NHS cut backs

[drinkswineoutofamug]

I've read on various news sites today that the NHS is proposing to make cut back on what GPS prescribe. Pain killers , gluten free food , indigestion remedies and sun cream.
They also want NHS staff to ask for I suppose would be the Eu/world version of the E11 card or whatever it is. Some trusts already ask for proof of ID, passports and bills.
To me , an NHS front line staff worker I think it's a good idea, if it saves money and the money is then spent in the correct way not on managers and other useless ideas , believe me there are many!
Pain killers can be bought cheaply on the high street and to get gluten free food on prescription , do you actually ask for 2 loaves of bread and pizza based and biscuits each week?
My only issue is would this effect the low income and house bound? Interested in other opinions

I think its entirely reasonable and am shocked that those items are available on prescription.

I would also have no problem showing proof of my residency.

Pain killers can be bought cheaply on the high street

Yes they can but not necessarily in the quantity needed.

Paracetamol for example, I have to take 8 a day. There is a limit on how many you can get at a time which means we have to go to several shops to get enough to get me through each week. Someone who is housebound would be stuck.

Maybe if there was a card or something that you could show a pharmacist that says you need more than the amount they usually sell, would work.

Piglet - I think that doctors should be able to issue prescriptions which give you consent to buy large quantities of such medications rather than giving them free of charge

I agree, except for paracetamol.

My mum suffers from Arthritis and uses paracetamol several times a day. At the moment the GP prescribes it for her in much larger quantities. She'd have to visit the chemist nearly everyday otherwise.

In my GP surgery there are signs saying they will not prescribe paracetamol unless it is required for long term use.
I do wonder if a card or some sort of register at a regular chemist stating you are exempt from purchasing limits would be an idea for paracetamol.

Xpost

When will we start accepting that we can't have both high taxes and infinite cuts to public services. It's outrageous and any unjust system won't survive for long.
I need very strong pain killers routinely and I can't imagine spending the money on them if they aren't prescribed. Wtf are my taxes for?

I'm also front line NHS, and I'm not so sure...

Gluten free food sounds trivial, given that it is the latest craze. But people prescribed gluten free food are not following a craze, they are severely intolerant to gluten, I.e coeliac. It is still expensive to buy (although much cheaper in the last few years thanks to the gluten free trend) if you are exclusively and strictly gluten-free.

Im happy for GPs to suggest to patients to buy their own basic analgesia for minor acute issues. In fact, our doctors will often see patients and simply tell them to take paracetamol/ibuprofen, and not issue a prescription. This however, relies on patients being happy to buy their own. Often they are not. The far reaching consequence of this can actually be delays in discharge while you wait for a prescription of paracetamol to arrive from pharmacy before you can discharge someone. Cutting costs here is a great idea - if patients agree!

Sun creams are expensive, and essential when prescribed certain medications. If these are not prescribed, I believe patients just won't buy them.

As a person married to a coeliac disease sufferer, I am not so sure that gluten free food should Be taken off the list. Gluten free food is more readily available but at much higher cost. We do not use prescription food anymore, but do believe that should be still provided as an option for lower income families. My DH used to get prescription bread (not fresh, ready mix to bake at home) before it was widely available. The cost is at least 3 times as high for bread, pasta, cereal. For some, it's not a choice or a fad but necessity.

I dont think targeting specific treatments is the answer. As lovelycats says whilst some may seem trivial when you understand why they are prescribed it makes sense. Many of my patients are on multiple neuroleptic medications that can cause sun sensitivity. If they weren't prescribed sunscreen they wouldn't buy.
I'm surprised coproxamol is on the list,it's my understanding that this is only prescribed to people for whom an alternative pain killer has not been appropriate.

One of the major problems is that some of the general public don't take responsibility for themselves anymore! If you have a condition that causes sun sensitivity then it's common sense to buy sunscreen surely? Why should the NHS provide it for you? Far too many people abuse the prescription service, I see people on a daily basis complain because they don't receive plasters etc on prescription.

If you had to wear sun cream any day the sun might appear, including in winter because of over-sensitivity to sunlight, you would find it extremely expensive. Why should people on lower incomes suffer the brunt of this cost for something that they cannot help. We're not talking about people who choose to go on four sunny holidays a year demanding sun cream on prescription. For some this is as essential as any other medication.

I worry as to where it will stop. Yes paracetamol can be purchased very cheaply especially if you buy own brand versions but if you have a chronic condition which causes pain and you take lots, then surely it should be GP prescribed as part of monitoring what you take as well as for being able to bulk buy - I couldn't buy what I need daily, I can't get out some days! But I do think if you can afford a take out coffee etc then you can afford 30p for a box of paracetamol.

Gluten free food - perhaps it should be means tested? maybe? My DM has coeliacs and once gf food became more easily available, she didn't bother with prescriptions but I am aware she can afford £2.50 for 8 tiny slices of bread.

I hate to see what is happening to our nhs but I do recognise we need changes. Charging people for missing appointments (without good reason) might stop some of the misuse. What else could be done?

Hay fever medication is on that list too. So poor people's kids can just suffer in exam season.

Anti histamines are 79p in aldi
Paracetamol is 13p

Anti histamines are 79p in aldi
Paracetamol is 13p

If only Aldi was not a £3.60 bus ride way - on a Wednesday I could even get a bus home too...

Yes paracetamol is 13p however the dosage I need would mean 4 or 5 trips a week, plus DH is now also on them for an injury, so double that.

As pp have said those with chronic conditions should get a card or something to show at boots or wherever so they can buy enough - however with the rise in pain killer
Addictions I'm not sure that's feasible?
I appreciate that not everyone has an Aldi near them but most places have a pharmacy and paracetamol is very very cheap as and when you need it

...and I've been buying anti histamines for myself every summer since I was 18
They are much cheaper now thank goodness

surely if you are oversensitive to the sun, you put on extra clothes - especially in winter? If you are coeliac then you choose other foods - potatoes/rice. Have people got used to a certain way of life and expecting the government/tax payer to fork out? pitza/biscuits aren't essential?

daisy I'm a practice nurse who gets plenty of no-shows in my clinic.
I had three no-shows yesterday. Two in their mid seventies and a twenty two year old. Would you charge them all?

That's not all the news on the cut backs though, I've also read that GPs are going to be advised to refer less people for hip and knee replacements and encourage them to stay on long term painkillers instead! Oh and presumably they will have to pay for those painkillers. Such a short sighted and unacceptable idea!

Where is it all going to end? first class care for the rich who can go private, third world type care for the poor.

I think that a GP should have the ability to make a considered decision with regard to each patient. Patient 1 might need 100 paracetamol prescribed every month for an established medical condition, patient 2 just needs a box of 16 for a sprained ankle (or something). Patient 1 gets prescription patient 2 doesn't.

My daughter is Coeliac, gluten free food is very expensive, I paid £3 for a loaf of bread today. Some people can afford that but many cant, some people have easy access to large supermarkets with stocks of gluten free foods others don't. Personal circumstances need to be taken into account.

The prescription changes are not intended to include those who (like my DH) take paracetamol on a long term basis - here is some info (PDF link) from one of my local CCGs which clarifies that paracetamol prescribing will not be cut for people with long term conditions. This may be a local decision, however - I can't find anything from NHS England which specifically says this.