Patient Services

[Kaylz]

I'm sure some have mentioned using this method through their practice in order to get prescriptions, our surgery has only just recently started using it, most of my meds are on CMS but I opted to have my insulin go back on repeat as I was collecting too much "spares" and my ketone strips were left on repeat as "I shouldn't need to be testing my ketones that often" (pharmacist at the health centre's words) I get that but looking at the system I only have 7 available requests for each insulin and 2 for ketone strips, I understand they are expensive but I find it ridiculous to restrict the items as needs etc change, anyone else have this? xx

 

[Sally71]

Ours used to give 12 repeats but when it got down to 0 they would just get reinstated automatically. Now it’s gone online it seems to be a bit different, we’re only allowed one box of ketone strips every 3 months and glucagon every 6 I think. I suppose I should complain about the ketone strips but actually we don’t use many so every 3 months is OK for us. I only really use them if daughter has a tummy bug or if we have been having cannula problems causing persistent highs, even then they usually only tell you what you know anyway and then the ketones disappear once everything goes back to normal.

I did once try to order insulin only to find it was blocked with a message needing review, so I sent a message via eConsult saying that type 1 diabetes is incurable therefore my daughter will need insulin her whole life, what on earth is there that needs reviewing, and the insulin was reinstated by the end of the day!

 

[DaveB]

Hi. I don't understand the problems you are having. I use my surgery's online system for meds ordering. The surgery uses 'Systemonline'. I order more meds when I'm running low and can do that three weeks after the last order. Why do you use 'Repeats' rather than ordering online as needed?

 

[rebrascora]

I don't have any ketone test strips on my prescription. I have a few out of date (now) blood ketone strips which a DSN gave me on my DAFNE course and a tube of now "out of date" Ketostix for urine which I maybe used 1 or 2 from when I was first diagnosed 2.5 years ago but I have no reliable means of testing ketones and thankfully I haven't needed to in the last couple of years, despite the fact that I was changed to a Caresens Duo test meter specifically so that I could use it to test both. I suppose I really should chase it up as it's no good waiting until I need them and then having a mad scramble, especially if I am feeling ill at the time.

I use the "Systemonline" to order what I need, when I need it and it works very well for the things which are on my repeat list, providing I reorder in enough time.... Guess which stupid idiot ran out of Levemir last night!! Totally my fault.

 

[Kaylz]

Hi. I don't understand the problems you are having. I use my surgery's online system for meds ordering. The surgery uses 'Systemonline'. I order more meds when I'm running low and can do that three weeks after the last order. Why do you use 'Repeats' rather than ordering online as needed?

Because my surgery uses patient services and only has "order repeat prescription" and at the end of each item there is a limit of how many requests there are left for an item

 

[helli]

My online ordering system does not show how many times I can repeat an order but annually, they do a "review" and I am blocked from ordering until I have hassled my surgery.

I am able to include comments when I order my prescription. I use this to demand (yeah, I hate being demanding but last time my insulin and Libre were "awaiting review" for more than 2 weeks which required a demand) my script is reviewed.
Using this method, my last prescription was available from the pharmacy within 48 hours of my online demand to the surgery.

@Kaylz I wonder whether the "& requests" part on your script is how many times you can order that item before the surgery needs to do a review.

When my surgery just add things to my script when the hospital requests it (or at least within a month if I chase it up), the review seems to be a box ticking exercise but I can see that for some patients with some medications a review is necessary and wondered with they were complying with an NHS/NICE/NHE regulation for us.

 

[Kaylz]

@Sally71 I don't need to use them often either thankfully but there may be a time they are needed so having only 2 requests available with 4 months of the year left just seems a bit limited, as I say my surgery has only just changed to using the patient services so it's all totally new to me xx

 

[Kaylz]

@helli I've never had the surgery do a review in the almost 5 years I've been diagnosed, everything else like needles, BP pills, strips, libre's etc are on CMS so automatically dispensed from the chemist every 2 months xx

 

[helli]

@Kaylz I only know about the review my surgery do because they are always late so I see my items on hold in my prescription. If my surgery were efficient, I wouldn't see it.

 

[AndBreathe]

I have never knowingly had a medication review, but y record shows I have had them with astonishing regularity.

@Kaylz , does your surgery's system not have a "Make custom request" option? Like others on SystmOnline, I can choose what I need from a thankfully short list, but the custom request is useful when going on holiday or asking for a steroid cream I need infrequently, but definitely periodically.

It can take a day or so longer to achieve approval for the custom meds, but I just try to factor that in.

 

[mikeyB]

I 've never had any problem with repeat prescriptions, because my medication is reviewed constantly by various consultants. I get all of my prescriptions from Lloyd'sdirect (formerly Echo). I've switched off the annoying repeat reminders like "You appear to have run out of Abbott Ketone Test Strips" or all the other variable needs like needles or Tramadol. In fact, the only regular items I always request are paracetamol and Libre Sensors. (My diabetes consultant insisted I should get them on prescription, despite my pension being far above the salary of the diabetes nurse sitting by her)

My surgery appear to have accepted that the various consultants I see will fiddle with my prescriptions, and haven't bothered trying to review them. I know they get paid for doing it, but they'd get the bum's rush if they tried it with me. They even let me get my super expensive insulin needles on prescription. Mind you, they are so good I only change them once during the life of a pen, if that. I only change them when I can feel them going in.

That payment to GPs is the reason they insist on medication reviews, even for medications such as insulin that clearly are vital, and will hardly ever change. It's a waste of everybody's time, but it keeps doctors children fed.*

*Sarcasm

 

[Kaylz]

@AndBreathe it has "I'd like to request an expired repeat prescription or another medication" which I'd have to use when I need another spare insulin pen as that seems to have been removed 🙄 I haven't used the system to order anything yet as I had a fair stock of cartridges in the fridge, I also opted to sign up for full services which was supposed to include medical records but there's nothing there for that

Bruce hasn't even been able to sign up yet and the old way ended without anybody being made aware so he called the health centre in desperate need of an inhaler but the receptionist wouldn't hear any of it and just told him to use the repeat prescription line, I told him to phone the chemist and ask if they could spare him one and thankfully they allowed that but it's ridiculous that the receptionist was willing to leave him without
xx

 

[kevinr]

Morning Everyone. I might feel a bit stupid here but what are keystone strips I have never heard of them let alone seen one. What do they do and does all Diabetics have to have them ie type 1 and type 2. This is something new to me do you have to use a different testing meter to check for keystones. I think the best thing I need to do is get a book on the ins and outs of diabetes just to put me in the picture. I do know that diabetes can be life threatening and you can loose your limbs through it and I know about hypos but I don't know nothing about keystones.

 

[Kaylz]

@kevinr here's an article explaining it all - https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/ketones-and-diabetes

 

[kevinr]

Hi Kaylz. That's some interesting reading and thank you for giving me the link to it. I wonder if my blood glucose meter checks for keystones I use the Accu-Chek Mobile with the Cassette and not test strips. I use to use a meter with test strips but was unreliable as it kept giving me a false reading.

 

[Kaylz]

Hi Kaylz. That's some interesting reading and thank you for giving me the link to it. I wonder if my blood glucose meter checks for keystones I use the Accu-Chek Mobile with the Cassette and not test strips. I use to use a meter with test strips but was unreliable as it kept giving me a false reading.

No none of the Accu-Chek meters are capable of testing for ketones, ketone strips are far more expensive and only come in packs of 10, the ones I am supplied with cost the NHS around £21.94 xx

 

[kevinr]

Hi Kaylz. I have just given Accu-Chek a call and they told me they don't supply them and I would need to check out another Company for a meter. I best make appointment at my Diabetic centre and see if I can get one from them but I already know what they will say oh you don't need one of those just stick with the meter you are using.

 

[Kaylz]

@kevinr you may be lucky, some meters are capable of both bloods and ketones such as the Freestyle Optium Neo meter although BG strips for them are more expensive than others and I found them too fiddly when hypo (each strip is in a foil wrapper!) xx