Being told to go the pharmacy for cystitis by doctor receptionist

[Musica7474]

I have cystitis. I’ve had it before and had different anti biotic for it- sometimes 2 as it has been resistant to treat.

Ive left it to try and sort it self out for a few days by doing all the right things. It hasn’t.

Receptionist told me pharmacies now deal with cystitis and will advise me. I don’t need advice and I don’t want to be talking about my wee and symptoms in a packed pharmacy.

The receptionist made me feel awful for not wanting to go to the pharmacy and insisting on a doctor’s call( I’d have been happy with a prescription being left at the desk and no call just a gp looking at my records to check which anti biotic is best for me). She said I could have a call this time.🤔

Cystis can be really unpleasant and not great if not treated . Anti biotic are expensive and it’s not great to take several, I don’t think women should be made to feel like shit for wanting treatment for it and a gp to look at her records.

So much lack of knowledge about the training and expertise of pharmacists on display here. Have a look at the content of this five year course and tell me they are only trained to ‘sell eardrops’. https://www.strath.ac.uk/courses/undergraduate/pharmacy/#coursecontent

New nhs initiative. Receptionists are directed to send uti patients to pharmacists for antibiotics as a first line of treatment now. The receptionist was correct. It's a way to get people treated faster.

I said trained to dispense meds. Mine are very knowledgeable regarding doses etc <as you'd expect> and contact the Dr to suggest alternatives or correct errors. That is their job to be experts in medication. Not to assess, test bodily fluids and finally prescribe whilst people line up outside the little DIY consult area waiting for their prescriptions!

They won't access the records to choose antibiotic under this scheme. Most likely they will refer op back to the GP.

How do you know what their training involves. Are you a pharmacist? Their training has changed in recent years and they very much are being trained to prescribe.

Just to clarify, Pharmacists don't need to be able to prescribe to offer the Pharmacy First scheme as the scheme includes group prescriptions known as PGDs, that allow the supply of prescription medicines to people who meet specific criteria.

However, this means that only a very narrow range of treatments can be given through the scheme and in the case of infections, one or two antibiotics for 5 - 7 days. As discussed above, these medicines will be fine for the majority of uncomplicated infections. But not all of them.

People like the OP who have a history of infections are advised to see a GP or Nurse Practitioner because it is likely that they will a) need alternative antibiotics to those available under the scheme b) may need them for longer c) may have an underlying issue requiring investigation.

This is different to pharmacists, nurses & physios who have an additional qualification allowing them to prescribe a full range of treatments within their specialist area of knowledge. So for example, a specialist asthma nurse who is a prescriber, can prescribe a full range of inhalers, but not diabetes medication.

So whilst some Pharmacists can prescribe alternative medicines to those included in the P1 scheme, they can only do so if it falls within the scope of their practice. As I explained above, the OP needed to see a practitioner able to treat her appropriately for her history.

TLDR version. OP didn't meet the criteria for the Pharmacy First scheme & it doesn't work as some of you would like to pretend it does.

No I'm not a pharmacist. I should be really, show them how it is done.

There should be criteria before taking on a more extended role. For example a consistent turnaround time of ten mins per prescription. If they can't manage that <and ours certainly can't > then they shouldnt be taking on checking urine samples for 15 quid per 'consult'.

My point was more to do with the belittling attitude towards Pharmacists/outrage that they would be able to see health records.
They are highly trained healthcare professionals in their own right.

I still don’t understand the need to involve GPs or pharmacists at all though when OP can just choose and buy the antibiotics herself online.

That doesn't mean that pharmacists don't have adequate training to prescribe. The issue is that chemist shops aren't adequately staffed which will often be due to inadequate funding. Regardless, they aren't checking urine samples under this scheme. @Citrusandginger has explained it well.

She can't choose and buy them online. The prescriber will choose but in this case they will also probably refer her to the GP practice as it sounds like she is having recurrent infections.

Pharmacies are allowed to prescribe for a few standard conditions now. Got cream for my son's impetigo there last week. They generally have a private space for consultations so you wouldn't have to discuss in front of other customers.

There’s cystitis and cystitis.

When I get it, I go from zero symptoms to pissing blood and weeping on the bathroom floor in total agony within about four hours. It comes on incredibly quickly and it is like no pain on earth. I would rather give birth than have that pain, and I’ve got a traumatic birth story with the best of them. I can quite easily believe that in the pre-antibiotic era, women died of cystitis.

I have the antibiotics on speed-dial now but my GP is brilliant. I wouldn’t care how I got them, and if the pharmacist could do it, great. But anyone on this thread whose cystitis went away after they took the sachets does not know the kind of infection the OP is talking about. Sachets don’t touch the sides.

onlinedoctor.superdrug.com/cystitis-product-style-splash.html?gad_source=1&gbraid=0AAAAADrzrceAP0eql5yYBt6-15Tgk4I2u&gclid=CjwKCAjw_e2wBhAEEiwAyFFFozqdlOJuhZ8y87ejhuydKMtsmu7PtUrxygDBInGWfpBm3OcWQBEpOxoCHXAQAvD_BwE&gclsrc=aw.ds

monitor.clickcease.com/tracker/tracker.aspx?id=zmINtj4S7E0AiF&adpos=&locphisical=1007127&locinterest=&adgrp=59853893966&kw=cystitis%20antibiotics%20online&nw=g&url=e-surgery.com/conditions/tablets-for-cystitis-uti-treatment/%3Futm_source%3Dgoogle%26utm_medium%3Dcpc%26utm_id%3D1603154363%26gad_source%3D1&cpn=1603154363&device=m&ccpturl=e-surgery.com&pl=&gclid=CjwKCAjw_e2wBhAEEiwAyFFFo1FW34x3HW2ljaqEKA_pIaNqm9vcBrGlcqJCiqohGYN608_ITgnzfRoCyeMQAvD_BwE

www.healthexpress.co.uk/cystitis-cat?utm_campaign=10197298012&utm_source=google&adgroup=%7Badgroup%7D&keyword=order%20antibiotics%20for%20uti&matchtype=e&device=m&target=kwd-299889694289&network=g&location=1007127&gad_source=1&gclid=CjwKCAjw_e2wBhAEEiwAyFFFoxZaCMjv5MGmZx8451CT_26OBfXa-q3YkWkg02pJZBqEBng_owtp7hoCnx0QAvD_BwE

onlinedoctor.asda.com/uk/cystitis-splash.html?gad_source=1&gclid=CjwKCAjw_e2wBhAEEiwAyFFFoweQNTaTuOLlQs4zODqhuipJE1FJU3y_eitMckzdGCLK5qJ2XjyWjRoCL9wQAvD_BwE

https://onlinedoctor.boots.com/cystitis-treatment

She absolutely CAN choose to buy them online from many places.

Those (at least, the ones I clicked on) seem to essentially be private medical consultations with a private GP, albeit text-based and very streamlined so that they can offer it at a relatively low price.

Are we really moving towards an assumption that women who can't use the supposedly optional, very limited, pharmacy-based NHS service for uncomplicated one-off minor illnesses that's been rolled out recently in England, or who have personal factors meaning they feel uncomfortable about the setting or aren't confident the service will meet their needs, have some kind of moral obligation to buy private medical care rather than seeing their NHS GP?

I had a breast lump a while back, which seems to be one of the conditions that was mentioned a couple of times upthread as a justifiable GP job. Of all the things I can think of that I could have got annoyed about while waiting for the appointment, the prospect of someone else getting an appointment before me for a new attack of recurrent, antibiotic-resistant UTI who wasn't sure which drugs had failed for her before really wasn't one of them.

I don’t want to choose anti biotic myself. I’m not a GP. I want my GP to look through my notes and decide a good course of action from my history which is what he did. Under the new scheme we can choose, I chose that and shouldn’t be made to feel bad about it because choice is part of the scheme.

Those tablets in the link are £22 double what a prescription is and could end up being wrong and warranting a trip to the Gp for a prescription on top. Also looking at some of those questions in the online survey I’d doubt I’d get them. I e had customs previously within the year and have another medical condition.

What happens if you call the doctor and ask for an appointment and won't disclose to the receptionist what it's about?

No, you can't just choose any antibiotic and buy it online. The prescriber will choose the antibiotic and only prescribe if they think it appropriate after asking a lot of questions. In Ops case they would likely say she needs to contact her practice for a face to face appointment.

The private pharmacy consultant room have no air and are small. Full of germs.
After I was in one for 5/ 10 mins waiting for some basic info about a new prescription, I ended up with a sore throat that evening and an ongoing ear infection for the last month!
Never again.

I didn’t say you can choose any antibiotic.

I have used online pharmacies many times for cystitis treatment and you absolutely can choose yourself between Nitrofurantoin or Trimethoprim.

It’s not “a lot of questions” either.

Fair enough if OP is resistant to both the regular antibiotics used to treat cystitis, but she should know that information herself and let the receptionist know that she needs a particular type that only the GP can prescribe.

People need to take more responsibility with their own healthcare needs instead of this “oh it’s those round pills with the long name I can possibly remember, the doctor will know” attitude. Its irritating.

I live in aus and pay $100 per appointment to see my GP. Medicare return $49 to my bank account the same day.
prescriptions prices depend on the medication.
anyone on a low income can choose to be ‘bulk billed’ - this may mean they can only attend certain GPS, longer wait times etc.

having a price attached to health care can be extremely effective in streamlining processes. I only see my GP when I need to, use the pharmacist when I can and never miss a pre booked appt (no Medicare rebate for a missed app). I have an amazing GP who always asks me about my social and emotional heath as part of any consultation. She knows my kids and my dogs names and what I do for work.

it seems to me that most British people take an extremely entitled view to health care. Yes I agree that everyone has a right to healthcare but if you want everything for free you can’t dictate the terms.

if the NHS say you now have to go to the pharmacy, then either suck it up or get private health care.

I have recurrent BV and thrush but have absolutely no qualms about talking to a pharmacist about either of those things. They are medical issues, not life choices- if some nosy pensioner gets a kick out of over hearing me talk about my vagina that’s on them.

'it seems to me that most British people take an extremely entitled view to health care. Yes I agree that everyone has a right to healthcare but if you want everything for free you can’t dictate the terms.'

It isn't free, we pay tax and national insurance.

Yep, I am entitled to healthcare, what's your point? I'm not going to queue up in what is basically a shop with a urine sample, so 'pharmacy first' is still a no for me.

Oh do give over. The last time I had it I didn’t know a new scheme would come in. You need different meds for diff bugs, it’s not that simple. Because I get it a fair bit, can sometimes get rid of it without bothering anyone but when I can’t I feel really grim and can struggle to get rid of it even with anti Bs, then don’t feel that great after anti Bs, I would like to discuss alternative options with a GP have him/ her look through my history. I have a full time job and can’t have time off to fanny(if you’ll pardon the pin) around from pharmacy back to GP

It’s a choice so I can. I use the pharmacy for all the other things listed and my GP a lot less than most and have paid my tax and NI for many years so I’m happy with that.

They don’t say you have to, it’s a choice the receptionist forgot to mention and that I probably would be sent back to the GP anyway. Glad you have no qualms discussing your fanny and medical issues in front of pensioners. I do.

The point is that the pittance of national insurance each of you pays clearly can’t afford the health service you expect.

therefore you need to lower your expectations and be grateful that you have a free healthcare system. Because it is free, at the point of usage.

when I lived in the UK I worked for a CCG and in a GP surgery and the user wastage of the NHS was abonimnable, missed appts, unnecessary repeat scripts- which you can guarantee people wouldn’t do if they had to pay at the point of usage. Don’t even get me started on the heinous treatment of reception staff.

demanding to see a GP (probably that day) for every minor ailment instead of accepting a perfectly fit for purpose appt with a trained pharmacist is entitlement.