To think GPs should be able to check medication availability

[jeaux90]

I'm absolutely fed up of ordering medication to turn up at the pharmacy to be told the manufacturer is out of stock.

If they have access to the system why isn't the GP checking this and prescribing the alternative? Surely machine learning/AI would help here or are the systems not integrated?

I mean in the whole era of technical progression why are we running between Boots and the GP to get things re-prescribed?

For context this has happened with my HRT, my DD14 ADHD medication, antibiotics etc etc over the last three months.

AIBU to expect an integrated supply approach to prescriptions?

@Totaly ordering online makes no difference. The prescription still has to go to the GP to be signed off, and online pharmacies are under the same stock pressures as everyone else.

Pharmacies are private businesses, they have their own stock systems. They can release prescriptions back to the spine though so always opt for electronic prescriptions

All of this. Great post.

The pharmacy is NOT part of the NHS, so you cannot expect them to be joined up.

The pharmacy is a completely separate commercial enterprise that purchases the items directly from the manufacturer. They purchase on the basis of price, reputation, reliability, payment options, availability and how well they get on with the rep, just like any other business.

The NHS has given you a voucher aka free prescription for you to procure these items. It's not your GP's problem if the pharmacy has been unable to buy these items because of supply and demand.

A lot of these supply problems are Brexit-related and the fault of those who voted "leave".

Yes, it's a PITA but you will have to do the frustrating running around/ringing around yourself. YABU to expect your GP to do this for you.

It's a pity that pharmacies can't supply medication with a different brand but the same medication. The NHS trying to save money want people on Zapain which is
co-codamol but if the script says Zapain but they only have co-codomol the script is returned. They can and sometimes do advise surgeries what is out of stock/long term delays but have to rely on surgery staff "being on the ball" and being to implement this.

I also wish that pharmacies advise people what the alternative is and more importantly that is is in stock before sending patients to the surgery with "they said to ask your GP". If this is known then the receptionist can do an alternative script straight away and try to find a GP to sign it. Although this adds to pressure and would be in hindsight less of a problem if people didn't leave it to last minute ie no medication left, to order from the surgery and pick up from the pharmacy.

Yes but a GP could send an electronic prescription to a pharmacy that had stock, for someone to then walk in with a paper prescription and take what's left, leaving them out of stock again and the pharmacy to take the flack of 'but my GP said it was in stock'. It's not realistic to expect a whole new system to be implemented as the cost would be huge. When I haven't been able to use my regular pharmacy I just call round a few to see who has my meds in stock rather than traipsing round them.

Ok so people are conflating what a pharmacist has in stock with what is in the supply chain...when manufacturing supplies are out it's hit and miss whether the GP knows this or not and gives and alternative.

Also, pharmacists don't have the power to give for example 2x20mg of something if the 40mg is out of stock.

You have to go back to get a prescription specifically for this.

It's a nonsense and a waste of GP and pharmacy time.

ML and AI is used all the time in banking etc our current systems in the NHS are ridiculous, inefficient and I feel sorry for the employees and people who are then left with no alternative than to run around between GP and pharmacy.

Frustrating I agree, however as others have pointed out there are complexities with the steps in the supply chain.

Having said with the adhd medication nobody - GP or pharmacist - should even have to check any system to know there is an ongoing international shortage. There was a National Patient Safety Alert put out in September instructing doctors re. prescribing medications for ADHD.

Well that seems to have passed my GP by I now have no medication to give my child tomorrow as the Pharmacy is not allowed to give me 2x20 rather than the 40mg out of supply.

I am nearly 3 weeks in to trying to get my regular prescription. I have to start within about a week of getting the last lot. I have been on this medication for 3 years and I am not likely to stop. They prescribe 4 weeks worth of one thing, 4 weeks of another thing, but starting a week or two after the first. Then 8 weeks of something else. Then the hospital consultant has another go at getting the GP to prescribe something that only the hospital pharmacy can stock. Sometimes there are random meds missing with no explanation at all, or pharmacy and surgery blaming each other. It just makes managing a painful, chronic condition much harder than it needs to be. I am negotiating getting enough supply to tide me over the holiday period as I am going to visit family. I have to have a telephone consultation with the GP pharmacist that could be at any time over a 24 hour period. They will probably ring when I am in the loo.

@jeaux90 pharmacies can give 2 X 20mg instead of 40mg in many instances but some 20mg tablets cost the same as the 40mg tablets so the government will not pay out to cover the costs

So much down to Brexit and incompetent government

Awful @jeaux90. I've been back and forth myself between the GP and pharmacy countless times in the last few months for the same reason.

Our GP also insists on sending prescription to a nominated pharmacy so you can't even call round different pharmacies with the script to try and get it!

Hopefully you get sorted out early tomorrow with the right medication or a good alternative. I appreciate that doesn't help you in the morning though and know the stress it causes.

You’re not wrong, but the NHS isn’t exactly in control here. Pharmacies are private businesses. Medicines wholesalers are private businesses. Issues with national supply chain shortages are communicated but I suspect GPs are too busy to stay abreast of the situation, which is dire.

Why are we not shouting louder about the lack of medication in the UK, all down to lies written on a bus. Everyone should be contacting their MPs. It should be the headline in every newspaper until it is sorted!
My son has been diagnosed (finally) with adhd but no Ritalin for him (which he’d been counting in to get him through his A levels). Apparently they are not prescribing it at the minute due to a lack of availability. So to hell with kids’ mental health and lives. Equally shortages of HRT and epilepsy drugs are just awful for people. And those are only the ones I personally know about.
When Keir gets in, he better sort this out. (Don’t hold your breath mind you).

If you're on repeat prescriptions though they won't let you order 'early' - and with us it's not as if they tell you it's too early. No you go to pick it up only to find it's not there. So have to re-order, which could then leave you requesting your repeat prescription at the last minute, especially if you've had to take extra doses of your medication.

(All this could largely be avoided by prescribing three months at a time for DH - but they refuse to do that because of the risk of him wasting medication - the fact that he would die if he didn't take it and the advice for his condition is to give three months supply is, apparently, irrelevant.)

Our surgery has an in-house pharmacy. It’s hopeless

You’ll get what you need less than half the time .. the suppliers have it, they just don’t have any “in stock” and needs to be ordered in for the next day. This isn’t just a one off .. I was there last week where someone needed the medicine urgently for her brother who had terminal cancer, told her it would be next day (hopefully), she made a bit of a fuss .. and (surprise surprise) they found some round the back.

The whole place is filled with bags waiting to go out, and still seems to run on paper

Does anyone know why the manufacturers cannot seem to provide much demanded medicines?

Brexit. Also knock on effects of COVID (and in one case an earthquake I think) on manufacturers of the raw ingredients in India, China and other places.

They do often get alerts on their system if the manufacturer states that there is a national shortage but Pharmacies are not part of the nhs so there is no way a GP it system will have access to individual pharmacy computers.

But even if something was in stock on an imaginary system, someone else could go in with their prescription and deplete it. If pharmacies were state owned along with GPs then sure something could be put in place. The real issue is the affect of (mainly) Brexit which is leading to chronic shortages.

So many people on here having a hard time with this, I'm so sorry!

Yes I've written to my MP about it, but he's an idiot with absolutely no profile.

I'm coming at this from 25 years in the tech industry. It is absolutely resolvable they just chose not to.

I will give you a different view on this, it takes on average the NHS about 80 days to onboard a new employee often its a lot more, often 120 days. That's 20 ish working days a month. So 6 months. For a new employee in the NHS to actually be able to work from offer to being on site. 6 months.

In my industry its 20 days.

It's just another reflection on just how inefficient it is.

All this inefficiency impacts us every single day and I'm sick of it.

No political party will fix this, they never have.

It's not just Brexit. I just gave a different process/example.

It's the NHS systems and the lack of integration. Disgraceful.

Ironically I'm not sure it's others failing to grasp this. NHS IT systems are separate to both GP and pharmacy systems, to be fully integrated you'd have to make GP surgeries and pharmacies part of the NHS (not private businesses contracted out). I don't think anyone is going to argue about how efficient the systems are, nor that it would be nice and make life easier if this could happen; but people are explaining why it can't (save for serious serious investment and fundamental changes to how the services are all run).

Couldn't agree more. I've just retired from general practice. In Scotland we don't even have electronic transfer of scripts to the pharmacy so gas to be collected. The infrastructure is there but the government (SNP) isn't switching it on. Even COVID didn't improve things. It's a disaster

It isn't practical to integrate stock across all privately owned pharmacies. In spring my GP warned me a particular antibiotic may be out of stock, and asked what pharmacy I use, then said he'd have admin check stock and he would put through the prescription for whatever it was the pharmacy had, so wait until after X time to pick up. A time before that when something ran out the pharmacy checked systems and said we could collect from X place or ask the GP to issue Y, we decided to just collect from the other place. Stocks running out aren't ideal, but it happens, best thing is to just stay calm and ask for help from the pharmacist and GP to find you some solution that will work.