To expect my elderly dad's surgery to offer non-digital options?

[CaringForMyElderlyDad]

I care for my 89-year old dad. Alongside many other responsibilities, I help him to manage his medication by putting his tablets into dosset boxes.

When he is running out of something, I ask him to call the surgery to request his repeat prescriptions. I write down what he needs and when he needs it by, along with the number for the surgery. Then I check that he has made the call.

I probably could order it from the surgery directly, but until now, it has been something that my dad has been able to do for himself. And as that list of things is gradually diminishing, I feel that it is important for him to be able to do it.

However, he rang today to request some tablets that were running out, and they instructed him that the only way he can now order a repeat prescription is online. Which of course he couldn't do, because he is 89 and struggling with the consequences of cognitive decline.

Obviously, I can do it for him so it isn't an issue, but what if I couldn't? Surely it isn't reasonable to expect all elderly people to be able to access digital options?

To be honest, I don't really understand why he needs to order the repeat prescriptions at all. The GP surgery knows what he takes and how often he takes it, and it should be easy enough to figure out when he will be needing another batch. But I accept that he does have to order it, and that's fair enough. I cannot accept, though, that he should have to navigate his way around an unfamiliar online system simply in order to get what he needs?

Thank you. I'll try to find out a bit more. His prescriptions are fairly static.

I was with you until ‘the GP know what he takes’ the GP has 1000s of patients and really can’t be responsible for knowing when Doris, Fred and Bob run out of their medication we are already run into the ground the extra work that would generate is unfathomable. There’s usually a blanket ‘order online’ because of the above mentioned transcription errors over the phone and the pharmacy tendency to order everything regardless as to whether it’s needed but will generally make reasonable adjustments and let people order over the weekend phone if they genuinely can’t order online.

Thank you, this is helpful. I just wish that they could look at his record and work this out for themselves.

Would they do repeat dispensing? My sister has a learning disability and came into my care a few years ago and was surprised they set her up with repeat dispensing so she doesn’t have to order them in the same way I do, we just get a text from the pharmacy every month to say her medications are ready

The trouble is that GP practices just make their own rules and policies. I am so lucky I am with a good practice, a couple of friends just out of catchment are with a different practice and they are stuck with a virtual receptionist and e-consults only. One of the reasons I refuse to move. I need a good GP and a decent hospital.

I was imagining a digitised system rather than some poor GP running through things manually. But whatever - I accept that this may be possible.

As for reasonable adjustments, if they have an 89yo man on the phone telling them that he doesn't know how to do it online, then I would expect them to have the common sense to just say it's fine, we can sort it for you on the phone. Instead of telling him that they don't accept it by phone any more so he will need to log on via the app. My poor dad had no idea and just gave up.

It really shouldn't be that difficult.

It’s not just about keeping up though. My Dad is 88 and learned how to use a laptop, order his shopping online and research his hobbies. The issue now is partly his eyesight and partly his cognitive function not being as good as it was. He’s easily confused and gets quite stressed about things he once took in his stride.

I've asked about this in the pharmacy but apparently not. They do deliver once the medications are ready, which is helpful.

And until now, the surgery has accepted orders on the phone so it hasn't been an issue, but apparently they are no longer willing to do this. And their online ordering system doesn't seem to be working right now either. 🙄

Very blinkered to assume this means someone manually going through records. Why should patients keep up with technology when the NHS itself is so technologically naïve!

Yes it’s really worrying the way it is going. My dad has dementia and luckily I can order his prescriptions for him online as he would have no chance. At his GPs now you can’t make an appointment or order a repeat prescription even if you go in face to face. It all has to be through PATCHES. My dad would still be capable of going into the GPs to make an appointment himself but that bit of independence has been taken away and he’s totally reliant on me to do it all for him which is hard to juggle around work and children as I live an hour away. The NHS seem to have totally forgotten the vulnerable and elderly who can’t access services digitally

I agree.

I mean, if Mr Smith takes one XYZ pill every day and the pharmacist sends him a pack of 28 XYZ pills, I'm not sure why it would cause anyone any additional work to have the system pop up with a notification saying that Mr Smith will need another delivery of XYZ pills in 4 weeks' time. I'm not sure why Mr Smith's daughter would need to go online to tell them that the supply will run out after 4 weeks? Surely an automated notification would could just go through exactly the same approval process or whatever it is as the requests submitted online by patients or their family members?

This. I find Boots to be quite good with all of this, if he has one locally. I support an older family member with learning disabilities, who cannot read or write. Her pharmacist manages all of her repeat prescriptions, putting them into sealed dosette boxes, and delivering to her.

Slight tangent but why is it now a 10 page questionnaire on an iPad to check into A&E? My 82 year old father wouldn’t have a clue, nor have the dexterity now to do it even if he did understand it.

DH is on regular medication and our pharmacy does this. DH doesn't even have to re-order his meds, they just get delivered every 4 weeks. He gets his in dosette boxes.

This thread makes for interesting reading. I have medication on repeat prescription as do my children. For various reasons we sometimes forget to re-order medications. Previoiusly everything was on repeat dispensing and the pharmacy would either deliver or notify us that something was ready for collection.

Recently we've had to make sure we order repeats ourselves. I checked with the pharmacist who told me that the NHS no longer allows automatic repeat dispensary and that all patiens have to request the medications themselves. I haven't looked in to this any further and don't know if this is specific to my area or a national thing.

One of my children who is on an anti psychotic and ADHD medications is finding this really hard as they frequently forget to put in the online request and ends up without medications for a few days. I suffer from quite bad brain fog which causes me to forget things quite regularly as well. I have managed to work around this with regular alarms set up on my phone but this doesn't work for everyone.

There is such a variation in experience with GPs. Where I am in Scotland, my GP has nothing online. The only thing I can do online is send an "admin note" to the front desk which is things like blood pressure readings or wishing to cancel an appointment.

Everything else is done by phone. Test results (no NHS app in Scotland), appointments, prescriptions.

So there is a balance to be struck. The GPs shouldn't be excluding people who can't go online, but thre should be an online/easy way to request a repeat prescription for those of us who want it.

Not even elderly or tech challenged myself but I don't understand why we need to order repeat prescriptions. I've currently got 4 repeat prescriptions going, all issued at different times and two are for the same medication (I take as one combined dose)! And I can't order before roughly 6 days before running out anyway, or without it being issued by a GP and recent blood test or similar. But have to allow a good 5 days for them to fill it before I run out. And I have a job and a young DC, so much extra admin that I don't understand

Especially as two prescriptions are pregnancy related, that's a set amount of time they need to be issued for yet I have to request them

the technology just isn’t that great and he might take. X pill every day B pill just when his knees are sore. He misses pill Y on Tuesday and Wednesday as he pees after and it distrupts him at bridge club, He went into hospital for a few days didn’t bring his pills they sent him home with new boxes and he doesn’t need them. The system will order them then a phone call from his daughter more pills have arrived we don’t need them ‘he’s got too much it’s confusing him! Why did you send him so much?!’ It would be lovely in theory but the technology just isn’t there and there are so many variables especially with the elderly.

Repeat dispensing is possible for patients who are on predictable medications where all of them run out at the same time and are monitored at the same frequency. You need to speak to you surgery not the pharmacy though.

I'm lucky that I have a really good gp surgery. They are not perfect but work really hard to make sure their services are accessible to everyone. So when I read on here or hear on the news etc about digital only, I know that it can absolutely be done in an analogue way still. It's great for people who can do it all online to be able to do so as that frees up the phonelines for when a call has to be made

I totally agree with this. A lot of people who claim that they are too old to go online are not really. My FIL who would be 105 if he was still alive never had any problems doing anything online.
I am 10 years older than @Gettingbysomehow and I have always preferred to do things online as do most of my neighbours who are considerably older than me.
The doctor who commented that online systems led to fewer mistakes is correct. Before ordering online I had incorrect prescriptions, someone else’s prescription and mine sent to the wrong pharmacy.

I'm really pleased for you, truly. But not everyone is the same.

Sometimes people should just try a bit harder before they get too old.

You have no idea.

Don’t you get the part of the prescription home with the medicine that has the medications listed on it?
My granny, who was in her 90’s, would just tick which medications she needed on the slip, I’d drop it off at the chemist who would send it to the drs surgery to be approved. Then it would go back to the chemist to be filled and I’d collect it for her. She could have been registered at a different chemist that delivered but I was able to collect so it worked for us.

Can I just say something else as an GP about repeats scripts?
That’s that many elderly patients n multiple meds are atrial from their meds - statistically if you are in 5 plus meds the risk interactions is huge - more than 40 percent.
Older people on multiple meds need to see a Gp regularly - sometimes depressurising (reducing meds) is most important thing I do!
In a pressured health service it’s hard!