HRT, repeat prescriptions and charges

[FernBrighton]

I thought I’d drop this in here in case it’s helpful to anyone else.

Until a couple of months ago, I was able to request my HRT as a repeat prescription online. It was suddenly removed from the website and I was told that that it’s no longer allowed to be ordered online (along with the contraceptive pill) due to concerns over getting blood pressure checked.

I googled this as I wasn’t sure if it was a real thing, or if it was just my GP surgery trying to make it inconvenient in the hope of stopping women asking for HRT and unfortunately it does seem to be a common thing.

In addition, I discovered this:

www.gov.uk/government/news/more-support-for-women-experiencing-the-menopause

So basically, you can ask for a longer prescription cycle to save on charges. I’m guessing some people are already aware of this but I wasn’t till yesterday so posting it here just in case.

@FernBrighton Legally, the meds (like all) have to have an annual review. Some drs prefer 6-monthly. I think women are experiencing a range of behaviour by their drs. The new legislation on an annual one-off charge is not coming in till april 2023.

I've been told my surgery don't (won't? can't?) do HRT on repeat prescription. Each time I need more, I have to book an appointment with a doctor or a specific nurse. Seeing as they'll only give two bottles of Oestrogel per prescription (for me, two months supply), that is six appoinments per year. They have said it's because blood pressure needs to be checked (my bp had always been on the low side of normal). However, my surgery are still not doing face-to-face appointments, so won't check my bp in-house. The chemist no longer take bp readings (small, local pharmacy) so I've had to buy my own bp machine, take my own readings and submit them to the surgery, but still need to talk to someone every two months for it. It's a big pain, especially as you can only get an appointment if you phone at 8.30, and I work in a school so cannot do that (it regularly takes 20 minutes to get through and the school day has started before then). I have to ask my husband to book an appointment for me, but if he has early meetings and can't do that on a specific day, it can take a few days to actually get an appointment.

Pre pandemic I always had to have a face to face appointment every 6 months to have my blood pressure checked before my prescription would be issued. Since the pandemic I've taken my blood pressure at home (have a machine), sent in the readings and the prescription is sent directly to the pharmacy. However they will only issue a 3 month prescription. It's annoying as it saves me time, saves the cost and time of a face to face appointment which can be better used by someone else but costs me twice as much.

I'm going to ask to go back to a face to face appointment to save money. It'll be interesting to see if they will let me.

I have mine on repeat prescription and ordered last week without issue.

I can only order 2 months at a time and have to go in once a year for blood pressure check ect

Really interesting thread, thanks for the link.
I recently tried to request a repeat prescription online of hrt and it said I needed a review so I put a request in writing to the surgery and got a prescription, didn't have to see a gp.
Depending on which gp authorises the prescription sometimes I get 3 months supply sometimes 6 months.
Everytime I go to collect it from the chemist they try to charge me 2 prescription charges and everytime I have to explain its only one charge.
It shouldn't be that hard.

BTW, I have never had my blood pressure checked except when the gp first prescribed hrt and I've been on it nearly 2 years

My GP told me to get a home blood pressure monitor and phone in the results to avoid needing an appointment. I got one in a local chemist for £30, I think it would have been more like £20 in a big chain. I now just ring up and they repeat the prescription.
Also has the added benefit of being able to test the family - the cuff was too big for the kids so they had much amusement as having the blood pressure of zombies.

I'm on patches and pay two prescription charges so £18 something for 2 months.

I've always thought that was odd but it's always so busy at the chemist I have never queried, only been on HRT since new year.

Is it worth writing and addressing the letter to the GP and practice manager.

Point out the guidelines you link to and then explain the financial cost to yourself of attending every 2 months for a new prescription compared to every 6 months and every year. Remind them it’s 2 prescription charges each time. State you are struggling to afford it. Query why they will only prescribe 2 bottles of oestrogel over prescription and point out for someone on 4 pumps per day that will only last 1 mo th and result in 12 prescriptions for it.

Ask if you can come in for a chat and hope they can be more flexible and bear in mind the financial pressure it’s placing on you. You can say you’ve already spent out on a BP gauge and are happy to co tinge testing regularly.

Interesting that different GPs are doing different things though not altogether surprising, I guess!

Previously, I could order three months’ supply at a time via the online service and I had an annual review for BP check. Now, I have to physically go into the surgery, fill in a form and the prescription is sent to my chosen pharmacy. However, I’d seen the link that I posted in my OP and asked the practice manager if I could have six months’ worth instead now and they said yes, though if I hadn’t asked, they wouldn’t have mentioned it. I’m on a single tablet per day rather than patches/gel etc.

It does strike me as being somewhat pointless because all they’ve effectively done is make the repeat prescription process manual rather than online. Medication reviews were flagged online previously. The only thing I can assume is that they will make me go in, fill in the form, then the doctor may decide I need a review, so I’ll have to make an appointment, wait however many weeks until one is available, have the review, then finally get my prescription.

It’s just so inefficient land laborious. I even said to the practice manager that it felt like an attempt to discourage women from having HRT.

I order mine online, sometimes Get 3 months, if I'm lucky 6.
I add a note to the surgery to say I have no new health issues and have checked my blood pressure.
Much easier than having to go into the surgery, but the pharmacy never fail to wonder how many charges to put on (it's one)

But why does it vary between 3 months and 6 months for no apparent reason? That could be an additional 2 prescriptions for those having oestrogen and progesterone.

I don’t think it should be random and purely random based on which GP or pharmacist gets the prescription request and how ‘generous’ they are. Unless there are medical issues requiring more frequent prescribing (and 3 monthly first check-up and yearly check ups are standard) then why should it differ so much?

That’s why I would be writing to enquire and establish what I should expect and also pointing out the financial pressure of having really regular prescription requirements.

Often when you write and it requires a response and reasonable posts have been raised you get some there. It could save the effort of various trips and the cost of extra prescriptions and remove the irritation about the randomness of the process. But I know lots of people don’t like to challenge these things or cant be bothered to write and so just out up with it. Of course, no -one should have to write etc etc, but the reality is that there are wildly different prescribing and reviewing practices, so it seems speaking up and asking for explanations and for what seems the recommended approach isn’t unreasonable.

I got mine (6 months supply - two charges) last week after having a phone appointment with the nurse. Ive never been able to repeat my script online. Had to submit a blood pressure reading.

I had to wait a week for the whole order though as there's still a global shortage due to BREXIT/The Pandemic.

Interesting range of responses on here. I’ve been on it for 5yrs, one review pre-covid as I increase dose. But I have to pay and order it online every month. I bought a one year pre-payment certificate to make it easier. If they do change the charges then I won’t need the pre-payment cert which would save me £s.

My GP changed last year from applying online via Patient Access every 3 months for anything I'm taking (which is HRT and local estrogen) to automatic monthly prescriptions for a year at which point I have to review (to check it's still working well for me - no blood pressure checks needed though as not relevant).

DDs still order their pill repeat online and if it's not approved they know it's time to submit a BP reading which is done annually.

GPs are all working differently and sometimes we have no idea what's happening as it's not communicated very well.

Spoke to my GP about the once a year prescription for HRT and she said that it hasn't been implemented yet, but then proceeded to prescribe me about 12 months worth of HRT as one prescription

On another note, the workplace is being competitive about how they support menopausal women. My boss, in his attempts to be oh-so-supportive, asked me if I needed my own personal fan

*On another note, the workplace is being competitive about how they support menopausal women. My boss, in his attempts to be oh-so-supportive, asked me if I needed my own personal fan!

Brilliant. I hope you said yes.

@Campervangirl

Really interesting thread, thanks for the link. I recently tried to request a repeat prescription online of hrt and it said I needed a review so I put a request in writing to the surgery and got a prescription, didn't have to see a gp. Depending on which gp authorises the prescription sometimes I get 3 months supply sometimes 6 months. Everytime I go to collect it from the chemist they try to charge me 2 prescription charges and everytime I have to explain its only one charge. It shouldn't be that hard.

that depends what HRT you are on. If you are on a regime that contains both oestrogen and progesterone it is 2 charges as 2 different medications technically.

@astorsback

*On another note, the workplace is being competitive about how they support menopausal women. My boss, in his attempts to be oh-so-supportive, asked me if I needed my own personal fan!

Brilliant. I hope you said yes.

To be supportive workplaces need to ensure that their private health insurance policies cover issues linked to the menopause - anything else is sticky tape!