GP review for insulin

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Flower

Flower

Well-Known Member
Relationship to Diabetes
Type 1
I've hit the "this medication needs to be reviewed by the responsible clinician before it can be requested again" wall with my insulin.

I was seen at a pump clinic a few months back and told to carry on as I am by the Consultant but then get a block on requesting any insulin from my GP. The first review appointment is in 3 weeks so I've asked for my insulin to be prescribed asap as I've just started my last vial - I can order every 8 weeks and it is enough to see me through but there's not much extra which is fine, I don't want to waste the precious stuff.

It feels a waste of an appointment taking it from someone who needs to be seen by a GP. I need insulin to live & there isn't a cure but this dual system of being seen by a hospital clinic then reviewed by the GP for the same condition seems a bit of a waste of time for all concerned.
 
I sometimes get this comment but a phone call to my surgery seems to be able to overcome it without an appointment.
I get the impression it is a blanket NHS regulation type thing that all medication must be reviewed at least once a year. My surgery seems to have a computer system that sends out the reminders with a human available to screen them.

I hope your surgery is sensible and they can see that the review should be a checkbox exercise that does not need your presence for. If not, is it worth contacting your hospital consultant and/or DSN and asking for their assistance to explain the situation to your surgery?
 
It’s so infuriating, and the worst kind of box-ticking automation, rather than treating people as individuals.

I am astonished that they wouldn”t just override their system and issue the prescription. Can’t take long to see that you were seen at the hospital recently surely?

Perhaps you should kick up a bit of a fuss?

One time when I was asked to go in, I was a bit miffed for all the reasons you suggest. The GP‘s opening gambit was, “So why have you come to see me today?”

To which I replied, “Well, because you threatened to stop my insulin, which I need to stay alive”

”Oh no…” he said, looking rather shocked, “we would never do that!”

I’ve not had to perform the ritual since. No idea whether there‘s a big red mark in my notes :rofl:
 
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I get this every year, I have to keep an eye on my prescription, which has a note at the bottom 'date by which you need to see the GP for a medication review. I used to make an appointment to see my Gp, and the consultation took all of 30 seconds. She used to apologise for wasting my time, but said it helped her because she could use the rest of the appointment time to catch up on paperwork.
This year, we seem to have made a bit of progress, when I had my toe tickling, BP, and tick box exercise on whether I smoke and drink, etc appointment with the Surgery nurse, she said she could now do my medication review, so it all got done in one appointment.
 
I asked that my GP prescribe the insulin as soon as possible next week without seeing me on the 100% correct assumption I'm still Type 1. I thought the receptionist would override the need for a review appointment at that point but that didn't happen.

I will use your response @everydayupsanddowns and see if I have a big red mark attached to my notes.

I do find it a bit upsetting to have a block although temporary against an insulin prescription.
 
Sympathies @Flower I’ve had years of similar from my surgery - pointless reviews, many of which were with the ‘diabetes expert’ nurse who couldn’t answer any questions. I assumed she’d be happy to be rid of me but no, she insisted on seeing me each year 🙄 Once I let my review date go by and all seemed to be ok, until the surgery dragon refused to prescribe my insulin. It was very stressful. So, you’re not alone, and yes, it’s the stupidest, most pointless system and wastes time and money.
 
You can understand point of reviews for some meds but insulin for type 1s?

Looks like ongoing issue up & down country, got repeated messages about same & took few phone calls before they stopped, so understand your frustration Flower & hope you get it sorted asap.
 
Flower said:
I've hit the "this medication needs to be reviewed by the responsible clinician before it can be requested again" wall with my insulin.
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I just send in a request via the receptionist or via the online consult thingy. Have never had to speak to a GP in person regarding the renewal of my meds. GP's just reviews the request and that's it.
 
Inka said:
she insisted on seeing me each year 🙄 Once I let my review date go by and all seemed to be ok, until the surgery dragon refused to prescribe my insulin.
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This is illegal.
They can not refuse your insulin
It's your choice as to whether you have a so called diabetes review at your GP surgery. (Surgery gets paid £100 for the review)
Or you can opt out. I signed a disclaimer opting out of diabetes care from the surgery I was at (now moved) I just rewrote the opt out to say review declined due to staff knowledge (Lack of) and signed it. 🙂 I never ever had an offer of a review again just a letter in the post to sign to say I didn't want the review every year.

This enabled the surgery to claim the £100 for the care of a non compliant patient 🙂
 
I've never had a review. I needed to see the GP yesterday for a face to face about something unrelated to D. While there i asked a question about meds. He called them up on the computer and i pointed out that he had some on there that i hadn't taken for 4 years! He deleted them, said i needed a review, that he didn't have time then and that was that. As long as my insulin and other D needs are still on there i'm not going to go back for a review. There was no reason he couldn't do them. My 10 min app only took 4min.
 
freesia said:
I've never had a review. I needed to see the GP yesterday for a face to face about something unrelated to D. While there i asked a question about meds. He called them up on the computer and i pointed out that he had some on there that i hadn't taken for 4 years! He deleted them, said i needed a review, that he didn't have time then and that was that. As long as my insulin and other D needs are still on there i'm not going to go back for a review. There was no reason he couldn't do them. My 10 min app only took 4min.
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My medication reviews the last few years have been with the practice Pharmacist and are longer appointments.
 
freesia said:
As long as my insulin and other D needs are still on there i'm not going to go back for a review
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That has been my approach for years but the tick boxes for online ordering against each medication which normally open 7 weeks after my previous request aren't there. I thought a phone call would override it as it has in the past but this time apparently I have to see/speak to a GP to request insulin.
 
My GP takes nothing to do with my diabetes besides issuing my prescriptions. He's very much of the opinion that my endo and DSN know the subject better than him and he just renews the prescription as and when it's needed. I've also got a lot of other meds I take and he's agreed that if they're working for me, there's no need to change them. If I have issues like running out of needles, test strips, lancets etc all it takes is a phone call and the prescription is ready the next morning at the pharmacy. Even last week when I was changed from Novorapid to Fiasp, my pharmacy issued me the Fiasp and took the letter stating my prescription change to the doctor's surgery for me.
 
So I passed my insulin & medication review and can now order insulin! The GP asked "how can I help you today ?" So I said I'd been told I needed an appointment for insulin, he said I can't see a problem with any of your medication & re-issued everything. As the appointment was so quick I asked about high risk podiatry as I've been paying for private podiatry for 2 years whilst trying to avoid a below knee amputation I've been advised to have. He referred me 3 days ago & I've just been phoned with a podiatry appointment. Thank you so much GP 🙂 I've been hitting my head against a brick wall trying to get an appointment.
 
I would never expect a person with diabetes- type one or type two, to attend an appointment for medication review- I just check records to see if have been attending diabetes reviews- whether in secondary or primary care. If not attended either for a long time might ask them to attend a " prediabetes" check when HCA does bloods, BP, weight, feet etc then followed by review either by diabetes nurse practitioner or myself. What is the point of a medication review in either case. If diabetes reviews contemporaneous then has been done and if not then a full diabetes review is needed
 
I saw a different GP at our surgery a few years back for this cos yes, if I have no 'repeats' left then they will insist on a review and in the past in both places they've always all said 'This is a formality' and just renewed everything for 12 months. I said to this one, that obviously I just need you to tick the insulin, test strips, Thyroxine etc over for another year same as usual as there's no need to do anything else cos you can't just stop it, anyway, can you! and laughed. Was told very firmly that she didn't know where I'd got that idea from and I'd better get it out of my head entirely, because it was ENTIRELY in her gift whether she continued prescribing it or not - and no-one else's business! (I actually was willing her to stop prescribing my insulin but she disappointed me - I was rather looking forward to that little prospect ... !)

This is a middle aged white British GP, and she's still there unfortunately. 2 years ago when my TSH shot up to over 3 from under 1, where it had been previously for about 5 or 8 years I said to her, 'That'll need considering then' and she assured me that TSH constantly goes up and down at the drop of a hat. (EH??) As I only had a month till I saw my consultant I didn't bother having a battle with an unarmed woman - when I told my (Indian, male) consultant this, he said he didn't blame me - and instantly increased my thyroxine dose. (Oh gosh, what a surprise, not)

In 50 years impersonating a pancreas, Abi - I've never ever before had any such difficulty or heard such crap from a GP surgery. Nothing whatsoever seems to get dome automatically both husband with COPD and myself have had consultants telling us they're going to write to our GP and ask/tell them to do things and found unless we chase the things up with the GP, it simply doesn't get done even when the receptionist says Oh yes, that letter from Dr X dated (a few months ago) is on file. Well it asked the GP to do Z, and so far I haven't heard that it has been actioned, so has it and if not, why hasn't it? It will take more than a couple of exactly the same conversation with reception before we do hear anything! But instead of them saying We've asked for that, so you'll hear from the hospital soon - the first we hear is from the hospital saying you have an appt to see whoever blah blah. Oh, they did eventually action it then.

Sajid wants us to be proactive about our health, Oh good - like we don't have to be already??????????
 
I am absolutely gobsmacked and would have been tempted to take the situation further and get the silly cow into trouble. She was making veiled threats to stop a life maintaining medication. GMC or complaint at the very least....
 
Yeah well that was the point Abi - I previously understood that a doctor refusing insulin to someone who absolutely without doubt needs it - was a criminal offence! However to have that shot down in flames by a GP made me doubt my sanity. Sheet - what else have I got wrong? so it shut me up.
 
Flower said:
So I passed my insulin & medication review and can now order insulin! The GP asked "how can I help you today ?" So I said I'd been told I needed an appointment for insulin, he said I can't see a problem with any of your medication & re-issued everything. As the appointment was so quick I asked about high risk podiatry as I've been paying for private podiatry for 2 years whilst trying to avoid a below knee amputation I've been advised to have. He referred me 3 days ago & I've just been phoned with a podiatry appointment. Thank you so much GP 🙂 I've been hitting my head against a brick wall trying to get an appointment.
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Now that GP needs to be cloned!!!
excellent news Flower, but sorry that the automated messages caused you some stress at the start of the process. I hope tha podiatry appointment goes well.
 
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