Prescriptions OT ish

I think what gets uploaded to NHS Spine by the GP is an authorisation for e.g. 12 months for your particular dose of each medication to be dispensed at a given frequency (28,56 or 84 days).

Your chemist will pull drugs down against that record, no doubt they prefer doing it electronically to ease the admin.

OK Andy. That makes some sense. Seems to assume the patient is wise enough to stop taking the pills at some unspecified time. There used to be a *review by* note on my prescription which was eventually 4 years old!

Not here it isn't, My GP is the final arbiter of prescribing, even if its been recommended by a hospital consultant.

I don't use online or a chemist because the GP has a dispensary, and is a mile down the hill...

..I am responsible for re-ordering by ticking boxes on the 'next prescription' form, and the cocktail gets a phone call from a pharmacist to review every 6 months. along with an annual lung function test and various blood test at various times throughout the year.

I take about 9 pills a day plus other items on an irregular basis

You should be in touch with at least a pharmacist. at least annually

When you say the prescription form is blank, I assume you mean in the "medications to be dispensed" section, but your name and address is on the form. Has the form also been signed by a doctor at your GP practice? See 6.2 at

In general, the pharmacist will receive a message (internal NHS email) from the prescribing doctor. That will tell the pharmacist to dispense whatever medicines the doctor has prescribed. The doctor will have received the request from you online from a private company like Vision on Line or via the NHS app. As what you can request is limited to what VoL or the NHS app has on their "medications" page, all the prescribing doctor has to do is check that you can still get the medicines without a review.

It is also possible that - as Andy has intimated - you will have been given a "batch" prescription for a year to be dispensed monthly or whatever. All you have to do is inform the pharmacist that you want that prescription dispensed. That can be done in person at the pharmacy, by phone to the pharmacy, or in some cases by email to the pharmacy. Once the year is up, the pharmacist will tell you that he can't supply it because the batch period has expired, and you will have to go back to the surgery to get the medicine(s) prescribed for another year.

That seems fully controlled.

My pills are all for long term issues so I suppose the only likely variation would be dosage.

I have come to sympathise with a poster who whinged about difficulty picking up individual pills. Minor moistening of the finger tips is a cure:-)

On my repeat prescriptions and at least once a year is a note stating that they will not be issued again without a review being undertaken. In my case it a blood test followed by a review of te results being undertaken by medical staff and signed off by doctor. My GP practice employs a full time pharmacist, not for dispensing drugs but for reviewing existing (repeat) prescriptions. In my experience and in my area blood test results are available for me to see on-line within a couple of days, including some basic review notes. My last routine review blood test showed that I had a deficiency in one area and this resulted in the practice pharmacist phoning me on my mobile with some advice and a follow up blood test.

The problem I have is one of my pills is it is only marginally larger than the size of a pin head and pressing them out of the package often causes them to fly off in a random direction.

As for wetting the finger tips I also take one pill that has a tenancy to dissolve immediately on contact with moisture. It is also very bitter. Failure to swallow it immediately with the first swallow of water leaves an horrible taste in my mouth for many minutes.

I am on 7 different medicaments by mouth and one self inject one. On having a prescription renewed, I was told I need to have a review by my GP. Only one drug was prescribed by the GP, all the others originated with the Renal specialist at the hospital. I see him at 3 monthly intervals

Always a problem with LSD microdots. We used to stick them to sellotape

I have that problem sometimes. Many pharmaceutical companies film-coat their tablets to avoid this problem, but with generic prescribing I often get tablets which are uncoated. All statins are bitter, and so it seems is Amlodipine.

I 3D printed a supply of pill cups. I use the same technique as with pet cats. Throw head back, tip pills in, swallow with gulp of coffee or water.

Similarly with my GP practice regarding a full-time pharmacist.

I’d been taken off a medication (because it was ’a very old medication’) with unfortunate but foreseeable consequences, which I notified the surgery about.

The pharmacist rang me to offer me an alternate medication, which I declined on the grounds that it was red-flagged by NIHCE because of an interaction with another medication I’m on. Don’t the medical professionals read a patients notes?

The second medication on offer had a 1 in 100 chance of giving me a fatal heart attack. I declined this one on the grounds that my father and brother died early of sudden fatal heart attacks. This information is in my patient notes.

The final one on offer carried a 1 in 10 chance of inducing a particular form of cancer, which happened to kill my mother. This is in my patient notes. I declined this medication, and when, doubtless frustrated that he couldn’t bamboozle me into taking what was on offer, he dismissively said ”But there’s a 9 in 10 chance you won’t get it”. I laughed and said something like ”Is that what you think is a persuasive response?” and the conversation ended there. I’m now back on my old-fashioned medication.

If I have a blood test in the morning, the results are in my surgery that afternoon, and I can access them online. This gives me a valuable heads-up on what they might want to follow up, so I can get my ducks lined up in order to reject whatever simplistic or dismissive approach they want to take to any apparent problems.

Oh, and they don’t seem to realise I can see my data online, including their notes. They really need to take a course in note-writing, including how to phrase things with some tact. When I told my chiropractor (who has consultant surgeons on her patient list) about one such note, she was absolutely appalled.

My most recent episode concerned a blood test, and I was contacted by a receptionist to make an appointment for a repeat in two months time, but with no explanation. Naturally, this made me look up my results, which showed abnormalities in three areas. It took a very short time to realise that these three areas each had three blood markers, but one was common to each area, and it was this that was over the top.

Some research and a chance remark by my better half pointed to a possible simple cause among a whole host of really unpleasant ones. An everyday dietary supplement was ordered, leaving me with seven weeks for it to take effect. After that time the repeat test showed the relevant marker was now well in the normal range. No-one from the surgery called to ask how I’d done it, just like when I got the statins hard-sell call but my own supplementation brought cholesterol levels down and well into the normal range.

All in all, I’m not impressed with the medical profession at primary level, even down to the displayed levels of reading, writing, and inter-personal skills.

I just use the GP practice SystmOnline computer system to request my monthly eye drops. I am on them for life, but try as a I might I cannot persuade them to let me have 3 months supply at a time.

Their argument is that they need to 'manage' what I am taking. My argument is that only the consultant or Optometrist at the eye hospital can do that, but it's like talking to a blank space.

Now the GP practice is trying to force people to use the NHS app but this is utterly useless. SystmOnline holds all my medical details back to when I was born. It's like an online version of the green manila folders that GPs use to have for everyone.

The NHS 'app' only seems to have an overview and almost no historical detail.

The problem is how variable it is. I am absolutely happy with my GP and local surgery. Its small enough for one to have some sort of personal relationship with the GPs and the local hospital is friendly, mostly competent. and puts all its reports online.

Do they always get it right? No. How could they? But you can check your medications online to see what they do as side effects. I don't know what the GP to patient ratio in your area is but here its around 1:2500. In towns it can be a lot higher.

I was at a practice in London/Essex some years back and needed to see a GP. It was dreadful. 10 minutes to state your case and get some pills, no interest in you whatsoever. Basically long enough to write a sick note and that was that.

And swallow the Sellotape as well?

Sometimes

Your experience and procedure appear to be very different from mine. I order a repeat prescription useing the NHS app, it is approved by a doctor and issued to the pharmacist. When I collect a copy of the prescription is included. At intervals, don't remember the last time, I am asked to complete an online form that essentially determines that my health is unaltered from the last time, and the prescription is renewed.