Repeat Prescriptions for Essential Drugs

I am on Disopyramide and Apixaban. Both probably for life or at least a long, long time (hopefully!!!), and both without which I'd be in trouble. Without Apixaban clearly at higher risk of stroke and not something I'd like to interrupt and restart.

My GP surgery is reluctant to give repeat prescriptions until I run fairly low on stocks. With a poor memory and being quite busy, I often forget till I'm out or very low on stock. Then panic stations! The whole thing is made worst by them only answering the phone for prescription between 10:30 and 12:00; I always remember at 12:01. I end up driving down there and asking them face to face from the person who would have answered the phone!

So here I am, bank holiday on Monday, surgery closed and I will take my last Apixaban on Monday night, got some Diso left over so Ok there. Two days to get a prescription although I will ask for emergency action.

My question is, with drugs like this on which we depend, is it not allowed that we could hold a stock, say 3 weeks/a month. I'd like to have some in my car, some in my wife's handbag and my golf trolley. Is there something that I can quote to my GP to force them to allow me a stock. Last time we went on holiday, and so asked for extra supply, they wanted to know the actual dates of departure and return.

Also, why do I have to get a new prescription every four weeks which is costly and inefficient in admin, transport and time for everyone. Can I insist on a larger supply.

Thank you

Koll

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32 Replies

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  • Hi Koll

    This is not right, I get two months at a time, and all I have to do is phone my pharmacy they contact the doctor for the repeat prescription, and next thing that happens is I get a text saying come and pick them up. My pharmacy is open until 7pm so I can go after work.

    I think you need to challenge the GP on this process it's not good for you or them

    Be well

    Ian

  • Hi there I'm in Scotland so we do sometimes have different rules. However I can tell you that I seem to receive no more than 1 month supply per prescription for apixiban and verapimil despite needing them for life. They're easy to get though as I just phone up any time during surgery hours and they fax the script to y local chemist. It usually takes 3 days in total.

    When I was away for the 8 week summer holiday I explained and they gave me extra.

    I've been sneaky though and phoned early a couple of times so I've now got a "cushion" built up of around 2 weeks' supply. I feel safer that way.

    It is a daft situation and can't be cost effective. Why don't these just give us an annual supply and say see you next year at check up time unless any issues?

    I'm going to ask my GP that very question next time....bet she loves me!

  • An annual supply would waste a colossal amount of money due to changing does or changing medicines. Many places allow 56 days supply on long standing medicines.

  • Depends upon the Local CCG - ours also say you can only have 4 weeks supply. Loll would not be able to challenge the GP in Devon as it is not GP decision.

    The reason was a survey conducted in 2013 that found that people do hoard meds that they never take - many times because they don't want to tell the doctor they don't take them!

  • My surgery always gives 2 months supply at a time. I can usually reorder 2 weeks in advance . It's all done electronically at my surgery now so just ends up ready to collect at a pharmacy of my choice .

    Seems like your surgery is a bit behind the times Koll

    Sandra

  • Hi Koll and I do understand exactly. I have a seven day pill box which in theory SHOULD mean I never run out but with a 72 hour delay between popping in request (I must sign up for e mail requests) and collection this often goes whatsits up.

    My understanding is that one months supply is normal for NHS patients. It is about not wasting drugs and cash if you die on them and do remember some drugs ARE expensive. My hormone implants were £70 a month when I was having them. What you can do is put your order in a week early each time and eventually you should arrive at a situation where you have a few weeks in hand but don't forget to rotate them or they may go out of date. Because I am on warfarin and order the same each month which is well above what I take I actually have quite a lot of stock!

  • I have done the same as Bob and built up a small stock. It doesn't help that many packs have 28 tablets in them and this isn't a month's supply in a 31 day month.

  • I'm not sure whether it's the GP's surgery or the CCG that sets the parameters. Possibly a combination of both. Some of this stems back from the issues of people stocking medicines or people's dose gets changed or swapped and then medicines get thrown away.

    From previous posts I recognise that I am lucky where I am. All prescription repeats can be done online (and I have done at 3.00am on one occasion). I can see exactly when I last received each medicine I have been given, dose and also an information symbol I can click on to bring up data sheet. I can see all my prescriptions over the last year. In my case the default quantity is 56 days supply in advance (even for Warfarin for each strength - the dose may change). I have a box to say pick up location. I have a box to write a message. When I submit I can then log back in and see that status of my "order". The GP approves it electronically and then it is sent electronically to the pharmacy who then dispense and in my case then deliver it to me. I have had it that I have submitted the prescription circa 07:30am and it has been delivered at 11:00am the same morning. Normally it is next working day.

    From about a year ago round here at people can give instructions to my pharmacy to submit repeat prescription requests to the GP. The pharmacy is a small group with 6 branches. The request can either be by individual login or can be by completing a form in the shop. When I was in there the other day there was a leaflet showing that there was an App for both iPhone and Android - check because I think there are a number of different apps depending on the pharmacy's decision on provider.

    As I have used the GP service for a few years I will continue to use that one especially as it has additional functionalities once you have logged in such as GP appointments, nurse appointments, blood test appointments (other than warfarin), etc, etc.

    I would strongly advise everyone to use a single pharmacy rather than dropping in a three or four different ones so that all your information is in one place. In particular this allows pharmacist to review. Also in my case pharmacist was the one who suggested a medicine review and from that picked up that I was overdue blood tests having started statins and Apixaban and from those test picked up that liver function was failing (4 times max allowed) due to the simvastatin.

  • Peter I suspect it is CCG driven. Down here in Devon with our much older demographic it is bound to be more stringent than say London as the local CCGs are all up to their eyes in debt. We all live too damn long now that's the problem. Unless people do the decent thing and take up dangerous sports like base jumping it will only get worse.

    Use your pharmacist! As Peter mentions they are often more skilled with drugs than GPs. I'm on first name terms with mine.

  • Fortunately, like PeterWh I can order repeat prescriptions on line, and even request drugs which are not on my repeat list. The local pharmacies can also order repeat drugs for patients. My prescriptions are checked by the medical centre and then sent electronically to the pharmacy I use. Some time ago before the medical centre sent them electronically one Bank Holiday I would have run our of Flecainide but the Pharmacist gave me enough tablets to see me up to obtaining a prescription for them.

  • That's an awful palaver Koll and stressful - can your practice manager be made less reluctant if you explain some of the implications? Have a plan in mind when you approach him or her - two months' supply doesn't seem unreasonable as a minimum and it gives you leeway to build up an emergency supply.

    I don't know the funding restrictions in England but my practice in NI has online repeats, monitored by a central body, delivered to my chosen chemist. It's good practice to stay with a trusted pharmacist if you can. I was once or twice caught out like you and was able to get short term tideover tablets because the chemist's records showed my history with the drug in question.

    Hope you can get a better plan in place.

  • Thanks for the replies. I'll look into online ordering and the chemist I use, that would be easier. I used to order by email but they stopped that. I remember now that there is a replacement system, but I recall looking at it and not liking it for some reason but that was a long time ago so I'll revisit it.

    Re building up a stock, think I'll have to loose some because they seem to keep a record of how many I should have left.

    Thanks again.

    Koll

  • Koll

    The one that I know quite a few surgeries use is Patient Access on patient.info

    If it's that it is very good. All you have to do is sign a form at the GPs and then they "register" you there and then and give you an access code and then you login at home and set password, etc. Took 1 minute at the surgery. I have been on it for 18 months and in that time additional functionality and features have been added. Also good information on public pages without needing to login.

  • Thanks Peter, had a look and my surgery doesn't allow online registration so will go and visit first thing tomorrow face to face and get it done.

  • Yes. I don't think any allow totally on line which is why you have to go in and sign (I said that in my original reply to give everyone the heads up as I knew mine and some others did this and I was pretty sure it was universal).

  • Koll on-line ordering does work to an extent - but as they will put a date on when you can re-order which is difficult to always override as it is usually about 7 days before you run out it doesn't always help. This is how I got around things:-

    1. Make appointment with GP and say you are finding this difficult and have run out and missed several doses because of this system and ask for an 'emergency' script to keep for those occasions - in addition to your normal script.

    2. Get you usual script as well and put into chemist.

    3. When registered for online - ensure you order drugs on the date you can every month for a few months - then you should be able to have a few days supply in reserve.

    4. Cash the 'emergency' script in at chemist mid r-ordering cycle.

    5. Revisit your GP in about 6 months time to renew your 'emergency' script.

    Also useful for when you are travelling to keep an emergency script filed away.

    Learned from experience of running low through this new dictat which is very annoying!

  • Cheers CD, I'll try and build up a stock as you say. To run to within 7 days is simply absurd and assumes everyone is sat round doing nothing and going nowhere. Last time we went to Northern Spain, our ferry broke down and the next one was 7 days later. Even tomorrow I will have to stay here to organise my pills whereas I was hoping to go somewhere. Real nuisance.

  • You may find that the electronic system allows ordering a month in advance. I know that ours does. However that may just be because the practice has set the repeat ordering parameter as 28 days or one month.

  • Not in Devon!

  • Edited!!!!

  • I get 2 months at a time, but they all tend to run out at different times, because of pack quantities which is a pain. I do mine on line now, linked to surgery, and it is automatically sent to chemist who text me to say they are ready. I know Boots, and I'm sure other chemists will automatically do your repeats for you, did try it but it didn't really work for me. Doing it on line is much easier, but yes you do need to remember. Perhaps you could talk to your practice manager about increasing quantities?

  • I use two simple ways to track. When I receive my two packs each of 28 days I mark one A and one B. Then when I finish the 1st strip in pack B I reorder and then that way I still have 14 days in hand less the time to receive new supply. Due to start times at the point of ordering Bisoprolol I still have two strips of Digoxin left but I order at the same time.

  • As a retired GP I acknowledge this can be difficult. We are recommended to only issue 1 month supply, but with some 28 day packs and others 30, this can be awkward. The system automatically alarms if quantities requested are exceeded and then has to be overridden.

    The simplest thing is to speak to your doctor to adjust the quantities exactly- most will be happy to do 2 months if personally requested. Then as mentioned arrange for your pharmacist to reorder for you so they will have it already in stock for you when you run out

  • I still think the GP's electronic system is preferable (if they have pone of course) rather than the pharmacist's.

    Which ever use one that allows you to log in through the web or an App because that way you can do so anywhere especially if you got caught or were in a hospital.

  • Thanks Goldfish, I will have a word with my GP and see if they can do anything, also our local chemist who is small (the shop, not her 😀) and very good. It's really more having a stock rather than the re-ordering frequency. Luckily, I have found 2 Apixaban pills which I had put as an emergency in my car, so now have enough till Tuesday night. I don't mind running out of my heart rhythm pills for a few days (not ideal but I can cope), but really don't want to stop/start Apixaban.

    Koll

  • Hi Koll, sailing close to the wind with meds is not good for the stress factor either!!! I'm probably lucky in that my situation is much the same as Beancounters. Prescriptions are requested electronically and if I know I'm going to be away for an extended period I tell the surgery in the notes and so far, I have not experienced any problems. On one occasion before my prescription for Apixaban was regularised, there was a problem with the prescription being transferred to the chemist. I went to our chemists, (a local "small" Boots) and the pharmacist was happy to release the drugs on the basis that the medication was deemed to be far more important than a piece of paper......I appreciate that not all pharmacists may be as enlightened as mine?

    Methinks it will not be long before you get the matter resolved to your satisfaction!

    Best wishes, John

  • Hi Koll

    GPs usually recommended to prescribe one months supply or what is in normal box eg 28 tabs but most will do 2 or even 3 months at a time. Ours can be ordered on 24 hr tel no, on line or on surgery or indeed at an appointed Pharmacy.

    I have managed to get all mine ordered at one time now (2 monthly) and will always have more of some than others but saves on journeys and everyone's time. Remember the Pharmacy get paid for each prescription so if ordered each month they will make more money!!! (Being very cynical !!)

    If you run short take your repeats form to your regular Pharmacy and they will give you emergency supply.

    If still having probs with supply from GP also think about a wee chat with the Pharmacist as he may be able to sort Gps out!!

    Oh! the joys of all these pills, thank goodness for free scripts in Scotland!!

  • Well us over 60s get free prescriptions here in England!!!

  • I know and thank goodness for that but do feel sorry for those under 60 who don't PeterWh!!

  • So do I but at least they can buy an annual passport which can save a lot.

  • I order on line and it tells you when you can reorder which is a week before you run out. If you reorder at earliest opportunity you do build up a reserve. We also have an amazing pharmacist of mature years in Boots. Any problem and she will fax surgery on my behalf. She sorted ordering two boxes of 1 mg warfarin to one 5 mg when I was on 7 mg and faxes if I need additional supplies for hols too if I haven't managed to phone surgery

  • Well I got my prescription just in time, zero pills left, but they've only given me 7 days worth. This is because there is apparently a national shortage of Apixaban. I've been told there are stocks of 2.5mg and might have to have those instead and, presumably, take twice as many???

    I definitely need a stock of these pills if they're going to run out.

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