NHS &NICE

[Prada47]

I have read a few posts that say the NHS won't prescribe such and such a medication and wonder sometimes do we just blame the NHS, when really it is NICE calling the shots on what can be prescribed. I try to work on the basis that should I need it I will get it !!!

One thing on Heart Medication an awful lot of it is to prevent further problems, not to make you better. I think that is one of the difficulties with Heart problems we are used to going to the GP and being prescribed something to make us better ie a quick fix anti biotic, Bisoprolol for instance won't fix a broken heart it will just try to prevent it being broken further. So maybe we should just start to say NICE is not so NICE but the NHS is really Pretty Good.

regards

[Milkfairy Heart Star]

Clinical Commissioning Groups ( CCGs) are also involved in the decisions about the funding of care and treatment.

NICE guidelines will recommend a treatment however not all CCGs will follow the advice. NICE guidelines are also are not always updated quickly in response to new research.

Sadly there is a postcode lottery and no equal access to medications etc because of who is making the decisions about what we need and who is holding the purse strings.

The NHS has just closed its public consultation into Evidence based interventions.

engage.england.nhs.uk/consu...

I would encourage everyone to get involved as a Patient Representative at their local CCG and other Patient and Clinician groups to ensure that we all get the care we need regardless of where we live.

[MichaelJH Heart Star]

I wrote about NOT-NICE some months ago. My bypass was delayed by nearly two months as a result of people adhering to the guidelines and, in my view, not using common sense. The issue related to a tooth that abscessed some weeks after I had got "Fitness for Surgery" including the dental sign off. I was refused antibiotics repeatedly by my own dentist and the oral surgeon I was referred to for extraction. Two weeks after extraction I was still in considerable discomfort and was finally prescribed them. Within three days it had cleared yup and was pain free. However, I needed to be clear of them for two weeks before I could go back on the waiting list. A few years ago I would have been given them both as a diabetic and a cardiac patient. I understand the need to cut the prescription of antibiotics but common sense is also needed. I have had a similar saga with a chest infection that needed three GP visits. At one time I was prescribed an inhaler that actually made the hacking cough worse!

[Milkfairy Heart Star in reply to MichaelJH]

I love and hate the NICE guidelines too at times....there is at present no NICE guideline for my condition so perhaps it doesn't exist

I had a tooth access last year and my they hurt , I nearly resorted to some morphine. I was prescribed antibiotics in an attempt to save my tooth....no joy my pain stopped when my tooth was removed

[MichaelJH Heart Star in reply to Milkfairy]

Because my tooth was broken it was deemed it would have to come out. I was refused antibiotics, and told to use salt water rinses and painkillers! But the wait for the dental surgeon was totally unacceptable - you would be jailed for treating a dog like that. I think the pain exceeded that following my bypass surgery!

[Milkfairy Heart Star in reply to MichaelJH]

The pain is up there with childbirth and Coronary artery spasms !

My tooth was cracked too, my dentist just got the wobbles when he read my history gave me antibiotics waited a week ...they can't use a local with adrenaline makes the spasms worse, clopidogrel makes me bleed more....I got him to breathe and relax , one pull and the tooth was out.

I think he was more relieved than I was!

[Rosei]

I heartily agree with your post, I don't know what I would have done without the NHS.

Paracetamol is a point, it can't be proscribed now, it cost pence in most shops, it should have been stopped years ago. I have a friend who is coeliac, she bemoans the loss of bread for coeliacs, she is well off and spends most of each on expensive holidays.

[Inamoment in reply to Rosei]

You can only buy 32 paracetamol. Some people take a lot every day, should be on prescription.

[shopman in reply to Inamoment]

Depends upon where you live. I have Paracetamol prescribed by the box, 100 at a time. Usually get through 2 boxes per month.

[Dockdog in reply to Inamoment]

Please be aware that exceeding the advisory daily dose of paracetemol is highly dangerous and will cause liver damage. A young friend suffered just this and had to be airlifted from Plymouth to London for immediate life saving treatment - he was lucky!

[Rosei in reply to Inamoment]

Paracetamol would still be cheap, you shouldn't take more than eight a day.

[npchsw]

Don’t knock NICE too much please, they may not be perfect but it is nevertheless world-recognised as a thorough review of evidence on tricky clinical questions or new technologies. I was a patient member of a nice guidance panel a few years ago and impressed by the (sometimes excruciating) level of detail, and the dedication of the participants to really providing the best advice available. But it’s a long and detailed process. My frustrations lie with ccg’s who can overrule the guidance for financial reasons, or implement it SO SO Slowly! And so little accountability for their decisions. That’s where the postcode lottery plays havoc with our lives. Don’t blame NICE, they are trying to do the right thing for all of us.

[dunestar]

On the whole I support NICE and same goes for the NHS. I agree with npchsw that NICE is trying its best. There are some surprising gaps though in their work eg they are only now working on guidelines for the assessment and treatment of thyroid problems. The NHS is generally wonderful but it can only be as good as the resources which are put into it. The post code lottery thing is a real concern. Also there needs to be far more attention paid to prevention. They are brilliant at intervention but less good at preventing things in the first place. Witness my GP who seemed unconcerned by my rapidly falling levels of blood flow through my kidneys. No doubt they would save my life if things were to get critical but not so interested in stopping things happening. The opposite is true though for heart conditions where most of the pills seem to be to prevent nasty things happening.