AIBU to think the GP just needs to issue the prescription?

[lawandgin]

Not sure if this is an AIBU, but donning my hard hat and posting anyway.

DD is 4 months old and has suffered terrible reflux since she was a newborn. We're all getting through 3+ sets of clothes a day, I'm constantly worried about how much milk she's actually keeping down and it's very stressful all round. For context, she was small for gestational age weighing 5lb 8oz when she was delivered at 38+3. She lost 8% of her birth weight and took over 3 weeks to regain it.

Just over a week ago, we ended up in A&E when she just would not stop screaming. I'm talking 7 hours. The long and short of it was that they thought it was a delayed reaction to her 16 week vaccinations, but the doctor said we needed more support with her reflux and that she likely had CMPA. Knowing that she wouldn't be a priority on the NHS as she's gaining weight and there's a several month long waiting list to see a paediatrician, I paid to see a private paediatrician the two days later. He confirmed he thought she had CMPA and needed dairy free milk and also omeprazole to treat the reflux. We happened to have some dairy free milk left over from a previous trial, so were able to put her straight on that and we saw a huge improvement in some of the other symptoms, but the reflux remains. The doctor prescribed omeprazole privately and wrote to the GP and asked them to continue the prescription.

The pharmacy ordered the omeprazole off the back of the private prescription, but it's £400 for a six week supply. I requested an NHS prescription for the same on Wednesday, chased it twice on Friday (each time being told it would be done that day - their turnaround time is 2 days) and it STILL hasn't been done. The doctors haven't phoned me to explain the delay and neither we nor the pharmacy can understand what they're playing at. I have a sinking feeling they're going to refuse the prescription due to the price and I'm ready to do battle with them on Tuesday as DD needs this medication and we simply can't afford £400 every six weeks. Especially as I'm only on SMP and with bills going through the roof.

So....AIBU to think the GP is out of order for not completing the prescription within their specified time frame and AIBU to think they shouldn't refuse to prescribe it at all (as I am anticipating)? Bonus points for tips on how I might tackle the conversation with them!

My baby was on liquid Omeprazole so it’s not cost related. However my GP assessed my baby and decided that the medication was required in that form rather than the cheaper tablets dissolved in water or infant gaviscon (prem baby who was exclusively breastfed and had CMPA and has a sibling who had been the same). You say your baby is on formula so has infant gaviscon with that been tried?

Surely if you start down the private route to skip the queue you can't then nip back into the NHS to save yourself money.

GP's are not required to dispense on the back of private prescriptions. If you have jumped to private you should stick with it.

Christ alive, a BABY has a medical condition that is causing her distress and discomfort and could, if left unchecked, lead to scarring of her oesophagus and a raised risk of oesophageal cancer.

The baby is as entitled to NHS medical treatment as anybody else. The OP ONLY took her to see a private doctor in the first place because of the piss poor NHS standards that allow patients in pain to suffer and get worse because of unacceptably long waiting lists for the simplest of appointments. Waiting list waits that do not - in any way - relate to medical need or risk.

The OP should not have had to pay out of her own pocket to see a dr who is notionally available on the NHS. We all pay for the NHS, it’s not free. She’s actually saved the NHS the cost of the consultation, though this should be neither here nor there.

She should not in addition be expected to pay for a medication she should have been prescribed at an NHS appointment already.

Just because somebody can afford to pay for a private consultation when the NHS lets them down, this doesn’t mean they can - or should - pay for every medication or any other appointment going forward.

You’re right on one thing though - she should not have to waste her time or NHS resources on an emergency appointment. Any competent GP should be able to read the consultants letter and realise that an Omeprazole prescription is entirely appropriate in the circumstances and action that without delay.

Surely if you start down the private route to skip the queue you can't then nip back into the NHS to save yourself money

Why on earth not?

Just because somebody can afford to pay for a private consultation when the NHS lets them down, this doesn’t mean they can - or should - pay for every medication or any other appointment going forward.

That's exactly what it means. You can't pick and choose the bits of the health service you want and jump lists then expect to jump back in. People do but GP's are clamping down on it and starting to refuse to prescribe/ do follow up tests on the NHS in this scenario

Not all lawyers are loaded. If OP was a junior criminal barrister she’d have gone from earning not a great deal to nothing whilst on maternity leave. Affording one private consultation does not mean ongoing prescriptions at £400 a pop are affordable.

Who says you can’t?

And why not?

Do you think the waiting lists are acceptable?

What should we all do, just meekly accept them and wait, heads bowed and grateful for any crumb chucked to us, while we suffer and possibly get worse?

People die on NHS waiting lists. Some of them people who would have lived, had they been seen within a sensible timeframe.

It’s completely unacceptable.

Of course the GP should just prescribe, the baby has seen the specialist, the specialist has diagnosed. How ridiculous to think that you should carry on paying for private prescriptions while waiting to see possibly the same specialist on the NHS to you can get the prescription on the NHS, which is what some people seem to be suggesting. Great way to add to the backlog.

I'm guessing some of the judgey responders have never had a baby with reflux.
My daughter is 6 and Still on omeprazole.

Keep on at your Gp, you're entitled to it.

Hope you're ok, it's bloody tough!

I think your being unfair on the GP both with the timescale your expecting it to be sorted and expecting them to just prescribe without seeing the baby themselves.

Why would you expect a GP - a non-expert - to have to see the baby and pronounce on it, when a consultant - an expert - has already done so, and given their expert opinion?

How can the NHS, with its already ridiculous delays and waitlists, possibly afford to do this? It would be a completely redundant doubling up of process.

We don’t need the NHS to waste time and resources doing things twice. We already have too much of this the other way, where patients have to see a GP who everybody knows has no hope of being able to give a definitive diagnosis or treatment plan, before they’re allowed to see somebody who might actually have a clue about what they’re suffering from or how best to treat it. We certainly don’t need to double up the other way, where we ask a non-specialist to check the work of a specialist! That’s just nuts. The epitome of inefficiency.

There's a whole lot of guidance on the .gov website about this. The fact that they system is broken is irrelevant. It still means you can't pick and choose free care without properly engaging with the system.

When going through an ASD diagnosis for my DC we were advised that to do any part of it privately to speed things up would mean that we had left the system and could not re enter to save costs as and when we wanted. It is exactly the same principle.

There needs to be a 'shared care' agreement between the private consultant and the GP surgery, if there's not then you need to keep buying the private prescriptions. It's possible that this is already in place in which case when the GP has seen the letter (won't be the day you take it in, possibly several days/weeks) they will prescribe, however if it's not in place will need to be arranged first.
Why do you need the meds now though? If you've only seen the private paediatrician within the last week (you said you were at hospital just over a week ago?) then surely you've still got 5 weeks left?

This must be a regional thing. In London and the South East, this never appears to be an issue. Thankfully.

I really think it’s the height of cheek to leave patients languishing on a ludicrously long waiting list with no help and then stop them from getting that help another way. The NHS is meant to be there to help us. If it’s incapable of doing so, that’s bad enough. To then actively stand in the way of patients trying to get their needs met in other ways is obscene.

It’s financially illiterate too. Patients going private, even for part of their treatment, saves the NHS money and time.

We shouldn’t have to do it though. The monumental fuck up that is the NHS system is not our fault.

@StickywithSuncream Why would you expect a GP - a non-expert - to have to see the baby and pronounce on it, when a consultant - an expert - has already done so, and given their expert opinion?

Why would you expect a clinician to prescribe a medicine for a baby they haven't seen? If they do this they take legal responsibility, not the consultant. The prescription (script and medicine) is ready and waiting in the pharmacy. OP just doesn't want to have to pay for it.

@KimmySchmitt yes, we first saw gp for reflux issues when she was 2 weeks old. We've tried gaviscon but it made her constipated.

Thanks @Bunny2607 that's helpful.

Thank you @StickywithSuncream, someone who gets it.

Because of the long-standing ‘shared care’ arrangements, which are, frankly, common sense? They allow the GP to rely on the clinical judgement of the consultant, who, in effect, takes her risk of the prescribing, rather than the GP.

It’s a well-established standard way of operating that’s been in effect for years.

It’s sensible.

If the GP in question doesn’t have this with an NHS consultant, I’d be asking why.

What would you prefer, the utter waste of NHS resources that doubling up entails?

@BungleandGeorge I didn't say in OP, but we have tried first line and it didn't work. A GP told us they would be happy to prescribe if a consultant had recommended. So why aren't they now? It's not a case of saving money, it's money we don't have, it's been recommended by an NHS paediatrician, albeit practising privately. So what's the problem?

@Capturetotalelotion but the GP doesn't know I'm a lawyer do they ans as you well know, this is irrelevant. Not all lawyers earn big bucks, I suggest you educate yourself as to the typical salary of a non-city, non-corporate lawyer and I think you'll find some of us earn not much more than a nurse. Would you be so scathing then?

Oh and why would you think OP should have to pay for a private prescription?
Why isn’t she entitled to NHS care in your opinion?

She’s been let down once already, having to go private. You think she should suffer a double whammy? Why?

Why @Sirzy ? It's their own timescale, I didn't set it. They can see the baby if they want to, I have no problem with that. But they haven't asked to. They're effectively ignoring me.

@DownToTheSeaAgain the wait to see an NHS paediatrician is over 4 months. I feel like I'm teetering on the edge of PND due to the reflux issues. Would you be happy if I ended up with PND because I dared to spend some of my savings on a consultation- saving the NHS time and money in the process? Would you be happy with my DD contuing to suffer? You can piss right off.