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Sorry folks, it’s last orders

Of the many and varied piles of crap we have to plough through on our return from Christmas/New Year bank holidays, one of the piliest, and certainly crappiest, is the need to wade through the antics of our dearly beloved patients, as elaborately and laboriously described by good old NHS 111.

And what strikes me as I emerge, blinking, from this crudfest, is how the out-of-hours service is fast becoming an-out-of medication service. I don’t know what’s more annoying – the fact that the punters can be so feckin’ feckless that they pop their final pill and inhale their final puff just after we shut up shop, or the fact that the OOH angels seem so keen to rectify the problem that they pop round at a moment’s notice with the required supplies on a silver sodding salver.

In this last batch, I’ve clocked patients requesting salbutamol, amlodipine, co-codamol, amitriptyline and, of course, the contraceptive pill – and receiving them, usually via a consultation with the OOH doc. And no, for any ‘consumer advocates’ out there poised over the ‘Submit comment’ button, that’s not an implied indictment of the nation’s repeat prescribing services, which are beyond reproach, it’s an explicit indictment of the quality of the nation’s patients, who are beyond belief.

I don’t do OOH, but my response to the vast majority of requests for emergency treatment supplies would be, ‘Tough’. After all, there’s only a tiny handful of drugs which are ‘essential’ and an equally tiny handful of situations where sudden discontinuation would cause a serious problem. In which case, fine, we’ll sort a prescription. But it doesn’t need a consultation with a doctor, it requires a phone-call to a co-operative pharmacist, hopefully one situated far enough away to cause the punter some edifying inconvenience.

And to those OOH doctors still veering towards the play-safe approach of giving in, remember: most of the time, patients don’t take their medication properly, anyway. The only time they decide they will is when they can’t, because they’ve run out: in other words, as usual, they want what they can’t have. And if they’re going to act like children, that’s how they should be treated. Just say no and ignore the tantrum.

Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.