GP refused my prescription for insulin!

[trophywench]

I'm awfully sorry Ellie, your post has come over a little bit sharp. It does sound as if you think B is going off on one and accusing people of doing things she has no proof of. She really isn't - she's just trying to stay patient until the geezer deigns to ring her (that's bad enough - the surgery don't seem to see her and her child's life as being either important or urgent) and she can discover at whose door to place this disgusting failure on their part.

But I'm guilty of sounding sharp enough times myself.


Anyway - now that's really interesting because earlier this evening I was on the revamped BNF website (everyone has to re-register from 13 March 2012 to accept new T&C) and I read the prescribing guidelines amongst other things.

One thing amongst the very few items doctors are instructed to never NOT prescribe when requested is INSULIN. I was pleasantly surprised about that but thought no more of it ...... you can coss question the patient after the event. But the Hypocratic oath also requires you to do no harm and to preserve human life in all circumstance under your control. So IF the doctor HAS refused then he ain't no doctor, and if he did do that frankly, I've now upped my game. I now want to report him to the GMC.

And the same instruction the pharmacists - as long as they personally 'interview' the patient, are satisfied that they need it, AND have had it before (this wasn't specific to insulin, it was all the things on the list I refer to above) - then they are instructed to lend the patient some, just as Babysaurus' one did.

But until B interviews him on Tuesday, she won't know if it's his fault or not, will she?

 

[Cate]

Sorry Ellie, I didn't mean that you were wasting the GP's time by doing this, I was just surprised about it as an idea (having read back what I wrote earlier, I agree it comes across like that, which I didn't mean! I originally wrote, then deleted, a bit about only visiting the GP for antibiotics and flu jabs ).

Personally I have 5 10ml vials on each repeat prescription, and I collect that about every 2 months (all my repeats are on a 2 month supply). When pregnant, I collect around once a month instead, which still meets the 28-day criterion I suppose.

Also, even on a meds review and needing to make an appointment with the GP, I thought it was standard practise to issue a prescription for 1 vial (or pack, or whatever) as an interim measure. Maybe not.

 

[Pumper_Sue]

My test strips and insulin are PRN.
IE, order when you like and as needed. I have never in 47 years of insulin had the amount of insulin retricted. The thought of it shocks me beyond belief.
OP has already had a consultation with her GP re her test strip requirements, who from the sounds of it has a power complex problem and also suffers from anal retention. 😡

OP needs to take a list of demands for her prescription repeats.
Test strips PRN
Insulin PRN also spare syringes or pens incase of pump failure
Glucogen.

So was the GP trying to restrict BS insulin or was in fact the doctor trying to get her into the consulting room to see medical proof or should I say her pump data/bg data to confirm what BS is saying over the phone, where the GP has no indication other than tone of voice used to determine is what she says is correct. The GP needs to see body language and some evidence to establish what's going on..

Sorry Ellie, could you come and clean my keyboard up for me just spilt my coffee on it
Hands up anyone who has a GP who even knows what a pump looks like let alone knows what data is even if they had the software to upload it to their computer 🙄

 

[Ellie Jones]

Another rant, so I won't be offended if you log off now and don't read any further 😉

Just went to get the prescription I ordered on Saturday only to be told by the pharmacist that the surgery wouldn't issue it and instead were apparently going to call me (they haven't.) I used the absolute last of my insulin last night filling my pump and it would be due, all things being normal, to run out tomorrow mid morning. Hence, I would have NO insulin.

Thankfully the wonderful pharmacist has 'loaned' me a couple of bottles of Humalog which they had in to keep me going. I have a midwife appointment at the surgery tomorrow so plan to have a word with the practice manager. My mother also suggested I ask the GP to write down precisely the amounts they are prepared to prescribe, and the reasoning behind these decisions. I will then ask for a copy and suggest they keep a copy on the basis that if anything happens to either myself or this baby as a result of this I shall sue.

So f**king angry! As if I don't have enough on my plate!

😡

This is what BS posted at 6pm 13/3/12 which is a Tuesday,

Now I think everybody should read all of BS's replies throughout this thread...

As it tells a different story to the one people seem to be making comment on..

from this first post, you can see that BS has left ordering her insulin up until the last minute when she's almost out of insulin.

Her GP hasn't said anything about restricting her insulin, BS's is attempting to instigate this.

So looking at this one post, you can see that BS's isn't concerned enough to ensure that when ordering her insulin supply that she's making a reasonable allowances to cover any hitches, such as the wrong insulin is ordered, the request goes missing, hitch in supply at the chemist (these all happen) or the refusal of her repeat that did happen.

But it's wrong for the doctor to refuse a repeat prescription when that repeat flags the system, which the doctor has to investigate by law

So the fact that BS's was put into the position of not having enough insulin to last is partly her own fault..

In other posts, she's going to see everybody complaining about this GP, except the GP themselves, sorry her midwife and the practice manage can't issues/authorise repeat prescriptions or change them, nor can they instruct/demand the GP does..

How does BS's know that her GP doesn't know anything about diabetes, she may well be an Endo... You train to be a GP after you've qualified in a particular medical field as a doctor, so all doctors have an area of speciality.

So all those who's saying that a GP is putting the welfare of their patient and the child they carrying in danger by placing unfair restrictions of insulin use on them or refusing prescriptions think again... As I don't believe this is happening, their is certainly lack of communication going on but even with that BS's isn't talking to the GP but everybody else instead!

And I do wonder what 'exercise' actually means in the case of a almost 7 month pregnant women!

As my niece compete's in Triathlons, when she was pregnant her training regime changed, by 7 months she her exercise consisted of long walks, no gym, no cycling and no running, drove her bats, she didn't resume training until 8 weeks after her son was born.

So in many ways I'm intrigued to what 'exercise' means and why can't it be put on the back burner or changed until after the baby is born

 

[Pumper_Sue]

The doctor and the surgery carried out their duties complying with the various rules, regulations and legislation that govern the issuing of a repeat prescription.

No they didn't this involved insulin. They can not withhold it.

How does BS's know that her GP doesn't know anything about diabetes, she may well be an Endo... You train to be a GP after you've qualified in a particular medical field as a doctor, so all doctors have an area of speciality.

Read previous posts re test strips 😱

 

[Ellie Jones]

Sue

Sorry but they have the 'right' to refuse to issue a prescription if the authorisation of issuing a prescription breaches the rules, regulation and/or legislation set down in law surrounding the issuing of medication.. To do so, would mean that the could be struck off or even face an custodial sentence...

To suggest that the doctor withheld a prescription that would endanger his patients welfare, s/he would have to refuse to authorise the prescription with full knowledge that the patient didn't have insulin available or know that the amount of insulin available to the patient were such that it would run out before authorisation issues that need to be investigated are completed.

And at what point did BS' notify her GP (or should say the authorising GP or surgery) that she was almost out of insulin? Tuesday the day after the GP refused to authorise the repeat!

Now the first person to know that BS's was seriously low on insulin was the chemist on Tuesday...

Now on Tuesday when the GP was made aware of the situation in hand, swiftly issued a prescription for the necessary insulin is this an admittance of guilt on part of the doctor, No it isn't if the doctor had been aware of the full facts on Monday when s/he was signing off all the repeat prescriptions it would have been authorised.

So making allocations that her GP is trying to restrict, with held or with hold insulin is unfair and unfounded.

After in a court of law, a defending lawyer would point out that BS's was fully aware that there were issues surrounding her repeat prescriptions, which if I remember right she was made aware of this just over a week before! So why had she left it until the last minute to request new supplies which would leave her with less than 24 hours worth of insulin when she picked her new supply up?

At what point had she contacted her surgery to clarify if her repeat prescription had been adjusted to meet her new requirements or to pre-warn the surgery/GP that she was almost out of insulin.

Has BS's at any point asked for a second opinion from another doctor in the practice to make amendments to her repeat prescription to reflect her new needs, so it avoids unnecessary flagging the system causing her problems getting her repeat prescription NO she hasn't what she has done is approached other medical professionals who even yes can support what she says, they can not over turn the medical opinion of the doctor.

In fact apart from the initial phone call from her own GP who phoned BS, she has not requested a consultation in surgery with any GP within the practice to discuss her needs at all... Which doing so give's her the advantage of showing her own or another GP clinical data, to show yes her insulin needs have dramatically increased and explain her need for a unusual amount of test strips with the backup data that proves that she's using them effectively to maintain diabetic control that is conducive both to her and the baby she's carrying welfare...

A lawyer would also point out that if BS's felt that her GP's qualifications meant that she didn't have the medical understanding to make a suitable clinical decision concerning her diabetes combined with pregnancy needs, why hadn't she requested a transfer for her care to be overseen by another GP within the practice that she felt did have the necessary qualifications or knowledge?

Even with the complaint procedure at the practice all these questions will be asked... What part did the individuals play, what actions were taken by both parties. What effect did these actions have on the situation etc...

Which in this case, I feel the real failing on the surgery point of view, is that the GP failed to insist that BS came into the surgery to show the clinical data she holds (her pump data and BG data). Which in hindsight this would have avoided unnecessary aggro for both parties.

If you'll going to throw blame and allocations around. You need to except what part you played in it...

As from experience with dealing with complaints of lack of professionalism or misconduct you often find, that blame can be proportioned between both parties... more so when situation like BS's have a snowball effect to them ending up in a very difficult situation.

 

[margie]

Ellie

It may be that based on that conversation Babysaurus came to the conclusion there was a lack of knowledge - if this is the case then she has not had an opportunity to request a transfer.

The earlier thread indicates that the surgery had said they were going to restrict the insulin to what they thought was sufficient. The thread says how much Babysaurus is using. If this information was passed to the surgery then they should be able to calculate the usage in a month and based on the prescribing history have an idea of when the insulin would run out.

 

[Pumper_Sue]

Anyway - now that's really interesting because earlier this evening I was on the revamped BNF website (everyone has to re-register from 13 March 2012 to accept new T&C) and I read the prescribing guidelines amongst other things.

One thing amongst the very few items doctors are instructed to never NOT prescribe when requested is INSULIN. I was pleasantly surprised about that but thought no more of it ...... you can coss question the patient after the event. But the Hypocratic oath also requires you to do no harm and to preserve human life in all circumstance under your control. So IF the doctor HAS refused then he ain't no doctor, and if he did do that frankly, I've now upped my game. I now want to report him to the GMC.

Yesterday 11:29 PM
trophywench

I rest my case😡

Which in this case, I feel the real failing on the surgery point of view, is that the GP failed to insist that BS came into the surgery to show the clinical data she holds (her pump data and BG data). Which in hindsight this would have avoided unnecessary aggro for both parties.

Oh come on no GP will ever ask for pump data, they don't have the software on their computers to download. Most GP's have never seen a pump.
There's 46 or 7 in Cornwall. I'm at a surgery with 8000 patients. Guess who's the only pumper?

Same with BG meters none have the software on their computers.