Frustrared by GP surgery but unsure if bad enough to formally complain?

[Bruce Stephens]

If it were just the way a Doctor spoke to me, I'd take it up with the practice manager, but for something so fundamentally wrong, got to be GMC.

If it's the practice pharmacist I fear going to the GMC might not really work. I'm speculating that the GPs are doing the right thing and the fact that the system's broken (because, I speculate, the pharmacist is seeing the large amount of insulin and assuming it must be a mistake) hasn't really been understood by everyone.

But I'm speculating. The DSNs or hospital consultant ought to be able to sort out whatever's going wrong.

 

[Amity Island]

If it's the practice pharmacist I fear going to the GMC might not really work. I'm speculating that the GPs are doing the right thing and the fact that the system's broken (because, I speculate, the pharmacist is seeing the large amount of insulin and assuming it must be a mistake) hasn't really been understood by everyone.

But I'm speculating. The DSNs or hospital consultant ought to be able to sort out whatever's going wrong.

Perhaps it should be the GPC then?

 

[Pumper_Sue]

I speculate, the pharmacist is seeing the large amount of insulin and assuming it must be a mistake) hasn't really been understood by everyone.

If my pharmacist is not happy with a prescription or unsure as to what is meant, she rings the GP practice before dispensing the mediation.

 

[Bruce Stephens]

If my pharmacist is not happy with a prescription or unsure as to what is meant, she rings the GP practice before dispensing the mediation.

Absolutely. But it sounds like this isn't the pharmacist at Boots (who's (one hopes) only going to produce exactly what's on the prescription (maybe after checking with the GP as you say)), rather, it's a pharmacist at the GP surgery (as @everydayupsanddowns comments this seems to be a new thing). (If it's them, then I assume it's just some screwup: well run GP surgeries shouldn't be limiting insulin supplied to people with Type 1 diabetes, since that's just not going to end favourably for anyone.)

(As a general thing, I can imagine having pharmacists at GP surgeries can make sense. They're likely to know lots about medications, and quite a few things people might otherwise see a GP about might be handled by a pharmacist. I got on the Libre trial via my surgery's pharmacist. After a phone conversation she agreed I might qualify and the local diabetes team agreed. (No sign of any decision now that the trial has finished, but I don't think that's anything to do with the pharmacist.))

 

[KittyGecko]

Thanks everyone for your advice. Lots to consider here.
Yes, as others have said being overweight and my diet are obviously part of the cause of the insulin resistance. However, that is something I'm working on with the hospital gradually so I feel that the gp pharmacist just arbitrarily deciding I don't need this much insulin isn't really their decision to make and doesn't change how much I do currently need.

I don't really want to share the amounts I use here as I know it's too high and any potential negative feedback I receive about that is not going to do any good for my anxiety. Rest assured myself and the hospital are working on it but I have been overweight my entire life so it isn't likely to change overnight. I assume I'm using about twice what people with good control normally use based on the amounts the gp pharmacist seems to think are normal.

Thank you for all the advice, I think I will see how the conversation with the gp pharmacist goes on Monday but I will use some of the info and advice you guys have given me so thank you. Overall I think a change of gp surgery is on the cards for me but I have a lot of anxiety around medical issues so it may take me a little while to find the courage and mental energy.

 

[grovesy]

I would not worry about saying how much Insulin you are using as it is generally regarded that you need what you need. Everyone is differnt.

 

[AndBreathe]

Hi Mike,
Is this lawful? For a GP to refuse to give the necessary amount of insulin to a diabetic? It sounds like something they would be struck off for?

This makes a good case for what I had posted some time ago about T1 diabetics being able to collect their insulin direct from pharmacist without a GP's prescription if they attend a hospital consultants appointment etc

I would say it is lawful, but that would be my assessment, based on logic.

The Doctor is not refusing the prescribe insulin, they are adjusting the amounts prescribed. It seems a bit bonkers, bearing in mind there is a fee for every prescription dispensed.

@kittygekko mentions in her opening post that she has metal health issues, so it could be the surgery have concerns about issuing too much at once.

Of course that last part is pure speculation, and may be clutching at straws, but just trying to see a reason why this would be done.

Kitty, I apologise if my final remarks are way off the mark.

 

[grovesy]

I would say it is lawful, but that would be my assessment, based on logic.

The Doctor is not refusing the prescribe insulin, they are adjusting the amounts prescribed. It seems a bit bonkers, bearing in mind there is a fee for every prescription dispensed.

@kittygekko mentions in her opening post that she has metal health issues, so it could be the surgery have concerns about issuing too much at once.

Of course that last part is pure speculation, and may be clutching at straws, but just trying to see a reason why this would be done.

Kitty, I apologise if my final remarks are way off the mark.

That is a good point .

 

[Pumper_Sue]

I don't really want to share the amounts I use here as I know it's too high and any potential negative feedback I receive about that is not going to do any good for my anxiety.

Hello again Kitty,
Simple logic says you need what you need.
There are some people who use higher strength insulins I think there's a U200 and a U500 as they need so much insulin.
So it doesn't matter how much you use, it's what you need to hopefully stay fit and healthy.

I think you need to go and have a talk with your GP rather than the pharmacist and also your consultant.

 

[JohnWhi]

Just a couple of additional points.
Experience suggests that, surprisingly, many GPs may have only a vague idea of the number of units in a particular amount of insulin. Last year my practice tried to reduce the amount by half. I asked for an appointment with a GP to explain my concerns, and he was apparently astonished to hear that 1ml only gives about 100 units (less any amount vented).
Secondly, I had a case last year when, a fortnight after requesting insulin, the GP dispensary told me they were unable to obtain it, and their suppliers could not indicate a date on which they would be able to send it. (I went into vertical take-off, wrote to my MP, who spoke to the Health Minister, who wrote an unctuous letter saying that all would be resolved at some point in the future.) I made the point to the GP that we need some reserve supply to cope with such situations.

 

[grovesy]

Just a couple of additional points.
Experience suggests that, surprisingly, many GPs may have only a vague idea of the number of units in a particular amount of insulin. Last year my practice tried to reduce the amount by half. I asked for an appointment with a GP to explain my concerns, and he was apparently astonished to hear that 1ml only gives about 100 units (less any amount vented).
Secondly, I had a case last year when, a fortnight after requesting insulin, the GP dispensary told me they were unable to obtain it, and their suppliers could not indicate a date on which they would be able to send it. (I went into vertical take-off, wrote to my MP, who spoke to the Health Minister, who wrote an unctuous letter saying that all would be resolved at some point in the future.) I made the point to the GP that we need some reserve supply to cope with such situations.

Many find if a dispensary has no supplies or say they can't get, getting a paper prescription and ringing around other local ones have managed to get.

 

[KittyGecko]

I would say it is lawful, but that would be my assessment, based on logic.

The Doctor is not refusing the prescribe insulin, they are adjusting the amounts prescribed. It seems a bit bonkers, bearing in mind there is a fee for every prescription dispensed.

@kittygekko mentions in her opening post that she has metal health issues, so it could be the surgery have concerns about issuing too much at once.

Of course that last part is pure speculation, and may be clutching at straws, but just trying to see a reason why this would be done.

Kitty, I apologise if my final remarks are way off the mark.

I would totally understand that if they were dealing with someone with self harm tendencies. Luckily I am merely exceptionally anxious. You make a good point and I will check with them that my mental health isn't part of their reasoning. Thank you for the ideas.

 

[KittyGecko]

I just want to say thank you all for the reassurance. There is a very welcoming atmosphere here and I feel very reassured. Will update when I've spoken with the gp pharmacist on monday.

 

[Ljc]

I really hope you get this sorted quickly. With insulin ,It is a case of you need what you need

 

[Drummer]

I'd suggest contacting the consultant who made the original prescription, reminding of the original decision made and quoting the amount of insulin you have been allowed, then ask what you are meant to do in order to survive on what you are being given. Consultants tend to be a bit touchy about arbitrary alterations to their treatments, so with any luck there will be a rocket heading towards your GP surgery.

 

[AndBreathe]

I just want to say thank you all for the reassurance. There is a very welcoming atmosphere here and I feel very reassured. Will update when I've spoken with the gp pharmacist on monday.

To be honest, Kitty. I'm not sure talking to the Pharmacist is the answer in this instance, although you could use that chat to find out exactly what is going on and why this is happening.

It could be (and this is pure speculation on my part) that the pharmacist is tasked with ensuring patients are dispensed with the minimum medications to deal with whatever ails them - whether diabetes related or not. I'm thinking things like blood pressure, statins, thyroid meds, maybe.

If that is his remit, then the issue lies with the GP. Let's not get into whether the approach I'm speculating about is correct or not, but there surely has to be a distinction between fixed dose medications, and those, like insulin, where the doses required are likely to be dynamic, based on all life's variables. I think you need, at the very least, to be seeing your GP, then if that doesn't work, escalating it to your Consultant.