I’m posting this just to highlight the difficulties the NHS is in at the moment, I’m a 75 year old asthmaric and have had a cold and chesty cough for nearly 3 weeks. I finally decided this wasn’t going to clear up by itself. There was no way I was going to get an appointment with my GP any time soon. However, they have this iconsult system where you post the problem on the system and they guarantee to respond in 24 hours.
I posted the problem said it had affected my asthma a bit and that I was normally fit,active, and a gym goer, if anything I was expecting to get antibiotics. Within two hours I got a text saying they were prescribing steroids and I could pick them up at the chemist next door to the surgery later that afternoon. Btw I have an emergency pack of steroids for my asthma. So I’m confused about the diagnosis but hey, maybe this is a new way of treatment for a long chesty cough, so why not start taking from my own stock of steroids straight away, which I did on the six’s day basis.
I call in to the chemist twice l ate afternoon and the next morning but no prescription, so I go next door to the surgery and queue for 25 minutes to talk to the receptionist, She agrees it’s not been issued and will put it on the docs list to do. Still no prescription in the chemist late afternoon after more queuing. Then about 5.30 I get a call from a paramedic who says ‘ you put in an iconsult and asked for steroids?’ No I say, they prescribed steroids, He says but you’re not wheezing. Yes I say I was expecting antibiotics. Friendly guy this and he says yeah that’s strange I’m going to get a prescription for antibiotics into the chemist in the next twenty minutes. I’m finally delighted and tell him so. Only problem now is I’ve taken two days of 6 prednisolone I don’t need and would Ihave to continue? Fortunately, chemist says no and this morning after taking first two antibiotics last night, I’m noticeably improved.
sorry, a long post but just to illustrate, things aren’t right in the NHS sadly.
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TwoPuffsAl
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Well, I guess the prednisalone didn’t make all the difference, but I’m glad the antibiotic is kicking in. And also you seem to have the support of your pharmacist who probably is more accessible than your GP anyway, even though it isn’t the preferred protocol pathway for medical advice as it seems at present.
I’d keep posting the iconsult but also going back to your pharmacist who now knows about your present situation, I’m sure they’ll point you in the right direction, and at least you’re not alone despite not being able to access your GP 👍.
Well done on finding your own way, although you really shouldn’t have to be doing this 🙄. Good luck!
hi Homely, totally agree about the time wasting. Ahead of me at the docs reception a lady told them she needed an appointment in two weeks, her hospital doc said. The receptionist went away to a pc and came back ten minutes later with an appointment in three days time. After being corrected she went back for another long time with a correct appointment on paper to get it agreed and then went back to the pc to enter it . Very inefficient.
Re NHS app, when I was doing the iconsult, it asked if I wanted to continue on the NHS app, which I did. But thanks I didn’t really realise I could have confirmed whether the prescription had been issued. Good to know.
Things are similar at my surgery, ie hopeless. Mine have done away with the E-Consult system so it's even worse. I'm in my 70s too, recently I was very very poorly, impossible to get through to surgery over the 1st week, did covid tests myself all negative. Calling 111 didn't occur to me i was too ill to think straight. Result, almost 4 weeks in bed, soaking pillow/sheets, shaking, non stop coughing, upped the Fostair, ventolin went from zero to 20 times a day. Coincidentally I was sent an online review form, I wrote the truth inc. ventolin x 20 daily. Not a word did I get back, I'm sure no-one read it.
Quite a few surgeries have been using para-medics now.
Hang on to any extra pred &/or antibiotics you get for future use in case you're in this predicament again or they stop allowing rescue pack as many many surgeries are doing. Mine hasn't allowed me one for 8 years, flipping annoying.
Hello peege and sorry to hear about your nasty illness and lack of response from the medics.
Hope you are on the mend now.
Im lucky to have had access to the rescue pack for many years. I came very close to dying from an asthma attack when I was 35. Resuscitated in an ambulance and in hospital for a week. Maybe this has helped with the rescue pack continuation.
Good luck with the ongoing tussle to get medical attention.
I must be very lucky with my GP surgery. If I ever phone them because of an asthma flare they always arrange for a same day call back, usually the practice nurse. They assess whether I need a GP, otherwise they will prescribe additional asthma treatment including antibiotics and Prednisolone. But if I want Azithromycin, then I get to discuss that with a GP. One GP won't prescribe it, despite written instructions from the respiratory consultant, so I have had an issue with that.
Before I went on a 5 week trip this year I realised that I hadn't replaced my emergency pack of antibiotics and Prednisolone, after using them last Christmas. I was departing on a Wednesday and only telephoned the surgery on the Friday to explain (& apologise). I got to collect the prescription from the chemist on Monday.
Even when I had a trapped nerve in my neck earlier this year, after seeing a physio (privately) & they advised me to get amitriptyline from my GP to tackle the nerve pain, I was really surprised to get a same day telephone appointment with the practice nurse, who agreed with the physio's assessment and arranged for a prescription. The receptionist even called me later that day to say the prescription had gone through to my chosen chemist.
I do wonder if my records have a big sign on them saying, "treat carefully" or something, as I think the service has actually improved in the last 5 years. Maybe they chose to give asthmatics priority because of covid? Anyway, I have very little to complain about in terms of their response when I need them.
😁 I'm always surprised myself, I always expect to face resistance because of one bad experience years ago. I do wonder if it's because they missed diagnosing me in the past and I ended up seriously ill (not asthma). Anyway, I'm not going to rock the boat.
How do I get emergency antibiotics or steroids? I've seen a few people mention this but sometimes i get refused if i ask the doctor for a steroid even though I've been in that position a few times before and know that if I get a couple of days on them it'll clear my chest.
It's very dependent on your asthma nurse and/or GP. I've had some GPs who categorically won't approve an emergency pack, but my current GP is more open to them on the understanding that I let him know if I start them so that he can have a telephone chat about how things are going, just so my records are up to date and to ensure things aren't escalating.
The argument for me is the need to start treatment as early as possible rather than have to wait and talk to a doctor and then go out for the prescription. Having said that, I will only take Prednisolone and/or antibiotics if absolutely necessary.
The general resistance from GPs is based on the premise that it's important to see the patient and assess their need for targeted treatment. That's all fine and good if you can see a doctor the same day and absolutely unacceptable if you can't see your doctor or asthma nurse urgently. So if you can talk to a doctor and get early treatment for an attack or flare up, then that may be why their policy is antianti emergency pack. Some patients will have approval from their hospital consultant for an emergency pack.
If you still can't persuade your GP or asthma nurse, then the only option is to ask your consultant. Failing that, for any out of hours exacerbation I would use 111 in order to get early treatment. I've had to do that in the past for my asthma because of a chest infection after my GP at the time wouldn't prescribe antibiotics, as he said I had a virus...I got an emergency GP appointment at the out of hours clinic and they were less than impressed with my GP. But that's the reality for some asthmatics, unfortunately.
Your health Trust may have published their policy on emergency packs on their website and that may explain your surgery's stance.
Thanks, I think i'm quite lucky to never have had a proper "emergency". I play the bagpipes and one of my triggers is not being able to fill the bag, when that happens I get in touch with the nurse lol. but I also think that playing the pipes helps keep my lungs healthy(ish).
I think it can be highly variable. I hear horror stories but my GP surgery has been good recently. Definitely had some less good encounters with them but recent ones have been positive. Including with the practice paramedic and a PA - I'm sure some can be less good if they won't admit to what they don't know but the same applies to doctors.
And I saw a pharmacist for a med review last month and ended up being sent to A&E - wasn't how I wanted to spend my Friday evening but can't fault the GP and pharmacist.
I do think the system as a whole including GP surgeries is really struggling though and sometimes it doesn't help itself - which affects staff too and makes them not want to stay.
I will say that I don't think a lack of wheeze, especially when that's just over iConsult and the phone, is enough for them on its own to say you didn't need the steroids. Wheeze is not a requirement for asthma or steroids for asthma and it's definitely a myth that persists with too many healthcare professionals! Though it does sound like the antibiotic was needed and of course if you can avoid steroids it's a plus.
my GP surgery are really supportive- can it be because I always send them a Christmas card and a box of chocolates? They insist on me keeping emergency antibiotics and prednisone and referred me to a consultant after my peak flow dropped and refused to return to my previous above target levels . Hospital consultant totally useless as he told me my PF target of 370 based on being a 65 year old 5ft2 female should be 331!! I checked with the standard graphs and my GP snd he was wrong!!! Don’t dismiss taking prednisone as if can help with inflammation.
It has always depended where you are. Things are much better at my local GPs in West Yorkshire. These days I rarely get exacerbations of asthma but did about 5 weeks ago. I filled in the local online form one evening. At 8.14am the next morning I had a call from the surgery making an appointment for me at 10.50. I needed to order a taxi to take me the 200 yards to the medical centre, and later home. I was examined. Prescriptions for steroids and antibiotics were sent electronically to the local pharmacy next door. I waited for 5 minutes on a chair in the pharmacy , and went back home with them.As age seems important to you I am 78. A fortnight later as I still had some infection I filled out the form again, saw a doctor the next day who sent a prescription electronically to the pharmacy,, which was ready by the time I arrived at the pharmacy.
Sounds excellent Thomas. So it seems from reports from all you good people that it just depends where you live as to what the service is like from the NHS. We need some levelling up!
I had a similar experience this week. Called just to ask a question to a doc/nurse about whether I could up my inhaler dose rather than starting my rescue pack of steroids. Was told there were no appointments all week. I replied that all I needed was a quick yes or no. Was told to call 111, which I did. They listened to my history and told me I needed an emergency GP appointment, to which I replied they told me to call you as they don’t have any. They then said they would make a referral and to call the surgery back, which I did and they ‘found’ me an appointment. Doc and I made a decision to try upping inhaler dose but to have a very low threshold for starting steroids and to let her know if I started the course. Next morning peak flow had dropped so started the course and messaged as requested. Called later in the day as hadn’t had a response and to make a follow up appointment to again be told there weren’t any and I’d have to call next week. I said the doctor specifically asked me to call and was told she was away for the next week. Next thing I know, two separate calls, one from the ‘absent’ doctor and one from my asthma nurse, who then made me an appointment to come down. I totally understand the pressures but what a huge waste of everyone’s precious time, alongside a receptionist giving out mis-matched information!
The thing that I find most frustrating about the NHS is that most of the problems seem to be due to sloppiness, not underfunding. If people were this inefficient in most other jobs, they'd be fired!
That includes everyone who drinks a couple of pints a week, single mothers who treat themselves to a Costa twice a week.
£20 to see a gp ( in southern Ireland it’s £50) residents in France pay on a card and get a refund if they qualify.
Pay for food in hospital - we don’t get free food at home.
Doctors should get a pay rise but have to sign a contract to work full time and stay in this country for the next 25 years. Ditto nurses. Sack the managers. Put in private management. Unfortunately there isn’t a political party in this country with the courage to do it.
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