RachelT
Well-Known Member
- Relationship to Diabetes
- Type 1.5 LADA
Well, here goes.
People suggested i explained what happens on the other side of the pharmacy counter, because it's interesting and i suppose it's something most people here have to deal with in one way or another.
Let me start by introducing myself. My name's Rachel and i've been type 2 diabetic for two years now and i've been working in hospital pharmacies for about six years. I'm currently a pharmacy technician in my local, general hospital. It's not something i had a burning ambition to do, because to be honest, before i worked in them hospitals scared me, but a kind of fell into the area out of curiosity after i was made redundant from my first job.
I'm going to try to explain a bit about how the NHS is organised (this week, things may have changed by next week.). At the top there's the ministry of health, followed i think by regional health authorities and bodies such as NICE (National Institute of Clinical Excellence: who advise the NHS on what is and isn't good or cost effective to give or do to patients) the MHRA (Medicines and Health Regulatory Authority, who are basically the rulers of the day to day running of pharmacies, they grant licenses which is all important and i guess i'll come to that later) and a host of other bodies that are being closed or merged or disbanded at the moment to save money.
Below that are the Local Health Authorites.
Then we have a split:
Primary Care (PCTs) who organise GPs, Pharmacies and other health services in your local area. These are also roumored to be on the way out. Nobody is quite sure what we'll replace them with.
Secondary Care : Local Hospitals
Tertiary Care: These are specialist hospitals and centres for treatment. Great Ormond Street in London is a tertiary care hospital because it deals exclusively (or vertually exclusively) with Children's medcine.
Basically you, the patient, start in Primary care, seeing your GP, and if he feels you could benefit from a more experienced or specialist doctor, he refers you to a Secondary care institution, probably your local hospital or a clinic in it. If the local clinic thinks you need further speciallist treatment or assesment then they can refer you to tertiary care. At the moment, i don't think a GP can send you straight to a tertiary care provider, but i think that's likely to change.
The PCT is in charge of the local formulary, which is what you GP is allowed to prescribe (he can probably prescribe whatever he likes but he has to give a good reason) which is probably the source of everybodies' test strip woes. Somebody in an office somewhere (and i'll have to be careful because of friend of mine probably does this 🙂) has spotted that a certain GP surgery has been giving out a lot of test strips...it's almost certainly not your fault, after all, i bet you're not the only diabetic at the surgery, but the surgery will have had a letter or email saying that they're been spending a bit too much money, would they care to cut down? And then lo and behold, you've had your test strips rationed or taken away completely.
Foundation Trusts
You may have noticed that your local hospital is now a foundation trust, what does that mean? Well, it was the benchmark all hospitals were supposed to achieve or work towards and was set up by the last government. What happens next, i'm not sure, but my employers are currently applying. It gives a hospital a greater say over how it is run and how it spends it's money. The hospital has to elect a board of governers made up of chief executive type people, senior consultants and a number of other people, who can be anybody over 16, who want to take part and have a say. You also have to meet a number or targets in regard of safety, spending and hygiene.
Ambulances arn't part of any of this, they have thier own trusts.
Sorry is this is all a bit vague, but the government is trying to rearrange stuff, and i'm trying to remember what i learnt at college three and a half years ago.
Rachel
People suggested i explained what happens on the other side of the pharmacy counter, because it's interesting and i suppose it's something most people here have to deal with in one way or another.
Let me start by introducing myself. My name's Rachel and i've been type 2 diabetic for two years now and i've been working in hospital pharmacies for about six years. I'm currently a pharmacy technician in my local, general hospital. It's not something i had a burning ambition to do, because to be honest, before i worked in them hospitals scared me, but a kind of fell into the area out of curiosity after i was made redundant from my first job.
I'm going to try to explain a bit about how the NHS is organised (this week, things may have changed by next week.). At the top there's the ministry of health, followed i think by regional health authorities and bodies such as NICE (National Institute of Clinical Excellence: who advise the NHS on what is and isn't good or cost effective to give or do to patients) the MHRA (Medicines and Health Regulatory Authority, who are basically the rulers of the day to day running of pharmacies, they grant licenses which is all important and i guess i'll come to that later) and a host of other bodies that are being closed or merged or disbanded at the moment to save money.
Below that are the Local Health Authorites.
Then we have a split:
Primary Care (PCTs) who organise GPs, Pharmacies and other health services in your local area. These are also roumored to be on the way out. Nobody is quite sure what we'll replace them with.
Secondary Care : Local Hospitals
Tertiary Care: These are specialist hospitals and centres for treatment. Great Ormond Street in London is a tertiary care hospital because it deals exclusively (or vertually exclusively) with Children's medcine.
Basically you, the patient, start in Primary care, seeing your GP, and if he feels you could benefit from a more experienced or specialist doctor, he refers you to a Secondary care institution, probably your local hospital or a clinic in it. If the local clinic thinks you need further speciallist treatment or assesment then they can refer you to tertiary care. At the moment, i don't think a GP can send you straight to a tertiary care provider, but i think that's likely to change.
The PCT is in charge of the local formulary, which is what you GP is allowed to prescribe (he can probably prescribe whatever he likes but he has to give a good reason) which is probably the source of everybodies' test strip woes. Somebody in an office somewhere (and i'll have to be careful because of friend of mine probably does this 🙂) has spotted that a certain GP surgery has been giving out a lot of test strips...it's almost certainly not your fault, after all, i bet you're not the only diabetic at the surgery, but the surgery will have had a letter or email saying that they're been spending a bit too much money, would they care to cut down? And then lo and behold, you've had your test strips rationed or taken away completely.
Foundation Trusts
You may have noticed that your local hospital is now a foundation trust, what does that mean? Well, it was the benchmark all hospitals were supposed to achieve or work towards and was set up by the last government. What happens next, i'm not sure, but my employers are currently applying. It gives a hospital a greater say over how it is run and how it spends it's money. The hospital has to elect a board of governers made up of chief executive type people, senior consultants and a number of other people, who can be anybody over 16, who want to take part and have a say. You also have to meet a number or targets in regard of safety, spending and hygiene.
Ambulances arn't part of any of this, they have thier own trusts.
Sorry is this is all a bit vague, but the government is trying to rearrange stuff, and i'm trying to remember what i learnt at college three and a half years ago.
Rachel
