Told I can't get strips any more :(

[Markmids]

hi guys
Went to order some test strips today and was called into a separate room by a pharmacist, he told me that he would prescribe me some for this time but didn't think I needed them even though I'm on metformin, I've never seen this guy in my life and thought it was up to the doctor? Anyone else ever had this?

 

[pav]

It's up to your gp practice to decide if you get strips or not, what gp's are doing is to put patients onto more cost effective strips and meters like the ones that are £10 or under for 50 rather than some of the big brands of meters that can cost £25 + for a pot of 50.

A lot of docs and looks like your pharmacist won't prescribe test strips to type 2's who are only metformin as metformin does not cause hypos and say that a 3 monthly or greater HbA1c test is adequate to monitor how people are doing. A vast majority of diabetics believe the docs are wrong and it actually costs the NHS more in the long term as it leads to more complications.

If the test strips are on your repeat, it might be wise to change your pharmacist, or have a word with your gp practice to see if they are happy to continue prescribing test strips.

 

[Markmids]

Thanks Pav 🙂

 

[Amigo]

Change pharmacists! It's absolutely nothing to do with him. Pharmacists don't prescribe, they fill out the prescriptions that GP's prescribe and he has no right to even have that conversation with you. Speak with your GP and if you've given prescriptions for testing strips, take the script elsewhere. What a cheek the man has! 😡

 

[happydog]

I had this from the pharmacist at Boots a while ago. I reported it to my surgery and said if you sanction this I will not know where I am with my disorder and may develop complications. My surgery is very cost conscious but it seemed to do the trick and I am currently still getting 50 strips every two months. Might be worth a try. 🙂

 

[Rosiecarmel]

A pharmacist does not prescribe and as far as I'm aware they cannot refuse to fulfil a prescription written by a doctor. If they do, you are within your rights to get your prescription back and take it elsewhere

 

[Bubbsie]

hi guys
Went to order some test strips today and was called into a separate room by a pharmacist, he told me that he would prescribe me some for this time but didn't think I needed them even though I'm on metformin, I've never seen this guy in my life and thought it was up to the doctor? Anyone else ever had this?

Hi Markmids...I agree with all the comments above...firstly I would contact your surgery this morning...explain what happened ...secondly I would ask the pharmacy for an explanation...what 'authority' did the pharmacist act upon...were they exercising some kind of discretion?...sounds outrageous to me...if your GP decides to prescribe testing strips for you to control./manage your condition...how dare the pharmacist interfere with that...like the other members I believed pharmacists dispense medication...gave advice on its use...or do they now have some extended 'power' that we are unaware of...get back to us with an update please...Id be really interested to hear what happens.

 

[Copepod]

@Markmids - you need to find out exactly what has happened. It's possible that GP removed blood glucose strips, and then that decision was over-ridden by pharmacist. Either or both might be acting within CCG guidelines.
So, collect data before accusing anyone of anything - falsely accusation is not a good start to negotiations.

 

[Bubbsie]

There is absolutely no justification for withdrawing prescribed medication without prior discussion with the patient it has been prescribed for...whether following CCG directives or not...the CCG 'guidelines' are simply that...guidelines...nothing more...the local CCG's follow a very narrow interpretation of the NICE guidelines which refer to prescriptions for testing strips/meters for type 2 diabetics non dependant on medication which can induce a hypoglycaemic episode... NICE advise testing strips should 'not be routinely prescribed' in those circumstances...indicating there is room for deviation/discretion when considering this issue...his GP made a decision to prescribe despite that criteria...I am reasonably certain given the pressures on GP's to save money (sometimes at the expense of their patients) s/he would have given that careful consideration before issuing the prescription...there are no false accusations here...he was prescribed testing strips...the pharmacist has indicated they 'believe' he should not have been...and...as a concession is prescribing him strips this time...he is entitled to a full explanation...negotiate on what?...if the strips are needed for control/managing his condition...he should not have to negotiate with the pharmacist or his GP...the facts have been clearly stated...he had a prescription...asked for that to be filled...the pharmacist said they do not think it necessary...but will prescribe this time...does the pharmacist have access to his medical history...is he aware why the GP has prescribed them...has there been any discussion between the pharmacy/surgery without recourse to him...if any/all of those circumstances have occurred...that is not acceptable...I believe he is in a strong position to ask for an explanation...time & time again we do not challenge this shabby treatment...so it continues...if he has any difficulty obtaining the necessary testing strips with either his GP...or the local Clinical Commission group...I for one would be prepared to help in any way I can...my battle with my GP & the local CCG took time & effort...I now have my meter/strips provided on prescription...it can be done...should be done...we must sit up & be counted...in many cases once these decisions are challenged...concessions are made.

 

[Deleted member 18634]

Hi @Markmids - I'm sorry to hear that your test strips have been restricted. We're currently challenging this decision and you might find it helpful to have a look at our campaign page:

https://www.diabetes.org.uk/Get_involved/Campaigning/Test-strip-campaigning/

There's also an advocacy pack on there which is very useful and has a lot of information about what you can do to try and have this decision changed.

Let us know how you get on

 

[Amigo]

I've recently had the usual testing strip battle but got it resolved very quickly. My pharmacist is only too delighted to 'sell me' the testing strips because at the end of the day they are a commercial business who survive on this trade.

What would concern me is your average pharmacist has no access to individual medical records so could have no overall picture of the patients co-morbidities or general health which may impact on the need to test. As Bubbsie says, there is discretion and it has to be a clinical decision not solely driven by money.

Hope you get it resolved soon Markmids.

 

[Bill Stewardson]

This seems to be a huge issue. The NHS are in a terrible situation but nothing excuses a pharmacist going against a GP.
If that really is what happened then it should be in every newspaper and on every radio station.
Worryingly, if it is allowed to happen "here and there" you can guarantee it will soon become the norm.
What's next, restricting exemption certs ??

 

[Bubbsie]

This seems to be a huge issue. The NHS are in a terrible situation but nothing excuses a pharmacist going against a GP.
If that really is what happened then it should be in every newspaper and on every radio station.
Worryingly, if it is allowed to happen "here and there" you can guarantee it will soon become the norm.
What's next, restricting exemption certs ??

Fair point Bill...I wonder?

 

[Bubbsie]

Hi @Markmids - I'm sorry to hear that your test strips have been restricted. We're currently challenging this decision and you might find it helpful to have a look at our campaign page:

https://www.diabetes.org.uk/Get_involved/Campaigning/Test-strip-campaigning/

There's also an advocacy pack on there which is very useful and has a lot of information about what you can do to try and have this decision changed.

Let us know how you get on

It is possible to challenge successfully as an individual Emma...I have done it myself...after nine months of self funding my own meter/ testing strips...I asked my GP to prescribe these when I could no longer continue to self fund...my GP agreed ...however did warn me the local CCG may intervene...we discussed this...at the end of the discussion he asked me to write to the CCG...I read the NICE guidelines in detail...I also read the minutes of my local CCG meetings where they covered this specific issue...I wrote to them...justified my need for testing strips...gave them the results of my HbA1c results... explained the necessity for me as a Type 2 diabetic not dependant on hypo causing medication to test regularly... I advised the NICE guidelines were being narrowly/inaccurately interpreted by their committee...the guidelines left room for discretion...they did concede my GP could continue to prescribe my testing strips...I have a draft letter which can be easily adapted for other members to use...and would be more than happy to provide a copy to any member on request...I have looked at the campaign undertaken by DUK...in my opinion it focuses mainly on those who use medication that can induce hypoglycaemia ...I found that disappointing.

 

[Martin Canty]

focuses mainly on those who use medication that can induce hypoglycaemia

Agreed, disappointing..... Testing should be encouraged for everyone as the better our control the less possibility of complications.

 

[Bill Stewardson]

Lots of interesting stuff in this thread.
I know I'm the new kid on the block, however, I wonder what the effect would be if EVERY SINGLE ONE OF US wrote to our GP on the same day to request strips on repeat scripts ?
Would be illuminating to see any regional variations etc.
It seems obvious that testing should reveal any developing problems and hence potentially save the NHS money in the long term. Does Custom and Practice have any relevance here ?
Also, are there any black and white rules regarding the role of Pharmacists?
Wish I knew how much profit per strip is generated.

 

[Bubbsie]

Agreed, disappointing..... Testing should be encouraged for everyone as the better our control the less possibility of complications.

Absolutely right Martin...couldn't have put it better myself.

 

[pav]

Differences can happen within the same practice let alone regional variations, some GP's are prepared to help and others don't have a clue about diabetes, this can have a knock on effect when practices don't have a diabetic nurse (DN) or have what you might call a little Hitler that does not listen to you and treats everyone the same with blinkers on and won't deviate.

I have been arguing polity with docs and DN's for years asking for help and to go onto insulin as I suffer from meds intolerance to a lot of meds and can swing wildly from the high teens to hypo in a couple of hours. As a result I do have complications which is costing the NHS more.

Don't know how much profit is on test strips, but when I had a choice of meters the test strips were around £25 + for a pot of 50 strips. My last practice followed the CCG's guide lines and moved people onto meters that used low cost strips. Unfortunately for me the meter they chose to support did not support meal markers which are great for identifying trends. My new practice also follows the CCG guidelines and supports a different meter that is provide by the same meter manufacture as the old meter. The new meter supports meal markers and also supports an app on Android phones and connects to the phone via NFC so you can down load the results and show the trends etc when you see the DN or the app will even email the results to the DN. The test strips for the new meter I think are around £10 for a pot of 50.

 

[Bubbsie]

Lots of interesting stuff in this thread.
I know I'm the new kid on the block, however, I wonder what the effect would be if EVERY SINGLE ONE OF US wrote to our GP on the same day to request strips on repeat scripts ?
Would be illuminating to see any regional variations etc.
It seems obvious that testing should reveal any developing problems and hence potentially save the NHS money in the long term. Does Custom and Practice have any relevance here ?
Also, are there any black and white rules regarding the role of Pharmacists?
Wish I knew how much profit per strip is generated.

Bill not everyone wants to test...I have a friend who is an insulin dependant type 2 diabetic...she is prescribed a meter/strips...she rarely bothers to test...however...I do believe every well motivated diabetic should be provided with a meter & strips if they request it...some members here do have forward thinking GP's & DSN's who supply strips on prescription...sadly...they seem to be few & far between...of course as you say it would save the NHS time...effort & money...in addition to the obvious benefits to their patients... if those who want to test were supplied with the necessary equipment...they could manage/control their conditions effectively...delay/avoid complications...I believe those who are refused or have their testing strips withdrawn rarely challenge those decisions...it becomes accepted practice...in that respect type 2's using oral anti-diabetic medication that does not pose a risk of hypoglycaemia are an easy target...it is shabby treatment...more of us should challenge it...frustratingly few of us do.

 

[pav]

Last month the hospital DN gave me a leaflet about DVLA guidelines re testing and while on hypo inducing meds a reminder to say I need to test more. As my meds were increased and as it happened my driving increased last month as was doing a bit of travelling around my testing did naturally increase. This month got told off for testing too much and not to bother testing after meals, even though that's where my main problems are, then got discharged from hospital care.