1. djk

    djk Registered User

    Jan 6, 2005
    2
    my father's G.P. is now refusing to issue any further prescriptions for Aricept. Although his condition has not improved since taking them neither has it deteriored. His Consultant can see no reason to stop the medication. What will happen if the G.P still refuses to sign the prescriptions - this is what he indicated when I spoke to him on New Years Eve?

    Has anyone else had the same issue with their G.P.
     
  2. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Dear Denise, don't know what to say to ease your burden. I am sure someone on T.P. will have some comfort for you and maybe a solution. Please keep us up to date if you can. Thinking of you, Connie
     
  3. Chesca

    Chesca Guest

    Dear Denise

    I don't understand this at all. My mother was prescribed Aricept by her consultant, but the prescriptions were filled by his clinic and we had to collect them from there, not the GP's surgery.

    I am wondering if this a question of budgets, Aricept is quite an expensive drug: is the GP passing the literal buck? Surely it is the consultant's directive which should be followed by your GP. I think I'd be checking the line of responsibility here to ensure the very best treatment for Dad and if possible ask the consultant to prescribe in order for you to collect from him if possible. All seems a bit hit and miss to me. Anybody else know how this works?

    Sorry, not much help really.

    Best wishes
    Chesca
     
  4. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    I'd be inclined to agree with Chesca - Pass the Parcel is most likely the name of the game. In this case the parcel is the cost of the treatment.

    When Jan [briefly] tried Aricept, the consultant had recommended it and the GP supplied it. No problem [other than the fact that it did no good for her as her condition was too advanced].

    It would be worth checking the reason. I'd not think it unreasonable to ask the GP why he won't write the prescriptions.

    Best of luck!
     
  5. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Our consultant prescribed the Aricept and they are delivered by the CPN on a regular basis.
    The come direct from the hospital pharmacy.
    I agree with my colleagues check the line of command.
    Usually GP do not cease/refuse to write scripts for consultants requests.
    I suspect this is a GP watching his budget,and as Bruce says passing the buck(s)

    Norman
     
  6. Chesca

    Chesca Guest

    The one sure fire way to find out if it's to do with funding, is to tell the GP you are prepared to pay for them (you're not and you shouldn't have to anyway). But none of this should be necessary in a caring? world.

    Chesca
     
  7. Nutty Nan

    Nutty Nan Registered User

    Nov 2, 2003
    787
    Buckinghamshire
    When my husband's consultant first prescribed Aricept in July 2000, it was not available on the NHS yet, and we paid for it monthly for almost a year (the consultant told us where it was 'least expensive'!).
    When it did become available on the NHS, we ordered it from our village surgery, and our GP muttered very clearly that he thought the expense of this drug was not justified. However, since the initial prescription came from the consultant, we have continued to get the medication and repeat prescriptions from the surgery without problem.
    Best of luck!
    Carmen
     
  8. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Hi, can I just ditto the aboves, check it out! Love She. XX
     
  9. barraf

    barraf Registered User

    Mar 27, 2004
    308
    Huddersfield
    Hello Denise

    When Margaret was prescribed Aricept in 2000 the first prescription came from the specialist. The CPN did say she would have to write to the GP to ask him to supply future prescriptions, which he did.

    Therefore there must be a choice available to GPs as to whether or not they continue with presciptions.
    Unfortunately I didn't ask what would happen if he refused to write the prescriptions.

    I think in your place I would be contacting the Consultant to find out why this is happening, and then if you cannot get prescriptions from the hospital, immediately enter into the complaints procedure.

    I personally find that in a lot of cases if you shout loud enough and often enough things start to move. This is an unfortunate fact of NHS life, so don't be afraid to make your presence felt. From your post it sounds to me as if you need a long loud shout as soon as possible.

    Cheers Barraf
     
  10. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Denise
    as a last resort advise the GP that you are quite happy to make a formal complaint.
    He/she will not take this lightly.
    In a former life I chaired a panel investigating GP complaints and they do worry about complaints made against them.
    We too paid for our Aricept until they became available on the NHS,we then obtained them from the consultant as I described in an earlier posting
    Norman
     
  11. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    My only concern about the formal complaint route is that in the past I have heard stories of 'troublesome' patients being struck off GP lists, so hold that one as a course of last resort!
     
  12. emscub

    emscub Registered User

    Dec 5, 2003
    124
    Bath
    Denise,

    The only answer I can offer is from working in a memory clinic in the past, assisting with the monitoring of people being prescribed these drugs, as my Nan whom we care for has vascular dementia meaning that the treatments available aren't applicable.

    In my experience, it is exactly as most others have suggested - that is, funding is the problem. It seems that there is quite a 'lottery' when it comes to funding and in some cases the consultants who wish to prescribe the medication often have to get written permission from GPs that this will/can be done. Although in other cases it is done differently.

    As most have suggested, I would suggest you find out the arrangement in your situation.

    Emma
     
  13. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Hi all, regarding expensive of drug cost to the NHS, they are as follows: Donepezil 5mg daily £889 annually
    10 mg £1,245 annually
    Rivastigmine 1.5mg £884 annually
    rising to 6.mg £884 annually
    galantamine 4mg £710 annually
    rising to 12mg £1092 annually.
    Hospital costs are lower, but subject to V.A.T.

    Small price to pay to enable loved ones to be cared for longer at home, and to have some chance of quality 'time'
    Keep smiling, Connie.
     
  14. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Connie, thanks, that is brilliant ammo information! If we know the facts, we are so much better equipped in the battle for care for our loved ones. Love She. XX
     
  15. Chesca

    Chesca Guest

    It's not a high price to pay, individually. However, I suspect a lot of the Government financial jiggery pokery has left GP practices as self-funding; no longer are they doctors doing doctoring, they have to be accountants or appoint a practice manager to do the job and he doesn't come cheap - if the car driven by our practice manager is anything to go by! Norman, given his past experiences on the Medical Council, may be able to let us know a little more about this.

    The thing that really rankles me, and it doesn't take much, is that there are no end of facilities, clinics and outreaching for the needs of children at our practice, but very little in the way of support for the elderly or their carers, equally vulnerable, those who have contributed so much in their lives via taxes (inc. me), working all of their lives, keeping us safe from the 'Invader' during the war! Ha! Or is it that they are past their sell by date and not worth the investment?

    Chesca
     
  16. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Hi, drugs, what drugs. Have just sat through an evening with my dear Lionel. No response tonight whatsoever. Tomprrow may be better.

    I have coped tonight with a few glasses of wine, MY DRUG. However I gave up drinking regularly last March, and have found coping very difficult. Yes I see the problem more clearly, yes I know it it better all round, ( and I have dropped 21/1 stone) but I do not like my situation in the cold light of day.

    Maybe one day they will find a drug to enable carers to live a normal life, only joking, bad night! Love to all ,Connie
     
  17. Chesca

    Chesca Guest

    Hi Connie

    .........until that happy day the best we can hope for is an outlet here and with our understanding friends.

    Have tonight left Dad in his own house with great remorse despite his telling me he's OK, millions are going through it and as long as he knows he has us at the back of him he's fine. I wish I could take away his loneliness but the kind of company we provide is not what he really is in need of.......I hate that he goes to bed on his own, that the family home no longer feels like a home without Mum, even at her worst state of AD..too much for me right now, too sad!

    Somebody once said there is nothing lonelier than being 'alone' in company. Is that where you are tonight, do you think? Anyway, cheers. We all need our 'drugs' to help us cope - it's cheaper than pills, ask the Chancellor! Actually, don't tell the Chancellor, he'll throw even more excise duty on the tipples that float us!

    Love for now
    Chesca
     
  18. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Connie love, sending you a big hug, sorry you feel down. In Norm's famous words, day by day. Hope tomorrow is better for you, lotsaluv, She. XX
     
  19. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Bruce is right some GPs do remove troublesome patients from their lists,however evryone is entitled to be on a GP list and it is the duty of the health authority to provide one.
    I have known cases to the extreme where a very difficult patient is involved,the Drs in an area each .accept the patient on a 6 monthly basis.
    Really if you have an unhelpful Dr does it matter if they remove you from there list?
    Norman
     
  20. djk

    djk Registered User

    Jan 6, 2005
    2
    thank you for all your messages and advice. My fathers G.P. appears to have seen the light. A repeat prescription was waiting for my mum when she called in at the surgery. thankfully the consultant intervened and all is well for now.
     

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