Following on from my first post " frustration with NHS " I was possibly going to be left high and dry without any of my new medication ( Leflunomide ) because my GP would not prescribe any more as he had not received a letter of authority from the hospital. I rang the Specialist nurse on Christmas eve but could only leave a message explaining the situation. I decided this morning that I was not prepared to just wait for someone to reply and so rang the Specialist nurse this morning to see if any action had been taken only to be greeted by a message saying that no one will be available for the rest of the week! The message did give me another number to ring ( one of the consultant's secretary ) but yet again I could only leave a message and asked if they could deal with it urgently this time. To give the secretary her due she did reply within an hour to say that the letter had been written and she would fax it to my GP straight away.
Not trusting anyone from the medical side these days to keep their word I went to my surgery to make sure the fax was there. Fortunately it was but among a whole load of other paperwork to be dealt with so again had to point out that I needed these tablets by the 5th Jan and we have New Year and the weekend in between. The receptionist said she would get a doctor to authorise the prescription this afternoon. Fingers crossed!!
Again not trusting anyone I went to see the Pharmacist as a back up and he was surprised that the GP would not give me the meds as they could have authorised it just by seeing the label on the packaging that the tablets came in from the hospital. That made me even more annoyed. Why did the GP not ask for this? The Pharmacist was great and said he would make sure he had the tablets in stock ready for when the prescription comes through.
Thank goodness I have chased after this myself as who knows if this would have been resolved in time if left to the people who should have done the job right in the first place.
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jeanjack
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Hi I was surprised to read you blog as the am on the same medication and have been told that that drug is a government controlled drug ? , by my consultant so am not allowed for my GP to prescribe it and each time it runs out I have to contact the hospital to prescribe it and pick it up from the hospital each and every time !!! Which is a chore plus paying for the car park !!! So I was in trestles to read your blog. How does anyone else get this medication prescribed ??? With more info maybe I could start getting mine from my doctors which is on the road I live on. This illness is such a post code lottery !!! Goodluck for the new coming yearound and am glad you were able to sort it. X
I am on lefl ( among other things!) and I just get it from my gp on repeat prescription so pick it up with everything else. My pharmacy tell me they don't stock it routinely as they do with mtx so sometimes takes a day or two longer for them to get it in.
What a pain for you to have to collect it from the hospital!.....haven't heard of government controlled drug.....perhaps someone will enlighten us x
Hi sarah1967. Just received this morning a copy of the letter faxed to my GP yesterday and the nurse has specifically asked him to continue the Leflunomide on repeat prescription. I does not seem fair that some can get the meds at their local surgery and some have to get them from the hospital as you do. I hope you can get your hospital and GP to come to some agreement so it will be easier for you to get your meds in the future.
It depends if the Practice has agreed to & signed a shared care agreement with the Specialist Jean. If they haven't then all meds, drug monitoring bloods etc, anything relating to your condition will have to be supplied by the hospital. Yours has & why (under normal circumstances!) you get your repeat prescriptions done through your Practice.
I'm pleased you've eventually received your copy of the letter by the way but it does sound as though it's still out there in the ether. Shouldn't have been necessary for your Nurse Specialist to fax a copy to them.
I've just looked at my letter again and at the top it says " transcribed on the 23rd Dec." ( my appointment was on 25th Nov ) so I'm guessing that it was written and ready to send then but never got sent I suppose due to the Christmas holidays. It was one of the consultant's secretaries who I rang that saw it and so was able to fax it.
Someone said on my first post (it may have been you nomoreheels) that it takes about 6 weeks after an appointment for a report to go through the clerical channels and it has just been unfortunate for me this time that I needed that letter sooner.
Guess it's a time of year thing. Think it was oldtimer that said about delays between dictation & typing & my Rheumy did mention to me at my last appointment it could be 3 weeks before my GP (& I) would receive mine. That said I've just looked at the report & it says "Date of dictation 25.07.14 Date of typing 30.07.14" so guessing it depends on the hospital & how busy they are at any given time. My first appointment report letter was dictated & typed the same day so who knows?! Wouldn't it be a idea if it depended on meds being continued that there was a matter of urgency noted somewhere though! Anyway even though your had all the running around I take it you've got them now & it shouldn't be an issue again.
Well no, not quite yet. Receptionist said they would be ready today but when I went to the Pharmacy he said he would have to order them and they will be in tomorrow.
Not enough communication between people me thinks!
So even the Pharmacist who appeared to be on the ball saying he'd make sure they'd be in stock once you'd got the script didn't come through either! Ho hum, at least you should have them before you run out.
I'm not too sure what your Rheumy means by that sarah1967. It is a Specialist-only prescribed drug but it's not on the Controlled Drugs list (controlled by the Government) as far as I'm aware.
What a faff you've to go through to get your repeats, particularly as it could be so much easier with your Surgery being so close. It would be worth asking if they have a shared care agreement with your Specialist which would mean your GP is at liberty of prescribing your meds. Not all Practices, or indeed Specialists do as GPs either don't feel confident or have the knowledge of dealing with Specialist meds or the Specialist may prefer to have sole control of his patients. I think it's worth a question though if you explain as you have here including how much it costs you each time, proximity of the Surgery to your home etc, see if given the circumstances it could be arranged.
The prescription is controlled - just as it is for methotrexate - and can only be prescribed on the authorisation of a specialist. But most areas have agreements with an agreed protocol between the specialist and the GP that has to be followed by the General Practice in order to write prescriptions.
In some areas there is no agreement in place - sometimes because the GP does not agree with the protocol proposed. Sometimes the specialist prefers to keep the management under his/her own control.
Sarah1967 - I would ask (not "challenge" - that leads to bad feeling!) if it is possible for you to obtain the prescription from your GP and, if not, the reasons for that decision.
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Merry Chistmas all. Rheumy and NHS
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