I had an argument with my GP surgery today and would like your opinions/advice. I asked for some pain relief gel (ibuprofen gel, voltarol gel and voltarol medical plasters if possible). They said because it was over the counter I would have to buy it and they would not prescribe it (I have pre-payment certificate so it is a lot cheaper to get it on prescription for me). I don't use all the gels at the same time but different gels work on different joints for me. (voltarol is much better on my ankle, ibuprofen on my knuckles).
I think this is wrong and they should be able to prescribe it. Have you managed to get anything like this on prescription? What should I say to the GP prescription team when they call me back tomorrow?
Thank you in advance for any responses.
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JulezH
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I'm sorry to hear this and hope there is a way somehow of getting it on your prepaid prescription. I don't know how true this is nationally but in some areas I have heard they wont prescribe things like paracetamol and some other over the counter things as they reckon you can buy them cheaper. My GP prescribes me effervescent paracetamol on my prepaid, so I'm not sure what the rulings are for each practice/ authority. I hope you can get something sorted out satisfactorily.
That’s exactly what I was told re nasal sprays (not the steroid ones etc) and also things like antihistamines. It is annoying when you have a pre paid annual script. I am allowed to have paracetamols every so often although I haven’t had much need for those in the last few years tbh, but had to after an op in March. They didn’t quibble and prescribed codeine too. Sorry you are coming up against a brick wall there, Pip. x
To date I've been ok as my GP prescribes things I need, it's from others I have heard they can't get things like paracetamol or creams. Mine prescribes me the fizzy paracetamol as I struggle with tablets at times.
I have Paracatemol capsules as I’m not good with any tablets tbh, especially large ones.
They can and do prescribe ibuprofen gel often stronger than over the counter. GPs are keeping costs down by offering cheaper brands or refusing over the counter meds. You have a life long disease that will not just disappear this will probably not be a one off. I just ask outright I can’t take NSAIDs so this what a need often daily.
I told my husband that doctors can prescribe a stronger gel, he's got OA in his knees. Doctor said they don't prescribed anything stronger than voltarol.
Seems mean was this a receptionist or the actual GP said no ? I think I'd ask GP directly as isn't Volteral gel in different strengths so you need to get the strongest one ? I've never come across this so can't help more sorry.
Hi, thanks for responding. It was the GP who also said she had to check with a more experienced GP as she was new. I currently use the 2.3ish voltarol.
I've never used it so I hope you get the right stuff. We should not have to fight for such a simple thing. We know the NHS is hard pushed but seems very trivial.
It depends what it was you wanted. If the higher strength gel then yes should be prescribed. And if you need large, regular amounts of a common drug that also should be provided.
But standard stuff does cost the NHS a lot of money because of the administration costs and so on. And there was a policy guidance about stopping the routine prescribing of products that can be purchased over the counter, and sometimes at a lower cost than that which would be incurred by the NHS – paracetamol is an average of four times as expensive when provided on prescription by the NHS, compared to when it is purchased in pharmacies or supermarkets. It can costs around £34 for 32 on prescription including dispensing and GP consultation fees.
However, it is still possible for GPs to use their discretion if they feel that this is warranted on medical or hardship grounds. And more importantly there are specific exceptions such as
“There are however, certain scenarios where patients should continue to have their treatments prescribed and these are outlined below:
Patients prescribed an OTC treatment for a long term condition (e.g. regular pain relief for chronic arthritis or treatments for inflammatory bowel disease).”
Here’s the document, ask your GP practice to look at page 12!
So glad I read your reply before writing pretty much the same at length.
We need to consider how fortunate we are in having a health service that is free at the point of need. If we continue to request prescriptions for over the counter medicines which cost the NHS much more t than we have to pay, we can expect NHS services to be more and more starved of funds and have to wait longer and longer for cancer treatments, elective surgery etc etc. A prepayment certificate saves so much money that surely even those with a long term condition can do or bit by purchasing cheaper items ourselves instead of requesting them on prescription.
As you said, we were told about this quite some time ago. It really is time we appreciated how much we have and stopped pushing for more and more.
Have you tried Capsaicin gel for joint pain. My Rheumy nurse recommended it and my GP had to prescribe it! I found it works better that over the counter Voltarol. So of you ask for Capsaocin gel it has to be prescribed!
I get things like paracetamol on prescription... because I need it all the time at the moment and you can only buy two packs at a time when you are out shopping. So it’s a quantity thing for me.
My husband pays annually for prescriptions and always got his hayfever items with it. This year, he was told hayfever tablets would have to be purchased over the counter and yet his 85 year old mother still gets hers free. Unfair!
It’s not unfair!! The NHS can’t afford to go on prescribing items that are easily and relatively cheaply over the counter medicines which costs them much more than it costs us.
This unnecessary expenditure is why patients needing treatments for acute serious health conditions often end up waiting longer than necessary.
That is absolutely outrageous!!! I have a large tube of diclofenac gel( voltarol) prescribed every month as it makes a huge difference to my quality of life. Make an appointment with your GP andd ask for it on repeat prescription . Dont bother with receptionist/ prescription clerk. Failung that if you do buy it look on Amazon as it is cheaper there . Good luck xx
Hi, I used to work in a surgery a few years ago now. But while I was there a new rule was brought in for all GP surgeries by the NHS that because it’s a whole lot cheaper for patients to buy otc than what it costs the nhs by prescription, GPs were no longer allowed to prescribe pain relief gels, creams, majority of antihistamines, nasal sprays, etc. However, if you have a good GP they will sometimes be able to prescribe a similar generic product instead of the brand name as this is a much cheaper way. I think it all depends on what it is you’re asking for. I too have a pre-paid prescription card and I do still have to buy my antihistamines and nasal sprays otc. Also pain relief gels but I do have a good GP who prescribes things where she can. It’s all about cost cutting sadly.
Hi. I have similar problems with getting factor 50 Sun cream on prescription. They told me it’s not on the list wheh I asked my dermatologist once. But for people with Lupus Sun sensitivity or skin cancer (or both like me) , it’s as important as this pain relief gel and if you’re allergic to the cheaper brands too I think we should be exempt - in principle.
That said I’ve never asked for the gel because, hard up as I am, they know what’s wrong with me and know I need to smother factor 50 on my face and neck 3 times a day all year round but have never offered me this or paracetamol.
Well done for asking and I hope you succeed, particularly if money is too short for you now, as is the case more more and more of us since Covid.
However I think Helix’s point about costs is the reason I don’t push harder for my sun cream or Voltarol gel on prescription. I just feel there are so many long term conditions and where will it all end? I so want to keep the NHS functioning for all and not to be sold off to the private sector. So I feel that those who can possibly afford to stump up for their OTC meds just now probably should, even if they feel there’s a principle at stake for all with long term conditions.
The thing I worry about is just the unreasonable costs of these gels. They are about £10 per tube and the voltarol plasters are £20 for 5 where each one lasts 12 hours. If the costs were not so high then I wouldn't mind stumping up but when you have to make choices about going without pain relief it is not so much fun.
I do understand. I guess it’s just that I am getting eye drops, ointments, special toothpaste and laxatives on my repeats so I feel I can’t ask for Volterol gel and sun cream (mine costs me at least £10 per tube) as well.
However the practice pharmacist is always offering me drugs like Pregabalin (controlled) and Amitriptyline and worries that I’m on no prescription pain meds apart from occasional naproxen and paracetamol and Diazepam for muscle spasms relating to spinal arthritis. She can see from my diagnosed conditions that I’m living with pain.
I am going to start trying Volterol gel on my Morton’s Neuroma now as this is currently preventing me from walking far as I used to do. NHS podietry services seems to still not be active apart from for emergencies so it’s a case of DIY these days! If it helps you’ve inspired me to ask the pharmacist since I tolerate none of the meds she offers at all. A lot of the pain I live with is in my face so Volterol and Capsicum probably aren’t options.
I just spoke to the prescriptions pharmacist guy at my GP surgery and he said that the CCG controlling the budget for the surgery is getting stricter so they think they will not be able to prescribe me any of the pain relief gels. He said that he would check for me and call me later but he said 'it would be bad for both of us if I prescribed you it and then you couldn't get it anymore'.
I wouldn't mind so much if these gels were not around £10 a pop and I go through at least 2 tubes a month. The voltarol pain plasters are £20 for 5! ridiculous money for something that will last less than a full week.
If I were in your shoes I would talk with your doctor (the organ grinder) direct rather than the prescriptions pharmacist. He isn’t a doctor and doesn’t know what you’ve been through/are going through. He has no right to know that either. Pharmacists can deal with minor illnesses.
A prescriptions Pharmacist is still a Pharmacist. Good luck.
I get Fenbid Gel on prescription which is anti inflammatory gel but not Volterol patches. I don’t think it’s as good as Volterol though unfortunately x
Have you not got any other form of painkillers/anti inflammatories? If you’re having to use gel that regularly It might be worth talking to your doctor about your meds to see if you need something else. If the doctor has told you to use this gel then I don’t see why they are suggesting it if they won’t prescribe it. As others have said, they do prescribe the gel so is it just they used to prescribe it for you and now won’t or have you always bought it? It’s already been said that the cost is way higher to an already poor NHS than to you so I’d think about that too. I hope you find a solution.
They have prescribed fenbid before but not the voltarol/diclofenac gel. I am also on co-codamol but would rather use the gels than the co-codamols on the days where the pain is not as bad and is managable with the gel.
Before I even got to that he said 'I need to go and check and will call you back later today'. I am thinking of calling the practice manager and complaining
I no GPS started trying to keep costs down few years ago. That’s why you can’t over order your medication. I personally have never asked for pain killers because I can buy over counter. Also I buy Volterol and tiger balm.
I am sure it all depends on your surgery or even different doctors within the surgery as to who decides what people can get on prescription. My doctors always let me have pain relieving gel on prescription. As to getting paracetamol on prescription I would agree with people getting it over the counter, if they only take a small amount of them. In my case however, I take eight of them a day and that would mean having to keep going to a pharmacy ever day or so to buy more, so my GP prescribes them for me.
A couple of years ago a friend who is in a lot of pain told me about Matrifen pain patches that she wears. I asked one of the GPs at my surgery if I could try them and she told me that they were only for people who can't swallow. As the friend who told me about them and she can swallow perfectly well, I thought that was strange. However, I had an appointment with my rheumy the following week and asked him about it all. He said that he had never heard that said before and that he would write to my doctor suggesting that I could try it. A few weeks later, I was told there was a prescription waiting at the surgery for me, which was the pain patches.
So my suggestion is to keep on trying, ask a different doctor, ask you rheumy, go with some printed information about it. Try lots of ways to get it. I hope you succeed. I feel that these days, we all have to keep looking out for ourselves all the time.
Update : GP have just called and said they will prescribe the voltarol but like a total rookie I forgot to ask if they are giving me the 2.32 % stuff or weaker. At least we got somewhere in the end.
Edit: it is the 1.6 stuff as apparently that is the maximum dose they can prescribe.
I agree with you! I've had to try to convince my doctors to write a prior authorization to my insurance company (they didn't want to and act like I'm a pest). Then my insurance company finds a new excuse every time my doctor explains why I need it). Bottom line nobody cares- neither the doctor or insurance company. All anyone cares about is money.
Incidentally, I had an argument with a GP about pain relief a few months back. I asked for strong pain relief to help me sleep during a flare. I said I didn’t want it for regular use, just for desperate times and I can’t take codeine. I was told that the strong drugs were like the Ferraris of the pain relief world and with arthritis, all I needed was a Ford Fiesta so take 2 paracetamol 4 times s day and I would be fine. I made an appointment to see another GP in the practice a few days (and no sleep) later and asked the same thing. They prescribed tramadol to get me through bad nights. I won’t repeat what he though of the Ferrari/fiesta comment of his colleague..So don’t accept the first response. Ibuprofen gel works much better on my hands and feet than taking ibuprofen tablets, which kills my stomach. It’s a tried and tested treatment for inflammatory arthritis in the hands and also helps my osteoarthritis.
Sorry, I know this post is older but it came up on my feed when looking for advice. I think the issue is that they reckon it costs £60-80 for a doctor to write a script. There has to be admin and chemist fees and stuff, I would imagine but that iswhy lots are not keen on writing scripts for stuff that can be got over the counter relatively cheaply. Especially paracetamol and ibuprofen tabs. I would imagine the gel would depend on how much you need. Hope you got sorted.
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