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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

217 replies

OptimismvsRealism · 31/07/2024 17:23

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?

OP posts:
Cappugcino · 31/07/2024 22:03

OP you can ask to see another GP, chances are they'll say the same though. At the end of the day it's their registration on the line when they prescribe, if they're not content to or it's outside of their local policy then you cannot force them to. It's understandable many don't feel comfortable prescribing something out of their area of expertise that hasnt gone through a system they are familiar with and have confidence in.

Ottervision · 31/07/2024 22:04

MitskiMoo · 31/07/2024 22:03

Honestly, it sounds like you thought you could beat the system because you could afford the private consultation. This used to happen a lot, especially with operations. They paid for the private diagnosis then jumped the queue. It's either/or, not both.

Why should it be? Op has saved the nhs money by going private. It's not beating the system at all, it's desperation.

OptimismvsRealism · 31/07/2024 22:04

MitskiMoo · 31/07/2024 22:03

Honestly, it sounds like you thought you could beat the system because you could afford the private consultation. This used to happen a lot, especially with operations. They paid for the private diagnosis then jumped the queue. It's either/or, not both.

Why shouldn't patients seek treatment as soon as possible when the fucking awful national health service won't see them?

We won't have a functioning support network for as long as I'm alive because of the desperate"saved me old mum" shite that prevents reform.

OP posts:
endofthelinefinally · 31/07/2024 22:05

If the doctor works in the nhs they need to transfer you to their nhs clinic and prescribe on the nhs. They can easily do this if they deem it to be in your best interest. Especially if you have been on a waiting list for years just to get seen.

OptimismvsRealism · 31/07/2024 22:06

My dad can't walk because he needs new knees. He won't go private because he's a babyboomer. He will die before he gets new knees from sickness brought on by his immobility.

Are other countries this lonely and frightening for the sick?

OP posts:
Ottervision · 31/07/2024 22:06

endofthelinefinally · 31/07/2024 22:05

If the doctor works in the nhs they need to transfer you to their nhs clinic and prescribe on the nhs. They can easily do this if they deem it to be in your best interest. Especially if you have been on a waiting list for years just to get seen.

They can but often it means going back to the bottom of the wait list.

IFollowRivers · 31/07/2024 22:08

OP I think the issue @MitskiMoo raises is about jumping the queue - People buying their way up the waiting list and then expecting to be slotted in to the 'free' offering further up the list.

If you've started with private can't you continue if it is just the prescriptions? You say they're not very expensive.

Nn9011 · 31/07/2024 22:08

Hi OP, I did this with my ADHD prescriptions. Initially I called my GP and asked if they would prescribe the meds and they acted like they'd never heard of shared care but said it would be fine.
Once I had the letter sent by my consultant they pushed back and said they couldn't do it. My consultant printed off the shared care guidelines attached with a form for him to fill in and sent this to them. He had to send it 5 times and eventually I took it in person because they said they didn't get it. After this, they finally gave in and prescribed it. Maybe you could see if your consultant has a similar shared care form to send to them?

Ftctvycdul · 31/07/2024 22:08

I often go private and then have my medications prescribed by my local GP under shared care. One of my disabilities is ADHD, although I’ve had no issues with my GP and my meds, many others living within my county have. They’ve navigated this by changing to a practice that will accept shared care.

Would changing your GP help you to navigate this problem?

Ottervision · 31/07/2024 22:09

IFollowRivers · 31/07/2024 22:08

OP I think the issue @MitskiMoo raises is about jumping the queue - People buying their way up the waiting list and then expecting to be slotted in to the 'free' offering further up the list.

If you've started with private can't you continue if it is just the prescriptions? You say they're not very expensive.

Shared care isn't queue jumping.

ColdinNovember · 31/07/2024 22:09

Ottervision · 31/07/2024 22:00

It is if they're prescribing under the specialists direction. That's exactly what it means. The specialist remains responsible for the care. Check ups etc.

It is not a valid defence at all.
Even less of a defence if they are going against the GP practice and ICB policy and decide to share care with a private provider and then something happens that ends up in court!

If you are not a prescriber I would refrain from stating things as fact that you clearly know nothing about. If you are a prescriber and believe this to be true then you need to educate yourself extensively. Look at the GMC or your regulator if not a medic.

If you sign a prescription you take full legal responsibility.

Nn9011 · 31/07/2024 22:10

IFollowRivers · 31/07/2024 22:08

OP I think the issue @MitskiMoo raises is about jumping the queue - People buying their way up the waiting list and then expecting to be slotted in to the 'free' offering further up the list.

If you've started with private can't you continue if it is just the prescriptions? You say they're not very expensive.

My local NHS doesn't have clinics for some of their waiting lists. They just add people's names to excel sheets and they sit in limbo. Not exaggerating our local MP got the trust to admit it. When you say people are jumping the cue please remember that that's not always the case.
Equally, if our NHS funded the doctors to work full time and have enough to see everyone then no one would need to go private.

Ottervision · 31/07/2024 22:13

ColdinNovember · 31/07/2024 22:09

It is not a valid defence at all.
Even less of a defence if they are going against the GP practice and ICB policy and decide to share care with a private provider and then something happens that ends up in court!

If you are not a prescriber I would refrain from stating things as fact that you clearly know nothing about. If you are a prescriber and believe this to be true then you need to educate yourself extensively. Look at the GMC or your regulator if not a medic.

If you sign a prescription you take full legal responsibility.

Going against the icb policy is entirely different and not what we were talking about. I can't imagine many GPs would do that anyway.

I know you do, but if you're prescribing it under direction the specialist service is still responsible for ensuring its still appropriate and safe etc, seeing the patient regularly.

It's funny because gps don't specialise in all areas, so why would they ever accept shared care for anything ever? There is a level of responsibility on them, of course. But the overall responsibility lies with the specialist for having diagnosed / prescribed initially. Or are you saying they wouldn't be dragged into court?

Izzynohopanda · 31/07/2024 22:22

What you’re describing usn’t a shared care agreement. A shared cared agreement is between a hospital and gp surgery.

What you’ve described is going to a private gp and getting a private prescription and then expecting the gp to take over prescribing. In our surgery, you had to have at least one or two private prescriptions before the gp would agree to consider taking over the prescribing. The gp is legally responsible for any prescription they write, so they’ve got to be happy with it. If they haven’t got the experience in that field, then they are fully entitled not to do the prescription.

jacks11 · 31/07/2024 22:23

There are many reasons- perfectly understandable- why a GP may refuse a shared care agreement. They can decline both private and NHS. In all likelihood it has not got anything to do with questioning the validity of the diagnosis itself- it is only related the shared care agreement aspect. I think there seem to be a lot of people who do not understand what a shared care agreement actually is. It really is not “consultant said prescribe this” so GP just merrily does as they’re told, no questions asked!

A shared care agreement usually relates to a medication which is specialist initiation only, and requires specific ongoing monitoring in order for prescription to be deemed safe. The GP agrees to prescribe locally alongside specific monitoring (e.g. blood tests), but the specialist takes responsibility for initiating the prescription and deciding whether/how to continue at specific and agreed intervals, as well as an agreeing to advise should concerns arise/monitoring throw up an issue.

If a GP prescribes something, they are taking on responsibility for that, including adverse consequences. “The consultant told me to” is not going to be accepted as an excuse- it is never going to be taken as anything than a potentially mitigating factor. If a GP is not confident that the medication is safe, or they do not feel they have enough understanding of why it is recommended for that patient or perhaps don’t feel they have enough knowledge to monitor their end safely, then they are right to decline to prescribe. Similarly, if the GP feels the monitoring proposed is insufficient or unsafe in any way, then they should refuse to enter into the agreement. Equally. if they feel they cannot safely hold up their end if the agreement due to staffing or work pressures, then they must decline to take on the shared care agreement.

What can happen- not infrequently- with private care is that they are not bound by NICE or local formulary restrictions and so have more “freedom” in that sense. Some private Dr’s do go completely off-piste and that can be both a good thing (pushing boundaries, new treatments, for example) and also an absolute nightmare for other professionals. However, regardless of all of that, it is also true that GP’s are obliged to comply with all of the national and local restrictions if they are prescribing on their NHS budget. They have to justify failure to do so- especially if an expensive treatment- again “the consultant said so” will not be a sufficient justification. Similarly, prescribing “off license” is also fairly common, but again the GP is taking responsibility for this- and may not really have the expertise to say if this is a good idea one way or the other- if it is a fairly common/routinely accepted use, this is usually less of an issue. With something less usual/commonly accepted/experimental it is a completely different matter and is more likely to lead to a refusal to prescribe.

GP’s are also restricted in some cases re monitoring (blood tests in particular)- there are some things which are only available to specialists and if requested “as per consultant” will be told to get the specialist to put the request on the system and if they can’t, then it can’t be done. In our area, any mention to the lab that it is for a private consultant request and the GP will be charged in the expectation that the GP will pass that cost on to the patient. It may surprise some to know that, technically speaking, GP’s could/should charge patients for making private referrals and any correspondence/work in relation to working with the private doctor (e.g. bloods).

Finally, sometimes the private route is used as a diagnosis but then the patient thinks they can just switch over directly and GP can prescribe until then. This is not always possible- until the GP knows that there is definitely planned follow up and monitoring in place, they may well not agree to shared care. E.g. the consultant only works every third Tuesday- who do they go to outside of those times? If there is no plan in place, the GP won’t take on the shared care as it is not safe. The NHS specialist is unlikely to answer questions about a patient they don’t know anything about.

There is also an ethical issue about the consultant putting into their own NHS list- essentially queue jumping. It puts those who can’t afford a private consultation even further down the waiting list and there is a debate to be had around the fairness of that. On the other hand, it’s also understandable why a patient who has a diagnosis would want to access treatment right away.

prescribingmum · 31/07/2024 22:23

Ottervision · 31/07/2024 22:13

Going against the icb policy is entirely different and not what we were talking about. I can't imagine many GPs would do that anyway.

I know you do, but if you're prescribing it under direction the specialist service is still responsible for ensuring its still appropriate and safe etc, seeing the patient regularly.

It's funny because gps don't specialise in all areas, so why would they ever accept shared care for anything ever? There is a level of responsibility on them, of course. But the overall responsibility lies with the specialist for having diagnosed / prescribed initially. Or are you saying they wouldn't be dragged into court?

A shared care agreement is comprehensive and gives clear direction to both GP and specialist. It outlines the responsibility for each.

In the OP’s case, she saw a specialist for a one off appointment, not ongoing care, they haven’t initiated prescribing and stabilised her on medication and haven’t committed to the specialist end of the document so it would not apply. Which means the GP would be taking on all the responsibility for prescribing, monitoring and follow ups etc. None of that situation falls under shared care and so it would all fall back onto the GP

Ottervision · 31/07/2024 22:25

prescribingmum · 31/07/2024 22:23

A shared care agreement is comprehensive and gives clear direction to both GP and specialist. It outlines the responsibility for each.

In the OP’s case, she saw a specialist for a one off appointment, not ongoing care, they haven’t initiated prescribing and stabilised her on medication and haven’t committed to the specialist end of the document so it would not apply. Which means the GP would be taking on all the responsibility for prescribing, monitoring and follow ups etc. None of that situation falls under shared care and so it would all fall back onto the GP

I know what a shared care agreement is.

I agree. I would expect her to be on a stable dose of whatever it is (I guess if that's applicable to whatever it is or settled in a routine no side effects etc) and then to transfer over via an SCA. I can't fathom whether she's on the meds yet ot not from the op.

Agree that the specialist needs to do routine checks etc. Again not clear from op whether that's on the table!

Izzynohopanda · 31/07/2024 22:28

Ottervision · 31/07/2024 22:00

It is if they're prescribing under the specialists direction. That's exactly what it means. The specialist remains responsible for the care. Check ups etc.

Yes and no. The consultant should oversee care etc. However, if the gp writes a prescription, they are legally responsible for the medication, not the consultant.

OptimismvsRealism · 31/07/2024 22:30

It could be worse I guess. The waiting list for fissure surgery in my area is current 18 months.

Clap for the NHS :(

OP posts:
prescribingmum · 31/07/2024 22:33

Ottervision · 31/07/2024 22:25

I know what a shared care agreement is.

I agree. I would expect her to be on a stable dose of whatever it is (I guess if that's applicable to whatever it is or settled in a routine no side effects etc) and then to transfer over via an SCA. I can't fathom whether she's on the meds yet ot not from the op.

Agree that the specialist needs to do routine checks etc. Again not clear from op whether that's on the table!

My interpretation is that she’s seen a specialist as one off who has diagnosed and given a treatment plan but not initiated yet (she said she can’t afford the private prescription). She also said she stretched herself financially for this appointment which implies she’s not under the specialists care on an ongoing basis until she moves to top of NHS list.

So I can understand why GP is not prepared to prescribe in this circumstance.

I do have a lot of sympathy for OP and the sorry state of our NHS. She should definitely not need to pay all her savings just to get a diagnosis and no wait for a specialist should be as long as she’s being expected to stay on the list. It is diabolical

Izzynohopanda · 31/07/2024 22:35

Op - have you spoken to pharmacies to see how much a prescription would actually cost? It may not be as bad as you think, especially if it’s an inexpensive medicine.

Ottervision · 31/07/2024 22:37

prescribingmum · 31/07/2024 22:33

My interpretation is that she’s seen a specialist as one off who has diagnosed and given a treatment plan but not initiated yet (she said she can’t afford the private prescription). She also said she stretched herself financially for this appointment which implies she’s not under the specialists care on an ongoing basis until she moves to top of NHS list.

So I can understand why GP is not prepared to prescribe in this circumstance.

I do have a lot of sympathy for OP and the sorry state of our NHS. She should definitely not need to pay all her savings just to get a diagnosis and no wait for a specialist should be as long as she’s being expected to stay on the list. It is diabolical

If that's the case then I wouldn't expect them to accept it. I assumed she was on meds because I've never (in my limited personal experience!) Known an sca to be suggested before that point anyway? I took it from "made a plan " so I can understand why they wouldn't take that on.

I feel sorry for op regardless as well, because it really is a shit system, and tbh re diagnosing her with whatever is a complete waste of time, money and nhs resources and it drives me insane.

My own gp told me a right to choose diagnosis "isn't real" and honestly I despair. Its no wonder the nhs is up shit creek.

Ottervision · 31/07/2024 22:38

Izzynohopanda · 31/07/2024 22:35

Op - have you spoken to pharmacies to see how much a prescription would actually cost? It may not be as bad as you think, especially if it’s an inexpensive medicine.

Edited

Also, shop around!! Ime items cost differently per pharmacy (idk what drug it is but I've had a few private scrips for stuff cost different amounts)

Greytulips · 31/07/2024 22:39

But most of us go private in desperation, for speed, to be seen and helped. We wait and wait on the NHS, get nowhere and then in desperation go private

Which given the waiting lists, just extend them further. It’s like ordering two drinks at the bar because it’s packed, just increases waiting times.

I think you thought you could queue jump, it doesn’t work like that. Don’t blame the NHS blame the government. Blame awful working conditions, blame entitles patients who shout at doctors and nurses, blame people who sit in A&E for non emergency treatment.

I saw this coming and was shot down last year. I see more and more friends taking private health care policies or making use of the ones they have - it’ll get worse before it gets better.

OptimismvsRealism · 31/07/2024 22:41

I have to be clear got a final definite prescription and I did pay for it for a few months to check it worked. Interesting that different pharmacies charge differently I must look around a bit

OP posts: