by KitKat » Thu Feb 28, 2019 8:55 am
Hello there,
If you get the London LAPPS newsletter, the most recent issue had some helpful comments. The lady who wrote it had a regular appointment with her GP and used it to ask for a special one-off paper prescription for a 2-month reserve of her essential glucocorticoid. (She takes prednisolone, which is much cheaper than hydrocortisone). The GP was happy to write her this extra one-off prescription, separate to her regular repeat, to make sure she wouldn't be caught out by any Brexit-related shortages.
I think would also be worth asking to have an allowance for illness built into your regular repeat, maybe an additional 20% above your maintenance regime? If you come down with even just a simple throat/chest infection, you would be at double dose for 7-14 days so could deplete your ordinary repeat in just 2 weeks. If that happened in the middle of a Brexit bottleneck, you could have some anxious moments. If you started an intensive exercise training programme you would be taking an extra 5-10mg for every exercise slot, so your ordinary supply would also be run down quite rapidly.
It also halves the pharmacy handling charges on your repeat medication if they give you the standard 2-month repeat rather than just one month at a time, so this is a saving to the NHS overall. For elderly people they sometimes get stingy and I've heard of practice staff saying some quite hurtful things about the wasted medicines if you die in a hurry! But if you have a tough hide you can argue the illogicality of this one out.
The information leaflet in every packet of medicine has to state where it was manufactured. If you have binned the leaflet you can find a copy online on the MHRA website. It is a faff to locate because they are badly labeled, but they are all there in an unsorted jumble.
Giving you just 1 ampoule of hydrocortisone at a time is impractical when they are delivered to the pharmacist in a packet of 5. I suggest you ask the GP to write your prescription to specify a box of 5 at a time. They cost just £1.66 each so this is less than £10 for the packet and it could save the NHS the cost of an ambulance call out. I've heard of people who managed to crush the amp trying to snap the top off and had to discard it and start again with a second one. It's easy enough to drop them, too, if you have shaky hands and are nervous about attempting the injection. Also, what happens if you are mid-Atlantic on a long haul flight at the time and it is another 7 hours till you land? Giving you just 1 at a time is basically a safety risk.
What I've found is that if you talk to a GP and show them the explanatory article in an appointment, they are usually helpful and will arrange to exempt you from the standard rules on safety grounds. But if you send the same information through on email it gets handled by the practice manager or support staff, who don't have a medical background or understand the seriousness of your condition. So they simply defend the rules and tell you no. The other thing that can happen is that the pharmacist in the practice goes through the records independently and tries to over-ride what a GP has written for your repeat to revert it to the standard 28 day rules. Then you have to politely explain that they do not have authority to change the GP's prescribing instructions, which were done on grounds of individual clinical need.
Best
Katherine