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Information prescriptions, 28-day prescribing and the need for ‘one-stop-shop' healthcare services are among the issues being discussed by patients, carers and healthcare professionals with an interest in long-term conditions.
A consultation on the new Department of Health long term conditions strategy is open for comments from people and professionals with an interest in LTCs until June 15. Comments can be posted here.
The consultation aims to consider:
Among the issues raised by respondents:
Information prescriptions: "Better use of information prescriptions could be made. For many a medicine prescription is the holy grail, but information on their condition, and services which can support them in the long term can be equally if not more beneficial in managing their long-term condition. There are some excellent examples of information prescriptions available on nhs choices . I think this is an area where GP's or support staff within a GP practices could support patients more. Printing off the information with a charity helpline and some practical tips wouldn't take long or cost much, and can be a massive benefit to patients. As many people either do not have computers, internet or know how to use them effectively it is a useful consideration to have a computer within practices for patient use, which can be supported by staff. A practice could also consider a health library, where patients can borrow books/resources to find out more/to help them manage their condition or link with the local librarys [sic] to create such a service."
28-day prescribing: "All I need and want is to be able to get more than a month's supply of medication at a time. GP practice refuses to provide more, citing ‘policy'. I've been taking levothyroxine and asthma meds safely for 35+ years and will be taking them until I die. It is really tedious picking up pills/scrips 13 times a year (actually more like 15 because two/three times a year they can't supply what I need and I have to go back again) and surely can't be cost effective."
"It would certainly help, not having to pick up medication every month. 3 or 4 times a year, would make a difference."
"Yes, there is increasing dissatisfaction from those of us with long-term medical conditions who want to stay well, to maintain a reasonable quality of life, and just get on with things that, suddenly we're told we're ‘not safe' to have more than 28 days medication at any one time."
One-stop healthcare: "I need flexible access to appointments with a one stop approach so I can get on with my life and work, sadly I do not get it, even though many activities are at the GP practice."
Patients have also criticized inequitable prescription charges, and dealing with "power-hungry pharmacy assistants" when re-ordering medicines and organising delivery.
DDA vice-chairman Dr Allan Tennant writes:
One-stop healthcare: Most patient healthcare is centered on the GP surgery, which is why dispensing patients are well aware that the best one stop shop is their dispensing practice. For non-dispensing patients, care has to include interaction with a pharmacy, where contact with the pharmacist may be infrequent, and sometimes may only comprise the physical act of collecting a medicine or opening the door to a deliveryman. The best place for a one stop shop is where the majority of care already takes place, with the pharmacist taking an increased clinical role and dispensers dispensing and doing the checking.
28-day prescribing: I have great sympathy with patients concerned about 28-day prescribing. However, the problem is even more complicated than portrayed above.
Patients can be prescribed combinations of packs of varying durations; 28, 30 and 35 days, plus PRN products , which can require reordering twice and, even, three times a months. In rural locations, this may involve a double-digit mile roundtrip. This could explain why some patients order everything every month, whether it is required or not, with the subsequent stockpiling and increased use of resources.
Unfortunately, prescribing frequency cannot be addressed without addressing the remuneration of dispensing contractors. Prescribing more infrequently than every 28 days will result in dispensing costs that are not covered by remuneration and purchase margins that do not cover the cost of dispensing. In other words, prescribe more infrequently, and you will dispense at a loss.
Information prescriptions: the suggestions are excellent. However, I would caution on adding further process into the already crowded consultation.