borrow the cash to get another.

Thanks confused - I'm sorry for the rant but I saw red when I read posts from people who clearly have no idea how much it can affect people's lives.

Anne, I also have asthma and sympathise about the patronising comments. My pharmacy insists on offering those medicine use reviews and I always get told I should switch to Seretide instead of separate Flixotide and Serevent inhalers. I ask if they have any advice for stopping the heart palpitations that I’d end up with it I had to take 8 doses of salmeterol when I have to increase my fluticasone dose when I have a cold or worsening asthma.

And it’s easy to spot the folk on this thread who have no idea what living with eczma is like.

Completely agree.

YANBU, OP. I suffer myself. Once you finally hit on something that works, it's like a ten tonne weight has been lifted. Cruel to take it away for pennies in savings. Especially when repeated visits to the GP will mean that the NHS has spent a pound to save a penny.

Sorry you're going through this OP.....my friend cut out sugar and it was like magic for her. She didn't even eat that much sugar but once she eliminated it, the condition cleared up completely.

Is the St Ives Oatmeal range any cheaper than Aveeno?

My eczema has gotten 10x worse in the last year. I moved (300miles ) and had to register with a new GP. Because she saw how long and the amount of skin I was applying steroid to she refused to give me any more but also refused an allergy test (it would have to be a specific test) prednisilone ( I’m too young) or a referral ( it’s not bad enough - she saw me in a v good day I am 40% covered including my entire back, bum and thighs + both arms, neck and one cheek). She gave me ....diprobase.

It’s ducking ridiculous. It is hell, I am constantly itching and tearing my skin open and bleeding and they don’t fucking get it.

As a long time psoriasis sufferer of 30 years it is the Holy Grail finding a particular treatment that actually works. To then have to go back to the start is so demoralizing so i really feel for you OP

Ive often found that many people (and medics sadly) often underestimate the emotional and psychological impact of skin conditions. There is no hiding from the thick plaques, flaky skin, dried blood and endless itching. Its so much more than just a dry bit of skin

I guess in my head there is a scale of cost from paracetamol to cancer treatment. If something is easily available over the counter, it tends not to be expensive and therefore closer to paracetamol on the scale. Obviously cancer treatment or emergency life saving surgery is not over the counter.

Also I think if you can afford to pay for your health then it makes sense to me to do so.

My FIL waited for a year to get his prostate out on the NHS because it had some abnormal cells. He is sitting on loads of money though. If it were my money, i would have spent it on whipping it out ASAP knowing I was definitely safe from cancer and then just be 100k poorer. He would rather risk his health and get it for free.

although child’s farm has actually helped somewhat which I didn’t expect.

And that’s not the point @vcrees6 I pay taxes and a pre-payment certificate so that my healthcare is covered and yet I have to pay £150 a month on top of that just to stop me ripping my own skin off in pain and discomfort. If you can afford to pay then we may as well switch to the American system and offer Medicare.

Possibly missing the entire point, but look for child's farm baby moisturiser (one with duck in front) it's £2.99 and bloody amazing for my kids otherwise awful skin!!
It's iften out of stock it's so good!
Big boots usually only place I can get it
Hth

It’s not just the American system though is it though? It’s the French, German, Australian, Swedish etc system as well

@vcrees6

I think in a decent society people’s access to healthcare shouldn’t depend on whether they can pay for it.

Also, there’s not always a correlation between the cost of a treatment and how important it is to someone’s well being. For example, many medications to treat high blood pressure are fairly inexpensive but are vital to the people who need them.

Lemony that's awful. Have you tried another GP? Or a complaint? She's clearly clueless. Or go back when your eczema is at its worst, and cry and just don't get out of the chair till you get the script you want, or a referral to dermatology.

@OhWhatFuckeryIsThisNow
Exactly the same happened to me. They randomly decided to take me off my steroid pump, told me to try beclamenthasine, in some powdered form. Didn’t work but they still made me have it for three months, then they gave me the pump version. Didn’t work and then after 6 months they finally gave me back my seretide. So approx nine months of solidly worsening asthma, and worsening of quality of life for what?
I swear, it feels like sometimes they just want to change things purely because they can