GP practice refusal to give repeat prescriptions

[Sylkwood]

Moderator note: These new replies were split away from an earlier dormant thread to avoid confusion with the earlier posts 🙂

I am in the same boat as you over these stupid pointless reviews and the Gods (Who must be obeyed) at my surgery are currently holding me to ransom by only precribing meds for 7 days at a time, refusing to do my repeat sick notes and will only issue 1 freestlye libre sensor per month instead of 2 so they know I will have no blood sugar results for 2 weeks per month. They are jumped up little Gods who think they can get away with treating us the patient like this. I have written to my MP and this matter is currenlty under investigation. These GP's are ordinary men and women doing a job like millions of others in this country but they think they are untouchable. I may need your support in the future if they keep getting away with this.

 

[Tdm]

I am in the same boat as you over these stupid pointless reviews and the Gods (Who must be obeyed) at my surgery are currently holding me to ransom by only precribing meds for 7 days at a time, refusing to do my repeat sick notes and will only issue 1 freestlye libre sensor per month instead of 2 so they know I will have no blood sugar results for 2 weeks per month. They are jumped up little Gods who think they can get away with treating us the patient like this. I have written to my MP and this matter is currenlty under investigation. These GP's are ordinary men and women doing a job like millions of others in this country but they think they are untouchable. I may need your support in the future if they keep getting away with this.

Thats just not on, you have a right to cgm/ flash glucose monitor

 

[Lucyr]

I am in the same boat as you over these stupid pointless reviews and the Gods (Who must be obeyed) at my surgery are currently holding me to ransom by only precribing meds for 7 days at a time, refusing to do my repeat sick notes and will only issue 1 freestlye libre sensor per month instead of 2 so they know I will have no blood sugar results for 2 weeks per month. They are jumped up little Gods who think they can get away with treating us the patient like this. I have written to my MP and this matter is currenlty under investigation. These GP's are ordinary men and women doing a job like millions of others in this country but they think they are untouchable. I may need your support in the future if they keep getting away with this.

I’d be delighted to get one libre sensor per month.

 

[Pumper_Sue]

I am in the same boat as you over these stupid pointless reviews and the Gods (Who must be obeyed) at my surgery are currently holding me to ransom by only precribing meds for 7 days at a time, refusing to do my repeat sick notes and will only issue 1 freestlye libre sensor per month instead of 2 so they know I will have no blood sugar results for 2 weeks per month. They are jumped up little Gods who think they can get away with treating us the patient like this. I have written to my MP and this matter is currenlty under investigation. These GP's are ordinary men and women doing a job like millions of others in this country but they think they are untouchable. I may need your support in the future if they keep getting away with this.

Write a formal letter to your GP saying that you do not wish to have an annual review with them and it is an informed decision.
Also request that you are referred to a hospital consultant if not under one already. If you are under one then point out that as the NHS is very short of apts, it seems rather pointless having 2 annual reviews, and also request that your prescriptions are reauthorised.

 

[Tdm]

That

I am in the same boat as you over these stupid pointless reviews and the Gods (Who must be obeyed) at my surgery are currently holding me to ransom by only precribing meds for 7 days at a time, refusing to do my repeat sick notes and will only issue 1 freestlye libre sensor per month instead of 2 so they know I will have no blood sugar results for 2 weeks per month. They are jumped up little Gods who think they can get away with treating us the patient like this. I have written to my MP and this matter is currenlty under investigation. These GP's are ordinary men and women doing a job like millions of others in this country but they think they are untouchable. I may need your support in the future if they keep getting away with this.

Write a formal letter to your GP saying that you do not wish to have an annual review with them and it is an informed decision.
Also request that you are referred to a hospital consultant if not under one already. If you are under one then point out that as the NHS is very short of apts, it seems rather pointless having 2 annual reviews, and also request that your prescriptions are reauthorised.

When my meds were reauthorised it was a 5 min discussion over the phone...they questioned why metformin was on my list and i confirmed hadn't taken since T1 diagnosis so it could have been useful had there been a misunderstanding. I, too, felt rather threatened by the idea of not being able to order more insulin

 

[Deleted member 21371]

My statins get cancelled without my annual review, even though that's all on the prescription now.
I can delay it a few months, but without the review, I can understand why just simply putting drugs on a continuous repeat would actually break the GP's duty of care, as things change, both physically and mentally, and I'll accept he needs to check on me occasionally.
It's a couple of minutes on the phone, after my annual realm of blood tests.

 

[Leadinglights]

A medicine review is to make sure you are taking the medication prescribed (many do not), to ensure the dose is right and to check on any problems you are having with any of the meds so really should be regarded as a good thing.
It also gives you the opportunity to ask for extra if you need it.
When my daughter did her GP rotation she asked somebody to come in for a medicine review as she noticed they had not requested a repeat of all the meds they should have been taking and it turned out that his wife had passed away and she had always sorted out his requests so he didn't know what he should have been taking, it had gone unnoticed by the surgery for 4 months. That is very sad.

 

[Pumper_Sue]

A medicine review is to make sure you are taking the medication prescribed (many do not), to ensure the dose is right and to check on any problems you are having with any of the meds so really should be regarded as a good thing.
It also gives you the opportunity to ask for extra if you need it.
When my daughter did her GP rotation she asked somebody to come in for a medicine review as she noticed they had not requested a repeat of all the meds they should have been taking and it turned out that his wife had passed away and she had always sorted out his requests so he didn't know what he should have been taking, it had gone unnoticed by the surgery for 4 months. That is very sad.

The review in question is a diabetes review and as a GP knows diddly squat about diabetes a nurse does the review and can not reauthorise anything on the prescription thus has to ask the GP anyway. Nine times out of ten the practice nurse has no knowledge of type1 either. So a simple phone conversation is all that's needed to renew in most cases.

 

[Proud to be erratic]

The review in question is a diabetes review and as a GP knows diddly squat about diabetes a nurse does the review and can not reauthorise anything on the prescription thus has to ask the GP anyway. Nine times out of ten the practice nurse has no knowledge of type1 either. So a simple phone conversation is all that's needed to renew in most cases.

While, @Pumper_Sue you make a fair point about the GP Practice having limited knowledge about T1, I don't agree with your conclusion.

Firstly, many of the annual review checks are appropriate to the GP Surgery and can readily be done by the Practice Nurse. Taking that 1st point further, I still get regular reviews at the Hospital Clinic and I prefer to keep my valuable time at the Clinic focussed on specific T1 aspects and queries.

Secondly, my Practice Nurse is authorised to write prescriptions (I understand all 3 nurses are authorised) and since my prescriptions are repeated from the GP Surgery it makes total sense to take the opportunity at an annual review at the Surgery to briefly discuss those repeat scripts, getting the obsolete or expired items deleted and items that mysteriously 'dropped off' the repeats reinstated. There is nothing better than face to face discussions to resolve such niggles.

But thirdly, and in some ways most importantly for me, this makes sure that I am seen periodically at my GP Surgery, which gives a point of reference for the Practice and myself for when things go adrift. From time to time I've had to phone or email to sort something out and when I can reference that 'sorting out' to a conversation had on a specific date with a specific person, then even the hardened 'guard dogs' who stand in for receptionists give way - particularly when I ask them to check with that nominated person and insist they phone back or email to confirm the outcome. Works every time. I won't (and didn't when it was suggested) allow my GP Practice to discard their responsibility for my overall care, by saying that since my T3c is complicated and assisted by the Hospital Clinic the Surgery can't involve itself in my requirements.

@Sylkwood I do agree that writing a letter or sending an email, preferably to your nominated GP, briefly explaining why you should have the repeat prescriptions is appropriate and necessary. This topic goes back to at least April 2015 and at post #27 @Northener provided a copy of what he wrote around that time. You could do worse than cut and paste that letter into your own correspondence with your Surgery; if need be use that vocabulary to reinforce your point with your MP.

 

[nonethewiser]

Despite being under pump clinic at hospital still got reminders from gp surgery about diabetes reviews, even though they get copy of hospital appointments sent to them.

Repeatedly told surgery that I didn't need reviewed as under care of hospital but still they send them, now just ignore them as sure they are just sent out routinely to everyone with diabetes.

No issues with prescription, manage to get 4 libre sensors each time, if didn't would get consultant involved to write to gp surgery, from past experience that does job.

 

[Pumper_Sue]

Despite being under pump clinic at hospital still got reminders from gp surgery about diabetes reviews, even though they get copy of hospital appointments sent to them.

Repeatedly told surgery that I didn't need reviewed as under care of hospital but still they send them, now just ignore them as sure they are just sent out routinely to everyone with diabetes.

No issues with prescription, manage to get 4 libre sensors each time, if didn't would get consultant involved to write to gp surgery, from past experience that does job.

I was told on Friday when I complained about the letter with the threat about meds removal that letters are sent out automatically and their system can not alter it! Odd as other practice did. My complaint about the threat/tone of the letter fell on deaf ears as no one else has complained.

 

[Proud to be erratic]

@Sylkwood, my earlier reply included a reference to a letter sent in Apr 2015 by @Northener, the vocabulary of which may be of use to you. Alas, that reference is now separated from this posting after the moderator's rearrangement. It is copied below:

"I found early on that you need to put your foot down and if your arguments make sense then they will usually comply. When my surgery tried to change my repeat from 300 to 100 strips I wrote the following to the practice manager:

I have Type 1 diabetes and test on average 6-8 times per day. I need to test for a variety of reasons, but have a valid reason for every test, using the information in order to stay safe and maintain good blood glucose control. This is reflected in the fact that I have maintained an excellent HbA1c since diagnosis five years ago. I need to test before administering insulin doses, for cases of suspected hypoglycaemia or hyperglycaemia, and to monitor the effects of changes to my diet on my levels. I am also a runner and need to test before and sometimes during exercising to ensure my levels are within safe limits. I also need to test more frequently during periods of illness, or when my insulin requirements are changing due to a number of factors thus making insulin dose calculation less reliable. Furthermore, it is a requirement of the DVLA that I test before driving, and during long journeys in order to avoid hypoglycaemia.
Restricting me to 100 strips per repeat will entail putting in a new request every 12-14 days instead of the current 6-8 weeks. All other items on my repeat provide for 6-8 weeks supplies. It is illogical and inefficient therefore to place this restriction on my supply of test strips since it entails not only inconvenience and wasted time on my part, but also extra work both for the surgery and pharmacy, and therefore extra cost to all parties. I feel that this is an unnecessary and inappropriate use of NHS funds.

My repeat was immediately restored 🙂"

 

[Sylkwood]

@Sylkwood, my earlier reply included a reference to a letter sent in Apr 2015 by @Northener, the vocabulary of which may be of use to you. Alas, that reference is now separated from this posting after the moderator's rearrangement. It is copied below:

"I found early on that you need to put your foot down and if your arguments make sense then they will usually comply. When my surgery tried to change my repeat from 300 to 100 strips I wrote the following to the practice manager:

My repeat was immediately restored 🙂"

I wrote to the Practice Manager first but she is in with the GP's and the letter I got back threatened to remove me from the surgery completely if my attitudes did not change.

 

[Lily123]

Have you spoken to your DSN? They could speak to the surgery if problems persist

 

[Sylkwood]

Have you spoken to your DSN? They could speak to the surgery if problems persist

I have Yes but she says she cannot do anything as they are GP's. She doesn't know about their latest stunt of cutting down my blood sugar testing equipment though as they have done this since I last spoke to her when their meds reduction and refusal to do sick notes failed.

 

[Tdm]

I didn't have enough teststrips prescribed at first as it was before i got a cgm and was testing a lot. I basically cried down the phone at them. That was effective ( I was rather emotional after my diagnosis...)

 

[everydayupsanddowns]

I wrote to the Practice Manager first but she is in with the GP's and the letter I got back threatened to remove me from the surgery completely if my attitudes did not change.

Sounds like the relationship is under a lot of strain @Sylkwood

Do you think starting afresh with another local practice might be worth considering?

 

[DaveB]

Hi. Your surgery is obviously not the best. I'm on our surgery PPG team and our Practice Manager is superb together with the surgery and wouldn't allow the mess you are seeing. I have a meds review every 6 months and that is dictated by the CCG (or it's new name ISG?) mainly to control costs. My scripts all assume 4 weekly renewal which I do online. My review is normally done with a nurse practitioner who has prescribing rights in her various disciplines so can change things at the review. I did ask for a referral to the county diabetes team for a C-Peptide test and the rather bizarre but good consultant offered me Libre 2s on script and my DN added those.

 

[Proud to be erratic]

Hi. Your surgery is obviously not the best. I'm on our surgery PPG team and our Practice Manager is superb together with the surgery and wouldn't allow the mess you are seeing. I have a meds review every 6 months and that is dictated by the CCG (or it's new name ISG?)

For info: not ISG, but Integrated Care System (ICS); and because the relatively modest-sized CCGs are replaced by very much larger ICSs, there will be a Regional descriptor in front of the abbreviated ICS. Ours is Bucks, Oxford, Berks (West) (BOB ICS) which embraces approx 43 former CCGs. Its a dramatic reorganisation, initiated in 2019, probably delayed or hindered by Covid and went live across England on 1 July 2022.