To ask if you've ever successfully challenged a GP refusal to prescribe under a shared care agreement

[OptimismvsRealism]

Debilitating illness - NHS consultant waiting list 5 years - used up significant savings and went to a private doctor who set up a plan - GP says no it's got to come from the NHS and no they won't take your diagnosis and adopt it you go back to day 1 on a 5 year waiting list. The same private consultant btw works on the NHS team that would make the diagnosis.

Cost of the medication to NHS is actually not that much but cost to an ordinary individual on private prescription isn't within realms of possibility.

Is there any alternative?

Oh and the aibu, aibu to despair that the NHS seems to actively want people to suffer?

I had to wait to see the same consultant on the nhs, as they wouldn't accept that I'd seen them privately first. Such a waste of nhs time and money.

depends on the diagnosis. Did you not realise before hand that this might happen?

Have you asked the consultant to continue your care on the NHS in which case he might be open to getting his secretary to write to the GP in his NHS guise . I went private several years ago to see an endocrinologist having been failed by our local NHS trust and my GP was only too happy to prescribe my medication and even suggested that he refer me for the blood tests (SST) that I was going to be paying for to save me money - I declined because I’d already got it booked and wanted it over with .

If you have seen a private doctor who has set up a plan. The prescription needs to come from him or he needs to transfer you to his NHS waiting list.
I work in the NHs but had private treatment due to waiting and the consultant was the one to the write the prescription. He didn’t ask the GP.

GP won’t generally prescribe consultant medications anyhow. When I was under a psychiatrist all my meds came through them and GP never did repeats. Same with my meds post eye surgery

Surely the problem is that is isn't under a shared care agreement, as GPs only have those with NHS teams?

The NHS don't want people to suffer, but there are protocols and care pathways. The medics' hands are frequently tied.
Sorry you are in this position, you either need to continue with private healthcare (it's usually under insurance so there are very few pathways in place for one off private care and medication)

I’m having the same problem. Chronic illness for 30 years has never been properly managed by the nhs. Lost my career to it!

Had a private consultation, paid for my first prescription privately (apparently this is nhs policy) and my GP doesn’t want to issue repeats.

It’s only been a couple of weeks but this medication has literally given me back my life. I never thought there would be a day when I wasn’t in pain but now I feel like I can rely on my body not to let me down from one day to the next.

Not having the medication would destroy me. If it comes to it I’ll need to pay privately (I know I’m lucky in that sense) but it stinks.

Why can’t the NHS interact with private consultants. It’s ridiculous that a GP can disregard the opinion of a specialist who you only see because the GP doesn’t know how to treat you!!!

But do they ? After my brush with death and expensive private care we joined Benenden Health and although they are like a half way house between the NHS & private care the NHS is happy to use all the Benenden test results etc and that is both GPs and NHS consultants.

I’m with Benenden and my practice are still digging their heels in about following the consultant’s recommendation.

@StormingNorman must just be different GPs then , ours is more than happy to work with them , how annoying .

They don't have to agree to shared care with nhs consultants let alone private ones so you have no chance. The consultant knows this.

They aren't prescribing under a shared care agreement though.

OP Im guessing but forgive me if I’m wrong that its ADHD meds? GP’s are often reluctant to initiate these as many people cannot tolerate them ( and some can become really quite ill) and initiating them safety requires a lot of monitoring.
NHS services will do all this initial work until such time a patient is stable on meds, but usually private clinics won’t, and won’t provide any ongoing advise to GP’s along the way, and so there is no ‘shared care’. In addition GP’s are under absolutely no obligation to prescribe any medication at all if they chose not to for a defensible reason.
your best bet may be to enquire to other GP’s as to what their stance on this is.

How do you know what the cost to the nhs is? If it is very expensive on a private prescription it very probably will be to the nhs too,

Shared care agreements vary around the country depending on the local commissioning arrangements. All agreements I have dealt with involve the specialist initiating the medication, stabilising the patient and then the GP taking over prescribing. The patient still remains under the consultant for ongoing dose reviews, GPs usually just prescribe and monitor blood results (where required).

The situation you are describing does not fit into this arrangement as the specialist has not started treatment. GPs will (quite rightly imo) not take on responsibility for something that is outside their area of expertise if there is no ongoing specialist guidance

Do you understand what a shared care agreement is, OP? Have you read your copy of it?

There are outline shared care agreements on the Internet, so anyone who is interested in looking can take a look at what one involves.

It is not just a case of the GP agreeing to take over your prescription. The consultant also needs to agree to their part of ongoing monitoring of your medication. And you, the patient, need to agree and understand that if the medication needs swapping or the dose changing it will be the consultant, not the GP who does that for you.

If you have gone privately as a one-off, it's really not clear that this sort of standard shared care agreement is suitable for your circumstances. Could you definitely afford to see the consultant again repeatedly if needed? If there is a problem?

I can't say I blame GPs who decline to enter into shared care agreements with private consultants.

I understand your frustration but you are being unreasonable to say the NHS wants people to actively suffer. A quick google of ‘shared care with private providers’ explains many of the legitimate reasons why this policy exists.

Even for NHS patients they don't have to do Shared Care if they don't want to.

I think it would be worth taking this up as a complaint as if they do Shared Care for NHS, and your consultant is the same consultant as you would have on the NHS and not suggesting anything unusual I think they are on dodgy ground.

But if they never do it regardless then the GP is fully entitled not to prescribe.

My GP wouldn't share care for adhd meds. Flat out refused with no discussion twice. No alternative GP in the locality.

Not true. GP surgeries have an obligation provide NHS care there is nothing ‘dodgy’ to refuse to support private providers by prescribing for conditions they have diagnosed.

When you think about it the system is not right, that it's automatically refused.

I think it's worth pushing, a letter to the Practice manager to ask for it to reviewed.

That's why, admittedly years ago now, after gp referral, I asked which consultants in the dept that ds1 was waiting to be seen, also did both private and nhs. Went to see him privately 3 times, but also begged that as the case had been so mishandled so badly, he would have a word to see if we could be seen on the nhs any earlier. (Thus I wouldn't need to see him privately anymore). I was seen on nhs, and ds2 diagnosed on the nhs.

I can't accept that a private doctors diagnosis is not recognised. I would ask that it was put in writing that the diagnosis was not recognised as an nhs diagnosis. Might they possibly back down on that if pushed, to put it in writing so that it was concrete evidence that everyone could then see, would that not humiliate them? Will OP's gp put it is writing?

You are fundamentally misunderstanding what shared care is and how it works.

Generally the cost of a private prescription is the wholesale cost of the meds plus a dispensing fee. The dispensing fee may be a couple of £ so it's basically the same as what the NHS pay if the item is over £5.

There are also some medications that GP's can't/won't prescribe for various reasons. They will always have to be prescribed by a consultant or specialist on the area.