If I make a complaint about my GP refusing to prescribe medication

[Sconesandgravy]

My neurologist asked the GP to prescribe a medication to help with a medical condition. The medication is one can cause birth defects. I spoke to the pharmacist this morning who called to say she was putting the request through to the GP. The pharmacist messaged that afternoon to say the GP has refused to prescribe unless I go on hormonal contraception or the copper coil. He has claimed that guidelines say he can't prescribe if I refuse the above types of contraception.

I want to complain about this for several reasons:

• My husband is completely infertile. He had multiple samples of testicular tissue biopsied and it was confirmed he has a condition that means his sperm count will always be 0. The only way I'm getting pregnant is with a sperm donor. I obviously can't do this by accident. The pharmacist made the GP aware of this because she called me this morning and said contraception is recommended, so I said I'm not on contraception and disclosed about my husband.

• I checked the guidelines myself. NICE guidelines state the need for effective contraception must be expressed. The BNF says effective contraception must be advised. On gov.uk there is a 2022 safety review of the medication that states health care practitioners "should fully inform the patients of the risks and advise them of the need to use highly effective contraception". Nowhere specifies what contraception should be used, and none of the above bodies specify that medication should not be prescribed if long term contraception is refused. The only thing I can find is that alternative medications can be offered if the medication is long term and the patient doesn't want to use any form of contraception.

• Condoms and abstinence are also effective forms of contraception. If I were a man these would be recommended as they're the only available form of effective male contraception. It seems discriminatory to suddenly decide they're not considered effective contraception just because I have a vagina.

• I'm an adult with full capacity. I have the right to make an informed decision about what I put into my body.

In all honesty it just feels a bit like the GP has refused my prescription and intentionally given me misinformation about the guidelines to try and coerce me into going onto a contraceptive that he deems the most effective, rather than allowing me to make an informed decision based on my own personal circumstances. I know this is dramatic and I won't put that in my complaint but I just needed to get that thought out of my system

AIBU if I complain?

Approach with query not all guns blazing. Tbh I understand the gp. They ha e a strict warning to follow if its the drug I assume ur talking about. They can't take the risk of someone accidentally getting pregnant even if their husband is infertile women could still seek elsewhere so to speak (i am in no way inclining you would this is just an example). So just ring and discuss with him i understand why u don't want to go starting contraception because there is side effects to some of those too but I dont think it warrants a complaint just have a chat make an appointment to discuss options

Highly effective contraception is defined as either the copper coil, hormonal coil or implant - assuming this is valproate your specialist will need to complete the appropriate paperwork to state you have exceptional circumstances which mean you are exempt from the pregnancy prevention programme (which seems unlikely in your case)

A dr spends 6 years at uni spending min 9 grand a year and still has courses after this to become a dr and you want to be a Karen and complain. Complain Iver something stupid.
Make an appointment with your gp like a normal person person no the pharmacy. Also...I'm under neurology and they would have prescribed you something to collect at the hospital pharmacy otherwise would have told you they would write to your dr with results and if your dr hasn't got the results or letter yet then your word means nothing. He also knows better than you and has ti make sure and cover is back so YOU don't go and sue him for something.

Is it fexofenadine? That used to be prescription only but you can now buy lower doses over the counter.

tell gp you'll take the pill-then dont

noone will know

I've been under neurology for 9 years, not once have I had a prescription provided to me by the consultant. Always passed to the GP to manage.

My CGRP injections are at least prescribed by the nurse and she sends it to a private company to be delivered to my home. That bypasses the GP completely.

I believe your old enough to understand the risks and your G.P is being a little heavy handed here.

Arrange to see the G.P, explain your circumstances. I too have been on medication where getting pregnant would be horrendous. I’m a grown up, I understood the complexities and practised safe sex, I was never coerced into having to take contraception.

Or you could accept the contraceptive pill and then don’t take it, just get your repeat prescriptions periodically, that’s if they’re going to be an arse about it, 🤷‍♀️

OP, what would the GP’s motivation for not prescribing it be?

Could it be because there’s a medical reason? Or is the GP just being difficult, for fun?

And also, I’m not sure if you’re aware, but sometimes married people have sex with someone other than their spouse. You might not choose to, but your GP can’t be sure of it. Over the years I’ve prescribed plenty of contraceptive pills (at the woman’s request) to women whose husbands have had vasectomies.

I don't think you've addressed the issue that you're angry with the wrong doctor. @Sconesandgravy

Your neurologist and the trust that they work for are under a contractual obligation to give you as much medicine as you need until the GP is happy to take over, and to request, not demand that the GP prescribes.

Why didn't your neurologist give you a script? And why aren't you raging against them?

If the lasagne really is that big I would cut it into squares and freeze. If it's too big for the freezer , could you blitz the remaining and make a savory stock pots to freeze in plastic bags ?

So your consultant hasn't fulfilled their contractual obligations for which their Trust is being paid, in nine years. Fancy reporting them for fraud?

Ffs. Wrong thread sorry. Bring a lasagne to you GP ?

My neurologist has never once given me a prescription, he always sends it to the G.P. This means trying to get another feckin appointment, I have M.S so life can be pretty shitty, and to top it all he says “It can come out of their budget” What a complete knob, I swear he’s on the autistic spectrum, he’s bloody hard work!

So presumably you've made a formal written complaint about your neurologist to PALS? What a shit. Please do.

OP, what would the GP’s motivation for not prescribing it be?

Not feeling confident with an area of clinical practise which he had purposefully passed to a specialist due to a lack of knowledge?

Wow, that’s interesting. Since 2009 my neurologist has always sent my scripts to the G.P. Are you saying this is illegal? It once took months for me to get a certain medication because the G.P wasn’t happy prescribing it, but the consultant stuck them out. It was like a tennis match, absolutely ridiculous. I gave in in the end, just couldn’t be arsed.

Like I’ve pointed out in another thread, he told me it can come out of the G.Ps budget! 😳

Yes it's part of the hospital contract to give enough from clinic until the gp can reasonably take over and what the trust is being paid includes this.

I remember when I was younger, a specialist said I wasn't responding to the standard treatments well, but there was one thing left to try that could work. However, as I was of child-bearing age, he wouldn't prescribe it.

Dear Reader, I was 14. I wasn't sexually active. I didn't want children. The twat didn't believe me.

I thought I was being dismissed because of my age, but three decades on, people (mostly men) still tell me I'll change my mind about having children.

Medicine is not designed with women and girls in mind.

I had a couple of really rough years but thankfully my condition got better with age. If I'd been medicated, I could have avoided those years of hell.

I'll never know for sure though. Because I couldn't get the treatment I needed. Because I was female.

Incidentally, I was told I couldn't have the medicine by myself because I was Gillick competent. The thing is, yes, I was old enough to make decisions about my healthcare and I didn't need a parent in the room. But I wasn't old enough to know what to do if my decision was overruled.

Yep, see MHRA website and guidance. You need to be on a PPP (pregnancy prevention programme) but you should be ok to get it in your situation, a risk assessment form will just need completed with your arrangements documented. Speak to your GP and Neurologist, they should be able to sort it out between them for you.

https://www.gov.uk/government/news/valproate-banned-without-the-pregnancy-prevention-programme

You basically have a choice between what, to you, is the least worst option: accepting the prescription and then just not taking the pills until your appointment with the GP, even though that's wasteful, or carrying on with the migraines. To me it seems to be a no-brainer - go for the first option every time.

Is there any chance of seeing a different GP within the practice?

Cheers for that information. I now know what to do for the next time he tries to fob me off 🤗

You're definitely NBU OP but I'd also be very wary of topiramate. Both my sister and I tried it for chronic migraine and whilst it helped (reduced my attacks by about 50% and DSis by about 75%), the side effects just can't be overstated.

I had pretty much all the side effects they warn you about (numbness, tingling, memory and speech issues, extreme fatigue, constant nausea and dizziness) plus quite a few others they don't mention. I dug around and did some research and found that there is growing evidence to suggest Topiramate causes serious mental health issues. My DSis became actively suicidal on it (no previous history of MH issues aside from PND 25 years ago) and I developed extremely poor judgement and was engaging in all kinds of not-typical-for-me risky behaviors. Both of us recovered from these issues within 2-6 weeks of stopping Topiramate.

Believe it or not, the migraine relief made me stick with the Topiramate in spite of the MH and other problems it was causing for me (I was in denial about it being the cause TBF) - I eventually stopped taking it because my hair started falling out (oh vanity).

By all means try it - I know the horror of life with migraine - but be prepared for the side effects and make sure your DH is looking out for behavioral/personality changes. My DH still talk about the "medication that turned me into a different person" and I stopped taking it 8 years ago. I'm not exaggerating when I say it almost ended my marriage. Oh, and HCPs will tell you the behavioral stuff isn't related - I can guarantee it is.

it's not valproate

Absolutely! have fun......

Yep, that makes sense. One of several reasons I’m sure. I was challenging to OP to reflect on why the GP might be refusing, because she seemed certain it was pure bloody mindedness.