Prescriptions

[Baldhead]

I take a cocktail of (at the minute) 24 tablets/day for pain relief. My new GP will only give me a prescription for one months supply althought the pain managemen consultant has said I will be on these tablets for the foreseeable future. I asked for more from the GP but he mumbled something about the type of drugs they are he didn't want to increase the prescription, although my last GP was more than happy to give me 3 months supply.

Has anyone else found this?

Is it to save the NHS money?

Do GP's have a 'quota' for tablets they prescribe?

I don't claim benefits as I have a private pension, I have been told I would qualify for benefits which would mean free presciptions but I don't want handouts.

That's my rant over.

BH

 

[Random Orbital Bob]

It is entirely about money. The way NHS trusts work (GP practices) is they get paid by the NHS for each and every prescription they write. One scrip is for 1 months worth of meds regardless of their use.

So if the practice wants to maximise it's profits, it makes each patient pay the maximum possible. You can apply for the equivalent of a "season ticket" for your scrip and you get a discount.

I had a similer battle with my GP years ago when I was diagnosed with a hiatus hernia...I was hacked of having to get to the surgery to manually walk the repeat scrip through the system...over to the pharmacy...wait half an hour...aaaggggghhhhh Grown a beard by this time.

In the end he kindly agreed to 2 months supply per visit..but it's entirely discretionary and if they're feeling skint...they force the month rule

 

[monkeybiter]

My wife's on a few meds and has a prepayment card, quite a saving in the long run.

 

[Phil Pascoe]

I'm on nine permanent ones, and mine have two monthly for years. I'm exempt on two counts - maybe they'll pay me when I get exempt by age as well.

 

[whiskywill]

Us lucky people in Wales get free prescriptions and my local pharmacy operates a system where they organise the repeat prescription and..........deliver it to my door, all free of charge.
We do have to pay for supermarket carrier bags though.

 

[dc_ni]

I'm lucky here in northern ireland, my script is free and the doc does me one for two months at a time.

When I need a new script I just have to ring the surgery to order it and its sent through to the chemist of my choice.

Dave

 

[Baldhead]

Bob

I too have a hiatus hernia, been on meds for it for about 12 years, I asked my old GP if he could give me a 3 month prescription, he agreed reluctantly, told me the only thing they can prescribe for more than 3 months is the contraceptive pill!

Going slightly off my original post, my new GP doesn't want to prescribe more than one months supply of Codiene Phosphate because its addictive, the pain consultant I saw increased my Codiene prescription and assured me it is not addictive if taken for pain relief, now who do I believe?

The consultant also doubled my Gabapentin and reintroduced Amatripylene, the GP wants to me to go from one Amatripylene to four over a period of 3-4 weeks. What Bob has just told me about how GP practices are funded by the prescriptions they write worries me a little.

BH

 

[Flynnwood]

I used to think that GP's (in England at least) were PAYE employees of the NHS.

They are not.

There is a yearly option for prescriptions, which could work out cheaper.

£104 for 14 (or more) items in a 12 month period.

http://www.nhs.uk/NHSEngland/Healthcost ... costs.aspx

 

[monkeybiter]

My wife was taking 8 Codiene Phosphate per day for pain, they are addictive, they are metabolised into morphine, and codeine commonly causes headaches. She has since swapped over to Tramadol, which is also addictive. The swap should have been managed over several weeks, but the GP didn't mention that. The hours of vomiting in the car were traumatic.

She also was prescribed two Amatriptylene a night to help sleeping [one total hip replacement at 35 and one deteriorating hip] but realised she was groggy all the time and has weaned herself off them and feels better for it.

 

[Eric The Viking]

It is entirely about money. The way NHS trusts work (GP practices) is they get paid by the NHS for each and every prescription they write.

I think it's exactly the other way round: every prescription is charged to the individual GP's drug budget. They are responsible for minimizing the cost to the NHS of the drugs concerned.

I'm pretty certain there is no connection at all between prescription charges and GP practices.

So if the practice wants to maximise it's profits, it makes each patient pay the maximum possible. You can apply for the equivalent of a "season ticket" for your scrip and you get a discount.

The discount is true. Prescription charges are per-item, irrespective of the cost of each item. If you regularly have more than two items/month it's cost-effective to have a discount card (the "pre-payment certificate"). I couldn't afford my own drugs without one.

I had a similer battle with my GP years ago when I was diagnosed with a hiatus hernia...I was hacked of having to get to the surgery to manually walk the repeat scrip through the system...over to the pharmacy...wait half an hour...aaaggggghhhhh Grown a beard by this time.

In the end he kindly agreed to 2 months supply per visit..but it's entirely discretionary and if they're feeling skint...they force the month rule

They're not supposed to supply more than a month at a time for various reasons:

1. Meds can't be returned for re-distribution. If your meds change or you come off something, any left over are wasted, sometimes expensively.

2. Some categories of medication, e.g. many classes of painkillers, are both dangerous and addictive. You're not supposed to be able to stockpile in case you sell them, get high on them, or whatever. Takes all the fun out of it, IMHO, but hey...

3. The prescription fee *is* income to the NHS. Cutting the number of scrips does cut down the income the NHS gets back in, increasing the overall cost of running the scheme.

I presently have 7 items on regular prescription. Having a pre-payment card saves a fortune. I also have an accommodating GP, who does 2-monthly scrips for some things, because it's easier to manage (some drugs suppliers' 'months' are 28 days, some 30 and so on - it's infuriating to try to keep track of everything).

Most practices now use EMIS Web as their patient management system (not great, but hey, that's NHS politics for you). EMIS have a national portal for appointment and repeat prescription booking. You need to set up access with your practice (paper form!), but it does save time and stress. Part of the GP contract and the GPSoC software provision framework (just expired) was a commitment to make sure that every practice has a web site with a defined information set on it and on-line booking capability (repeat scrips and other routine stuff) by April 2015 (IIRC). If your practice hasn't got that yet, ask them when they're implementing it!

E.

 

[AndyT]

Ask your pharmacist for a review of all the medication you are on. A 'medicines use review' is a formally defined service that a Pharmacist is paid to provide. Also ask them about the Electronic Prescriptions Service. This is gradually being rolled out across the country and is the way that the sequence of having your GP prescribe something and then having a pharmacy dispense it can be made much more efficient and convenient for you.

 

[RogerS]

Our surgery has been on the electronic system for well over a year. I simply login, ask for the repeat then pop down to the pharmacy attached to the doctors surgery a couple of days later. Works really well. Dead easy to get doctor's appointments as well within a short timeframe. Brilliant GP surgery. Can't fault them.

 

[MARK.B.]

Even here in the sticks our surgery uses a electronic system,it works very well and saves a lot of time and costs.
If you have a friendly doctor try asking him to let you see the price list for the drugs that they prescribe to you, i was amazed at how much the NHS pays for some of even the most common drugs,the cost for new or experimental drugs would make your eyes water, what you pay in subscription charges wont even come close to covering the cost that is charged to the NHS.

 

[Dodge]

On this subject there is another factor that naffs me off big time - as previously said a script or prescription allows you to get a months supply of your medication - so why when I get my tablets month on month are there 28 tablets in the box??? Excuse me but only one month is the year has 28 days in it!!! :evil: :evil:

Basically my monthly prescription means that I actually need 13 prescriptions a year.

Sorry my little rant of the morning over (hammer) (hammer)

 

[Jacob]

On this subject there is another factor that naffs me off big time - as previously said a script or prescription allows you to get a months supply of your medication - so why when I get my tablets month on month are there 28 tablets in the box??? Excuse me but only one month is the year has 28 days in it!!! :evil: :evil:

Basically my monthly prescription means that I actually need 13 prescriptions a year.

Sorry my little rant of the morning over (hammer) (hammer)

Dear oh dear that's terrible - no wonder you are so upset! :roll:

 

[Eric The Viking]

On this subject there is another factor that naffs me off big time - as previously said a script or prescription allows you to get a months supply of your medication - so why when I get my tablets month on month are there 28 tablets in the box??? Excuse me but only one month is the year has 28 days in it!!! :evil: :evil:

Basically my monthly prescription means that I actually need 13 prescriptions a year.

Sorry my little rant of the morning over (hammer) (hammer)

Yup, me too. As mentioned, I currently have seven or eight items on prescription, plus one bi-monthly injection. They vary from 28-days, to rolling weeks (days named on the blister-packs), to 30-days.

With the less important (and safe) stuff, I keep a Kilner jar on the worktop labelled "Poison - not sweets" and have blister-pack emptying sessions periodically. The blister packs take up a stupid amount of room though, compared to pills in bottles.

It's a right PITA keeping track of everything, but it does keep me alive.

E.

 

[Harbo]

So you want to go back to the days of a Pharmacist or Dispenser counting out pills and putting them in tiny bottles so you can have 28, 29, 30 or 31 pills depending on the time of year ??
Much safer to have them in 2 weekly blister strips x 2, with the day marked on them - that way you can keep track on them?

Our rural GP Surgery dispenses prescriptions, which can be ordered electronically and collected from the Practice or delivered to our village shop. It sends out 4 weekly electronic remainders and when annual reviews are required. It works really well.

Rod

 

[Reggie]

They have to dispense and count the pills in one form or another, I've had plenty of prescriptions where my tablets have been made up of broken up blister packs to make up the numbers. mine come in boxes of 56, my prescription is 84, someone has to break those up and count them. Mine does email based repeat prescriptions, supposed to give them 2 days to fill it and send it to the pharmacy across the road, invariably after 3-4 days it still isn't across at the pharmacy, this isn't part of a blame culture, this about them doing the job and providing the service they say they will provide.

 

[Mark Hancock]

If you have a friendly doctor try asking him to let you see the price list for the drugs that they prescribe to you, i was amazed at how much the NHS pays for some of even the most common drugs, the cost for new or experimental drugs would make your eyes water, what you pay in subscription charges wont even come close to covering the cost that is charged to the NHS.




Next time ask how much he makes on the drugs he buys in. Surgeries buy in drugs from a number of wholesalers having signed up for contracts giving them discounts on volume usage and the use of generics where possible. They are then reimbursed by the NHS at fixed rates which makes the surgery a nice profit

 

[Reggie]

Any unnecessary visits to a doctors to pick up prescriptions for ill people doesn't help them to get better, it's not about blaming, it's about wishing the system were better and wanting to know what's wrong with it.