New pharmacy rules announced

[CoverMeInMarmalade]

Pharmacies require stricter weight-loss jab checks www.bbc.com/news/articles/c5yeklrer39o

We knew it was on the cards but really frustrating if this now causes problems for those of us who are genuinely obese and need this drug to help save our health/lives.

It is also the right of the pharmacy to not prescribe to you if you refuse to allow them to contact your GP and if this stops them from prescribing within the safety guidelines. So you can both have your 'rights'?

Good.
Tighten these rules even more.

I don’t understand some of this. Where is the line drawn between NHS/state prescriptions and private prescriptions? To what extent does the NHS need involvement with a private prescription? To what extent do private prescriptions need to be documented on your NHS record?

I think to a certain extent, some of the lines are being blurred here. If you were to get cosmetic surgery or other privately prescribed medication, it’s unlikely that information would be passed on to your GP. For example I have bought prescription skincare medication privately, sleeping tablets, had private procedures etc, none of that shows on my NHS record. Even prescriptions from my dentist, do not show on my medical records.

So I think if the government wants the NHS to have more involvement than standard with private prescription weight loss injections, it’s a bit odd. The customer is inevitably paying for the medication privately as the NHS criteria is so narrow.

I think initially video consultations will stop people lying to obtain medication. However long term, people are allowed to be on Mounjaro for maintenance so presumably would look slim in a video call. So it makes me wonder if maintenance prescriptions would be scrutinised more.

I otherwise agree and welcome changes to discount and referral codes.

Honestly, I think it is right that this medication is put on your medical records, and it is very worrying when people don't want their GP informed.

If I were a prescriber, I would consider that a red flag that would stop me from prescribing.

Your GP can't do their job properly if they don't know about the long-term medication that you are taking.

Your prescriber can't be sure you aren't failing to mention contraindications if you refuse to notify your GP.

Your GP has a professional duty including confidentiality. Why wouldn't someone allow their medical records to record their prescriptions?

They still have discretion in how to implement the guidance, though. So, it isn't "compulsory video calls" that is one way of implementing some of the recommendations. There are probably other innovative things that can be done to ensure pharmacies are taking the necessary precautions.

It also isn't immediate. It is a request to review practices as soon as possible.

Can anybody clarify this point for me please?

I have been previously prescribed by Cloud Pharmacy. I chose Cloud because they didn't inform your GP. They have now removed any reference to this from their website, so I believe the GP is now informed.

I have no contraindications, but I have a poor relationship with my GP surgery due to my weight. I have tried to change but the next nearest surgery is over 10 miles away and they can't take me on due to distance.

If I see a private GP does my NHS GP need to be informed under the new regulations? If so it is the end of the line for me amd WLI, and I will need to just stop immediately and not taper down.

Yes it isn't a mandatory requirement for "compulsory video calls". The guidance says:

"When supplying medicines used for weight management, the prescriber independently verifies the person’s weight, height and/or body mass index. By ‘independently’ we mean that the prescriber uses a different way to verify the information provided to them by the person. This could be through a video consultation, in person, from the person’s clinical records or by contacting another healthcare provider such as the person’s GP."

So it's clear that there are different ways the pharmacies can use to independently verify the person's height/weight/BMI. I'd rather that pharmacies use video consults, as the thought of trying to get any information out of my GP seems exceedingly unlikely. I can't get face to face appointments for anything, you can't book appointments in advance for non urgent things, and I am fairly sure they would simply refuse a request for information from a private prescriber or charge for it.

My general guess would be (outside of weight loss):

• People whose jobs require security vetting where their medical records are checked. This means they may additionally have to explain the medication they take to their employer.

• people going through legal claims/processes where their medical records are relevant. For example police matters, employment tribunals, injury claims.

• people worried about who can access their medical records, especially as you can access your own medical records on your phone now. Personally my phone is private, but others may have snooping/abusive partners for example and just want their medical records to be bland.

In all these cases I don’t think it’s a big deal if that person is on weight loss medication, but I think the reluctance to have it permanently on your medical record may come from wanting to keep it private - as it can be a personal/embarrassing thing and draws attention to you being obese. Personally I was always slim then became obese, and I felt extremely uncomfortable when big and didn’t recognise myself. I’m glad those days are over.

I saw a private dr recently and I had to give my NHS details. This was the private hospital policy.

Even if you see a private Dr your GP will most likely be aware.

I’m in the crowd that doesn’t think this is a bad thing, but my provider requires regular online/face to face meetings. It was they who felt that even though I was only just in the 25.2 BMI zone I ‘looked’ slim and healthy enough that I should start titrating down and move to a maintenance plan, rather than aim for a weight closer to 23BMI zone.

They see my DS online too and agree that he probably won’t need to aim for a BMI of below 25 either because at 6ft 4, he now only looks like he needs to lose a stone at most, rather than the 3 stone the BMI stats indicate.

If this means that fewer people get to abuse the system, it will mean less public outrage and stigma so that those who are obese and able to use it under clinically approved conditions will be more easily able to do to.

On balance, I think this is an overdue change in practice.

I’m sorry but I don’t see any of these reasons as good enough to not have it listed on the medication you take on your nhs records. Not one of them justifies it.

I do see one big reason. You’re not eligible and lying to get them and if your doctor found out would stop it.

I'm going to be harsh here but this is a blooming hassle I don't need.

I'm happy for my GP to know always have been as far as I know they get a letter each time, I meet the criteria easily. I'd like the NHS to pay for it (wouldn't we all) but I'm also being responsible and trying to invest in myself. I wouldn't want to take up a GP appointment for this.

How is it my fault if someone buys random shit from a hairdresser etc. (why would you?!) or uses a dodgy photo etc. sad as it is i don't consider it the pharmacists/doctors fault if a slim person has got it via fraud. The liability should rest with the person who commited the fraud. If they've not lied of course then that's a much different kettle of fish.

It's very expensive I can't afford much extra costs that this will potentially add. I've never lied on my weight check each time. I've had questionnaires again filled in accurately. This should be more accessible for people (who meet the criteria) cost already means it's too limited

I could do a scale photo I suppose and would do but that's not infallible if a person is determined. I did give an accurate photo when I first started too.

But why is it the end of the road? The gp won’t stop it unless there is a medical reason you should not be prescribed. Poor relationship. Don’t like the drugs or anything else emotive is not grounds to stop it.

So it makes me wonder if maintenance prescriptions would be scrutinised more.

can’t see that happening, you can just do a video of you standing on the scales. Showing your weight. No biggie, they will know if you’re going to an underweight bmi.

I'd rather that pharmacies use video consults, as the thought of trying to get any information out of my GP seems exceedingly unlikely

I think you contradicted yourself again. In your opening paragraph you say multiple options, then say you just want video calls. There is a range of options. I dint want a video call for example. But I am happy to provide access to my medical records as it shows the drugs listed and my doctor supportive in her comments. Ie Lilly has lost more weight via mounjaro and her blood pressure is reducing.

I said that's what I'd rather, as in what I personally would prefer as an individual customer. Perhaps I should have been much clearer that I meant personally for me, although I thought the context of my specific GP being effectively uncontactable made that fairly clear.

Maybe they could collaborate with some pharmacy chains to hold the weightloss and management clinics there ad they could prescribe after face to face consultations to take the heat off the GPs. This could then put more money into the pharmacies and they could train up weightloss specialists etc

Well obviously! 🙄. What a stupid post pointing out the bleedin’ obvious. No idea what point you’re trying to make. If these guidelines are in force then I won’t have any choice, nor will the pharmacy. I did before, and so did the pharmacy 🙄. You seem to be lacking in basic understanding and argumentative for no reason in all your posts on this board.

Embarrassment about discussing it with a GP. This was my reasoning - I was obese yes, i had tried diets, exercise and was getting nowhere and was getting depressed, weight was going on not off. I only took the meds for 6 weeks which gave me the boost and start to my weightloss journey, I then stopped taking them and carried on with a healthy eating plan and I am now slowly but surely losing the rest. I didn't want to discuss it with my GP because she can be quite funny and I felt like she light tell me off.

This is a great idea. There could be some people trained up and authorised to weigh and measure new starters and talk about the side effects etc and then 3 or 6 monthly reviews. They could send notes to the pharmacy of your choice. They could be based in pharmacies but then they would be linked to that pharmacy I guess or maybe the NHS could do this part (I know they are too busy) or it could operate a bit like slimming clubs do. It would cost money though and bump up the cost of taking the medication.

I think this is a good thing but concerned about prices going up and delays.

We've got an entire forum here of people who consider themselves very adept at evaluating people's weight!!!

Bring it on, with a bmi of 44 due to being short in height current debating whether I'm just fat or am a diabetic. I welcome the discussion of just why I cannot got the injection by prescription, having been a diabetic. I bet the nhs will try and take the glory when in actual fact I've paid thousands.

I feel both sorry and angry for the nhs. The online support groups are in their own world and some dangerously scary (can I put this in my tea as I'm afraid of needles; nuts!) and my understanding is that most 'diabetic' people seem to believe they will get lifelong prescriptions even after their diabetes has reversed. How? and then there was the media farce about how the unemployed were going to be offered it, how the heck would that work!

Can we expect to see the online groups to be policed?

The nhs haven't helped themselves here either in creating this discord. Loads of questions forming for the diabetic nurse.

@Mindovermatter45 I'm a bit confused by your post. You say you're not sure if you are diabetic, then say you are diabetic but the NHS won't prescribe MJ for you.

I have T2 diabetes and a BMI of just over 27 . I also have high blood pressure. The clinical guidance says that MJ can be prescribed to people with T2 diabetes if other medication hasn't worked. I have been on two medications and my blood sugar is still too high so I have now been prescribed MJ. If you're not sure if you qualify, talk to your Diabetes Nurse.

I’m also confused by your post, you are not at that bmi simply due to height, it is due to weight for your height. You also can’t work out if you’re diabetic, you need a blood test. You can be both fat and a diabetic, both of not mutually exclusive.

and the unemployed are getting it as a trial paid for by the manufacturer, it will be rolled out over a number of years.