To complain about my drs, for only prescribing medication for 28 days

[Lardlizard]

Then when I say I need two months worth because of a holiday they have given two separate prescriptions.... rather than 46 tabs

I'm usually on the side of the NHS complainers, but I don't think it would even occur to me in this case. It's just something less than perfectly efficient. You must struggle with bureaucracy in general?

As with PP I think there is a difference between lifelong medication and medication to treat a particular condition. Is someone who takes a tablet(s) every day to keep them pushing along likely to share?

If you have a lifelong condition then you do see the process in a different way. You do see the same old bricks being tripped over. As a one off does it matter? Probably not. But month in, month out?

When you do need your medication just to keep going not even to get better, having prescriptions being wrong, sent to the wrong pharmacy, taking longer than a few days to process then having this repeated from month to month. You worry that this month will be the month when it all finally goes wrong and you run out of your very necessary medication.

You got 2 months supply on the same prescription so what are you complaining about exactly?

I am on medication and the patient information leaflet unfolds to a page bigger than the size of the Times newspaper! My hospital Dr told me the most important thing about my meds no dairy 4hrs before or 2 hrs after the rest i read myself. Its not unreasonable to expect a patient to read the medication information!

My gp practice will not prescribe anything my hospital Dr prescribes. I just phone up the hospital and they send the meds to the surgery to collect. Maybe pp with eye drops could try that?

“For those who say they can't easily get to a pharmacy there are pharmacies in boots (open til 8), Tesco and Sainsbury's near us. Order online, they send directly (electronically) to Sainsbury's pharmacy I can collect up to 9pm and at weekends surely everyone can manage this?!” Not true everywhere.

We only have one large supermarket here containing a pharmacy dept but even so the pharmacists don’t work past 7pm and not even that every day sometimes 5pm (there’s not even a regular schedule to predict which) and if the pharmacist isn’t present on the premises certain meds cannot legally be issued.

Other pharmacies in town close 5/6pm

I’m on ads long term, only get 28 days at a time. I’m housebound so get my prescriptions delivered so by the time I have to take into account the “allow 2 working days to issue a prescription” at my surgery and the “allow 2 working days” to process at the pharmacy then usually the earliest delivery slot once the pharmacy has it ready is at least another 2 working days later, then the working days thing means having to allow for weekends and bank holidays and any additional days my surgery may be closed eg between Christmas and new year...

I’ve now got a reminder set on my phone to reorder 2 WEEKS before I’m due to run out.

Even missing one dose can make me very unwell.

I’ve been especially worried about the possible effect of Brexit (which despite asking several times now both pharmacy and gp have only been able to say they don’t know if this particular med will be affected but that they are expecting some issues with meds, very reassuring - not! And yes I know not specifically my gps fault but I’d have thought it a good thing if through RCGP or their unions they could have put pressure on the govt to clarify), some meds have had issues with manufacturing for other reasons recently, another of my meds I was unable to get for 3 months and had to take an alternative which wasn’t as effective and again left me very unwell (yes again I appreciate that wasn’t my individual gps fault but what I was shocked by was that they didn’t even KNOW until I told them that there was even an issue with this commonly prescribed med, there was something of a “scramble” to get me the alternative organised).

I’ve had pretty poor experiences with GP’s overall. But I do understand there are difficulties that cause hassle for them too in terms of being able to prescribe certain meds and the frequency of prescriptions.

To answer the EU mner who asked about package sizes - yes the manufacturers issue packages in whatever number of doses they find works for them but prescribed meds are issued according to the exact prescription. I too have received meds in plain boxes/packing made up a of “bits” left over from other packages. It can be a bit bonkers and I agree the 28 days = month thing is daft!

28 days = 4 weeks

GnomeDePlume, that's exactly why I'm glad my health trust still permits 56 day prescribing, and I'm a bit alarmed by the prospect of changing to a 4 week cycle. The 2 pharmacies in my town only operate office hours plus weekends (Sundays on rota). DH and I order online and although it usually works it's very clunky. Sometimes it takes up to a week for the meds to show up at the nominated pharmacy; other times I get messages asking me to go and pick them up or let them know they're no longer required, inside two days. One of my meds is a heavy duty painkiller, and slogging into town to pick up the repeat will be the one thing I do that day. I'll be too wiped out to get anything much else done. The prospect of doubling up on these little trips and therefore halving my usefulness in other areas fills me with dread. It's not a minor inconvenience. It's a huge bloody hassle.

I get prescribed anti-D's 3 months at a time with no medication reviews. Weird.

For those who say they can't easily get to a pharmacy there are pharmacies in boots (open til 8), Tesco and Sainsbury's near us. Order online, they send directly (electronically) to Sainsbury's pharmacy I can collect up to 9pm and at weekends surely everyone can manage this?!”

Well great for you. Do you live in a bubble where only your experience is reality?
My nearest Boots or Tescos is 7+ miles away (technically in another country so couldnt use that service!) So its not a bit of use to me. Sainsburys is 30 miles away.
Not everyone lives in a major town or city so no not everyone can manage it.

If you have a chronic illness you really have to do your homework and keep everything on track.
I have to count my tablets and keep on top of ordering repeats.
I also have to order my blood test forms, book my blood tests at the correct intervals, chase the results, check the results, contact the GP if necessary.
I have to rebook hospital appointments if the hospital messes them up - for example, this week, hospital A cancelled an appointment for a special investigation. I have had to contact hospital B to rebook the scheduled appointment which was intended to review the result of the test at hospital A. Nobody else would have the information or even think to do that.
It is a full time job IME.
I am usually pathetically grateful if the repeat prescription I order turns out to actually have the right quantity of the right drugs in the bag when I get to the pharmacy.
This is just the way things are now.

Just a point about warfarin (which is a very dangerous drug), the safety regulations limit the frequency of prescribing because regular blood tests have to be done to determine the safe dose.

I take thyroxine tablets every day and will for the rest of my life. I get 8 weeks supply on every prescription. 28 days would be silly.

You are totally unreasonable OP. And you and your husband might want to be rather more proactive about your own health.

And also consider how much you get for absolutely free in the NHS and that the tolerant hard-pressed staff have better things to do than deal with frivolous complaints about only getting 28 pills in one go when they give you a repeat straightaway.

Attitudes like yours make me very annoyed.

@GnomeDePlume The testing/dosage is managed by the anti-coagulation dept. All my doctor has to do is sign the prescription. It would be a lot more convenient for all involved if I could get a bulk load of tablets

This will be for medicolegal reasons. The GP bears legal responsibility for prescribing the warfarin safely and being sure you are being monitored.
Case in a medicolegal journal- GP continued to prescribe warfarin whilst the anticoagulant clinic were not performing the monitoring blood tests frequently enough, patient suffered a stroke. Liability was 75% GP, 25% anticoagulation clinic.
So each time they sign, the GP will review results from the anticoagulation clinic. Unfortunately they can't just say "I'm going to trust you and the anticoagulation clinic to monitor this and adjust the dose", legally it is their responsibility.

@HopelesslydevotedtoGu what you say makes sense but it really is only a pretence of monitoring. My blood test results go to the GP and whatever the result, good, bad or indifferent the comment next to them will be 'Normal'.

Isnt this putting a lot of responsibility on a GP to understand the management of a fairly esoteric condition, no doubt one amongst many? My condition is managed by an anticoagulation team which is supervised by a heamatologist. It is unhelpful if a GP then feels they have to hold up the prescribing process to add their own checks if I am only allowed 4 weeks worth of at a time.

@GnomeDePlume the doctor signing the prescription is legally responsible. It isn't that your GP 'feels they have to hold up the prescribing process' by seeing your INR results. If they sign the prescription without checking and it turns out that your warfarin was not being adequately monitored by anticoagulation clinic and you suffered harm, the GP would be predominantly to blame, as in the legal case I mentioned above, not the anticoagulation clinic. If the GP issued a six month supply of warfarin and said "don't forget to go for your monthly blood tests though" and you forgot and your INR went out of range, sadly I think that would be the GPs fault too! GPs have been found at fault when they prescribed a medication and advised the patient to have a monitoring blood test and the patient didn't have the test for whatever reason.

Unfortunately anticoagulation clinics can make mistakes, patients can not attend for hospital blood tests, so the GP will want to see the result before prescribing. I assume by 'normal' they mean 'as expected' - if it came back unusually high or low the GP would check an appropriate plan was in place.

@HopelesslydevotedtoGu I do get what you are saying. To be fair for GPs in general, my own surgery is currently in the GP equivalent of Special Measures for failures in monitoring of patients on medication such as warfarin. I may be a little cynical!

Also, to be fair to GPs, blood clotting disorders such as mine (my blood is naturally sludgy) challenge the concept of 'first do no harm'. As a sludge blood, doing no harm means giving me anticoagulants. A clot is worse than a bleed.

Ohtheroses. I sympathise. I'm on levothyroxine too. It's the constant having to think about it. We're on it for life and I don't want it in my mind so much. I just want a year's supply so I can take it every night before I go to bed and not have to think about it otherwise. I don't want to have to go into the Drs to get a repeat prescription every 2 months, then go to the pharmacist. I know it doesn't sound like anything but when it's for life you just don't want the hassle of it. I'd just like a year's supply. It's not going to go to waste as I have to take it. I might try and get hold of a supply abroad somehow, don't know if it would be easy to get hold of.

To the person going on about her glorious year-long prescriptions from days past, the reason those were dropped is to do with cost.

The moment a drug has been handed to you, it cannot be taken back and used for another patient, even if you haven’t opened the boxes.

So if you collect your 365 days’ worth, and then drop dead the next day, that’s a year of medication going straight into the bin.

That’s the reason GP surgeries are no longer allowed to prescribe for more than 1 or 2 months at a time, depending on the area. And by the way - we don’t set those rules ourselves, it’s the CCGs who decide.

It's not going to go to waste as I have to take it

It will go to waste if you drop dead or get hit by a car though. Once medication has been given to you, it cannot be given to any other patient.

To be fair ViaSacra, I think that levothyroxine is one of the relatively cheap drugs. The loss to the NHS of a patient dropping dead with a year's worth in their medicine cabinet is fairly low.

@viascara Levothyrixine costs about £2.56 for 56 tablets so if I were to drop dead with even twelve months'supply in hand that would cost about £15.36. The admin cost to the surgery of handling 6 prescriptions must cost far more than that, especiallly as every time the Dr must go into my record and check my last blood tests to ensure I am properly monitored (which I know doesn't happen because they were last done in 2016).

Anyway good suggestion above about getting medication abroad. Don't know why I haven't thought of it as we have a house in France.

The admin costs of setting different prescription lengths for different drugs based on price would be far higher. Plus, if patients on cheaper medication were allowed year long prescriptions, but those on expensive medication were not, that would open us up to endless complaints.

I accept it’s irritating when the drug you need is not expensive, but it has to be one rule for everyone and for every drug.

I don't see your logic viascara. If I had one five minute apt per year to get a blood form and prescription for 365 pills what admin system would have to be set up. It would merely represent holistic, patient based care. Don't start me on the two month wait to get a blood test at 8am because I go to work.

The NHS shouldn't exist to support expensive infrastructures to roll out admin schemes. Case in point is CCGS commissioning CAMHS. Our CCG has conducted three complex reviews s ince 2009 each extending to multiple committees and 100s of pages. Each identifies what is wrong at huge cost rather than diverting money to improve the service. GPs blame CAMHS, CAMhS blame the CCG and government, the hospital blames the trust that runs CAMHS and so it goes on. The CCGs need to start operating more efficiently and being more accountable for some of the services they commission. I remember when my dc were small the HVs were commissioned to do health checks but they were not competent, missed much and yapped nonsense. One quick trip to GP sorted out a referral and the problem. Yet despite commissioning the service the GPs took no responsibility for its quality.

Far too much money is paddled towards bureacratic infrastructures and it has been thus since Blair set up the PCTs in 97.

FenellaMaxwell meds for inability to adult made me chuckle.

I love that we have the NHS but reading the original post makes me feel really sorry for staff having to put up with the entitlement and stupidity levels of some users.

As an aside so many pharmacies offer repeat prescription and even delivery services anyone short of time should perhaps consider using one of them.

My Gp does 2 months of meds on one prescription