Sadly, Anonymous GP partner (17th Nov 3.35pm) we would love to treat much more than we currently can - the restrictions on treating eg eye infections with chloramphenicol or a patch of eczema on the face with hydrocortisone is nothing to do with us and everything to do with the licencing of otc meds which means they cannot be used in these cases. Changes to the licencing of these products would enable us to alleviate some of the workload GPs are struggling with and contribute to the re-education of patients around self-care
You guys should worry - pharmacy, who will be hugely impacted by this, has been left out totally
I am quite surprised at the attitude of some of the people posting here under the guise of "GP" and their ignorance of the legal framework surrounding emergency supply, starting with the heading to the article. By definition, emergency supplies are without GP approval, otherwise it would be called "a prescription". Patients can only have items that have previously been prescribed within a reasonable time(so not from last year). Then there are restrictions on the medication that can be supplied - so no methadone, no "vallies". And the clue is in the title - supplies have to be justified as an emergency, so if it is in the middle of the morning when surgery, a supply is not appropriate. And as for the suggestion this is a "cash cow" for Pharmacists - requests are instigated by patients, so this is not a service that can be pushed on to patients.
I agree the systems in place are not ideal but this is a knee-jerk reaction to try to solve a bigger problem - medicine wastage is created by patients over-ordering and by GPs prescribing in quantities which are too large, such that when a medicine is changed, you cannot help but have lots of waste. Might I suggest that the LMCs & LPCs sit down and come up with local schemes, without the apportioning of blame, to resolve this
Dear Anonymous GP at 12:23pm
I AM on site
I DONT peddle unscientific rubbish
I AM involved with the local GP practice
YOU appear to have completely ignored my point and simply wish to have total control of the NHS funding. If that is so, and you are spending all your time managing these budgets, how will YOU get time to see patients?
I regularly read of GPs at burnout/saturation point and, having just this morning been to my own GP, am very aware of the issue. However, there needs to be a bit of "push-back" and sharing - Getting patients to take more responsibility for their own health, or referring them to someone else (Hello! Pharmacist here - quite happy to provide a Minor Ailments Scheme - and does!) to free up some appointments or, more importantly, just take some of the pressure off
Yes, GPs & Pharmacists fall out about services ('flu being particularly contentious at present) but all of that goes for nothing if the basic system collapses. Surely now is the time for us to put our differences aside (after all, we are unimpressed by dispensing doctors) and look at helping each other by collaborating to provide the world class health we all want to give and are able to give, given enough time. Does "free at point of use" cause problems? Of course it does but that should be part of what we should be trying to achieve - re-education of the patient to get them to understand that, just because THEY don't have to pay for it doesn't mean it costs nothing.
I suggest that the fall in uptake across all groups is much more to do with PHE announcing that the flu vaccine for 2014-15 was only effective in 3% of patients, leading most to think "Why bother?" I am surprised that GPs, when an invited patient declines a flu vaccination, doesn't follow it up to find out why. That would be if most benefit to everybody, especially the patient, as it gives the opportunity to discuss it with them
If GPs don't want to do it, give the funding to Pharmacists - we'll be more than happy to do it
It takes up to an hour a day of GP time - all they need do is have a list with the prescription clerk of pre-agreed changes and a standard letter to give to patients to inform them that due to shortages their medication has been changed. I wish it only took an hour a day for us to manage the dozens of shortages - not to mention the associated multitude of upset/anxious/angry patients (and, let's face it, GPs & surgery staff) who continually ask why product "x" is not available, as if it is a)our fault for the shortage and b) we can just knock up something in the dispensary as a replacement
Ref: Anonymous 9:12 - Any patient not in a risk group is not eligible for vaccination as paid for by the NHS; these must be paid for by the patient, therefore this assertion, whilst it may be true that the majority of those vaccinated by pharmacists are not in a risk group (I am not in a position to verify your comments) is a red herring as it does not "divert NHS funds" or "line pockets at NHS expense" - this is a private transaction between the pharmacy & the patient
To Arrogant, sorry, anonymous session/locum GP -
MOST GPs are forward-thinking and supportive of what Pharmacists can do. I can only surmise from your foam-flecked rhetoric that you can not be counted among them and you use anonymity to hide your own short-comings. That, I feel, is to the detriment of you and your patients and I am pleased you are not representative of those of your profession it is my pleasure to work alongside
Ref GP Partner 9:55am - you could do this but I don't think it would solve the problem; anything prescribed off-licence then puts a responsibility with the prescriber to confirm their intentions and to confirm they are aware of it being an off-licence use - every single time! The problem here is not about on- or off-licence use - the problem (and I am no expert in patent law) is about breaching a patent, which, it appears to me, to be a completely different kettle of fish. Believe me, we also have better things to do than "deal with this dross", Rog Neal - it is also a lot of additional work for pharmacists.
Here'sa thought - is it that the NHS will change the category of pregabilin in the drug tariff, so reimbursement is based on what is supplied? If lyrica is supplied, that is what will be paid for but if the (cheaper) generic is supplied, then that is the price paid and so save the NHS money
How is this a job for the GP? I accept the idea may stem from the "who sees patients in their own home" idea but what proportion over the group this is aimed at actually see their GP other than occasionally (ie at the regular "check" intervals) unless there is an acute problem? Better to give this to someone who will actually see the patient in time to prevent the hospitalisation (eg meals on wheels, pharmacy delivery services, the postman) since the implication is that neither neighbours nor family keep tabs. Whatever the motivation, is this really good use of GP resource, however rare or plentiful it may be?
Any practice would think of itself as hardworking and would consider themselves slighted should they get a negative report. This does not make the negative report inaccurate. However, from what the writer says, there does appear to be a mismatch between what is being said and what is being written (in the reports). From what has been said, it appears the writer was not informed of the public "naming & shaming" before it went public so they could at least formulate a response/action plan. One other view is that those practices providing care for the highest risk patients are the very ones where patients, by the very nature of their conditions, may be at risk from receiving poor care. Either way, it is not what you could call "positive re-enforcement"
I am always nervous of so called plea bargains as it does not serve justice - if the perpetrator is guilty, they get off with a more lenient sentence and the victim is badly served; conversely, if the so-called perpetrator is innocent, or only guilty of a lesser misdemeanor, then they are the ones badly served by accepting a punishment which may be too harsh. Don't accept this - it is only the thin end of a very big wedge!
Many comments say that antibiotic prescribing is not the fault of GPs, nor can they do anything about it. I accept that this is only one angle to attack on AB over-prescribing but if it doesn't start with GPs (and dentists and other prescribers) where should it start? Patients may request it but if a patient requested some other inappropriate treatment, would GPs simply roll-over? I don't think so.
Training costs are borne by the pharmacy, paid for out of the same fee that GPs get and NOT passed on, so are at NO COST to the NHS
You all seem to be overlooking patients in this - a family member went to her GP with a chest infection and associated breathing difficulties; the GP (via the receptionist) refused to see her as they were doing paperwork!
Way to go on patient-centred care!!
Andy Burnham is a typical (Labour) politician - promise to reverse whatever the previous government did that you didn't like.
Shame that every Labour Government seems to leave us (all) with a massive deficit!