IBS Network

Have you ever requested a trial of any prescription medication from your doctor(s) and been refused for no good reason?

If so, read the following article, by the chairman of NICE, published in this week's 'The Patients' Association' newsletter:

'Patients should be more pushy

The chairman of the National Institute of Health and Care Excellence (NICE) has called on patients to adopt an “American style” attitude to getting the drugs and treatment that they want.

Professor David Haslam has said that patients in the UK should be more assertive with their GP in requesting drugs that have been approved for use on the NHS by NICE. He would like to see a culture where patients are seen as “equal partners” with their doctors, with legal rights, saying that patients need to learn from Americans, who are more confident about entering into dialogue with their family doctors about their health and taking an active role in managing their health.

In an interview with The Daily Telegraph, he said: “When products have been approved for use on the NHS by NICE, patients have a legal right to those drugs - as long as they are clinically appropriate. The take-up should be much higher than it currently is." The rationing body is currently carrying out work to establish why so many patients are not being prescribed medications, despite being endorsed for use. Prof Haslam said: “Patients have a right under the NHS constitution to these therapies, so I really hope we can improve this.”

Professor Haslam adds that patients should educate themselves on their health conditions and tell their doctors if they believed they were missing out on potentially helpful treatment. “The fundamental point is it’s your body - and the more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor.” He said: “Americans tended to want to know more about their treatment than the British who tend to be much more ‘thank you doctor, I will take that’.”

Professor Haslam goes on to say that it is essential for the future of both the health service and the nation that patients understand their conditions, their treatments and work with their health advisors so they can have the best care. This does not mean that patients should issue orders or be confrontational, he said, but that they should be able to assert what they wanted, and only be refused drugs if there were good clinical reasons why the medication would not suit them.

Responding to Professor David Haslam’s call for patients to be more “pushy” with their GP’s, Katherine Murphy, Chief Executive of the Patients Association, said:

“Whilst we agree with Professor Haslam’s argument that patients need to start seeing themselves as ‘equal partners’ with their doctors and should be more confident when talking to their GPs, and welcome his acknowledgement of this approach, the NHS needs to do more to encourage and empower patients to do so.”

“The NHS Constitution is a tool that can allow patients to do so. In our report The NHS Constitution: Fact or Fiction we found that over two thirds of respondents have never heard of the NHS Constitution. In response to this survey, we developed a GP Checklist designed to promote the constitution and trialled it in 14 GP surgeries last year. The results showed that once patients knew about their rights under the constitution they grew in confidence and started asking their GP more questions about their treatment and care.”

“The NHS needs to do more to promote the NHS Constitution and the rights and responsibilities patients have towards their care if Professor Haslam’s comments are to be heeded.”

“We welcome the work being undertaken by NICE into why patients are not being prescribed the drugs endorsed by NICE. We hope the findings will improve better access and quality of care. Decisions about prescribing medication and treatments should be guided by the resulting benefits to patients and not by financial considerations.”'

5 Replies

Well I suppose it's the old doctor knows best thing which is certainly the mind set drilled into us when we were kids (now 67 ) in the meantime we have had an information revolution ,this site and access to it being a tiny part of that . So now we actually know how little medical science agrees on for many conditions and how much it is down to us ,the patient, to put two and two together and try and make four . If you can inform yourself about a condition you have and can spend far more time than your GP can researching it your voice becomes as valid as theres ,after all you live with it every day and ,as my GP admitted, can know far more about its particularities than they will . My view is that the average GP is as good as the average car mechanic at diagnostics and you really notice it when you meet someone ,in either profession ,who is above the average .If you are lucky enough to find one of either you stick to them like glue ! Cheers .


Fortunately, I've got a very good GP who treats all her patients as if they're both human and sentient, but there are so many people on here who just don't have that experience with their doctors. I'm not looking forward to moving to another part of the country later this year in case I get rubbish healthcare there.


Hello RozB and thanks for this post. The article you've posted is really interesting, especially when my own experiences, something that's often mirrored in others experiences, is that the dr knows best and ibs is all in our minds. Through the support of this site and others experiences, successes and research, I have felt more empowered to make choices that manage my symptoms. I feel much more in control, and this article further suggests that patients should have more control as equal partners. It's a shame that we have to be more pushy to be heard by gps, had I not found this site and read how others have successfully managed their symptoms, I'd never had felt confident in telling the dr that their approach didn't work and I was actively trialling my own solutions. For example, I was advised by the gp that the fodmap was a fad diet and would be more damaging to my health, yet following this was the best decision I've ever made. Having this endorsed by a health care expert makes me more confident that I have a right to be heard and taken seriously. So thanks for posting RozB!


So glad you've found some relief doing FODMAPs. I think it'll take a revolution though to improve the attitude of many GPs from what I read on here.


i do inquire. My neuro's very receptive.


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