“Get to from the pharmacy” message from GP

[itsgettingweird]

I’m not sure if IABU or not?

I have a chronic incurable rare neurological condition. I take a medication that causes constipation as a side effect.

When first started the medication I struggled and the GP prescribed a macro gel and said if it doesn’t resolve they would need to investigate further.

On the whole it resolved and I have needed laxitives a few times but I’ve just got OTC stuff for occasional use.

I’ve recently had to up my medication a lot and suffering chronic constipation again and so did an e consult asking for another prescription.

Message came back “you can buy it from the pharmacy”.

The reason I’m not sure IABU or not is I know that and support it for occasional use but this is a chronic problem caused by a medication I need and will need long term. I pre pay prescriptions because of the cost and the OTC cost for the macrogels is higher than a one off prescription cost even for generic branded products.

Before I go back and challenge this I thought I’d garner the thoughts and opinion pf a wider audience.

So my question is “AIBU to expect a prescription for a medication I need long term for the side effects of a medication I need for a chronic health condition?”

Obviously title should say “get it” 🤦🏼‍♀️

i would challenge this based on what you’ve posted

What is the medication? The pharmacy can advise you about side effects etc.

Can you afford to buy it ? If so then you should if not then I would contact them to request it is prescribed

I think it’s the cost OTC vs prescription which is the concern

If they’ve prescribed it before, they can do it again, I’d be challenging them.

Doesn’t matter if you can afford the OTC cost or not.

The cost is relevant though. If it’s something you can buy very cheaply then I really think the OP should buy it herself.

NHS guidance is that doctors are encouraged not to prescribe items that are easily purchased from pharmacies or supermarkets, so they’ll challenge requests on this basis. Based on your circumstances you can challenge back, as you have a longer term need for them - it’s likely whoever has reviewed your request hasn’t fully reviewed your records and has just responded based on “patient wants item which can be bought at the chemist.”

It’s about 12 quid a box not cheap

Tbh affording the OTC cost is a challenge but I could find the money.

bit it’s another £20 a month which is higher than a prescription cost and because I already take medication prescribed monthly I have a prepay certificate.

I would be happy with a system which only allows long term meds to be covered by the prepay and pay the prescription cost for this but it seemed very odd the want me to buy something I medically need.

mom the flip side I also know how much the nhs is struggling so didn’t want to make a fuss it their suggestion was reasonable by general opinion.

Thanks for all the nice replies as I know it can be an emotive subject the nhs!

Pharmacists can prescribe some things. I don't know enough to say if they can prescribe for this, but it's a possibility?

100% challenge this. I wouldn't think twice in your situation.

With laxatives as well, don't most shops/pharmacies limit how much you can buy?

I think the point is that you don't require a prescription as in you don't need a qualified medical doctor to make the decision about you taking them. That time, decision making etc and the associated notes etc also carry a cost to the NHS. Along with the admin involvement.

The econsult system is to ask for a medical opinion (as opposed to requesting a repeat prescription for eg)

You wanting a prescription to alleviate the financial burden of your illnesses is a different situation.

Somebody has looked at your message for max 20 seconds, seen the words 'constipation' and directed you to pharmacy without any look in your notes to see that you have a long term condition which requires prescription of laxatives.

I'd go back to the surgery on this, you are not bankrupting the NHS with your perfectly reasonable request for a repeat prescription.

Before I retired, I had medications recommended to me by my GP, since OTC was cheaper than the prescription charge, so I can see the logic there, but I notice that is not true for this case.
Do you think that the problem is the e-consultation; the program may not have been set up for subtleties like interacting with other medication, or may simply be offering the standard solution for the average patient suffering from a one-off bout of constipation?
The pharmacist may well have relevant advice to offer, or may recommend that you consult your GP.
Not quite the same, but I found the pharmacist very helpful when I was advised to avoid aspirin because of taking blood-thinners.

Might be worth looking into applying for PIP as that can help towards the additional costs people have with long term conditions.

I think morally a prepayment certificate should cover you for all the medication relating to your long term condition, including dealing with side effects.

It would perhaps be questionable if you were often using it for desperate acute issues (e.g. totally unrelated headaches, indigestion etc).

I think morally a prepayment certificate should cover you for all the medication relating to your long term condition, including dealing with side effects.

It would perhaps be questionable if you were often using it for desperate acute issues (e.g. totally unrelated headaches, indigestion etc).

Absolutely challenge i thought the reason gps prescribed certain things that you can buy over the counter for chronic conditions was dur to the quantity you need like i use to get paracetamol prescribed and I would get 200 at a time you can't buy that in shops.

I would imagine this is the most likely reason and it could be solved with a quick call or email

It’s possibly this.

However there isn’t a choice for constipation (because it’s an OTC medicine I assume?) so I selected other and explained it’s because I’ve had to up my verapamil and it’s a side effect.

i think the first point of call is the pharmacy as they are a prescribing pharmacy and then asking the lovely receptionist at my surgery for advice on how to contact them to challenge the decision.

Challenge this. I work in Primary care and if you have a long term condition which causes an issue or if meds you are on is causing an issue then you should get it prescribed

Thanks.

I wouldn’t qualify for PIP because the medication dose control the condition to an extent and I can work and care for my disabled ds - not always easily but I couldn’t legitimately argue 50% of the time I can’t.

My ds gets PIP.

Thankyou. Thats exactly my line of thinking.