Stop cancelling my insulin!!!

Brunneria said:

My understanding is that surgeries are required to conduct medication reviews, and have penalties if they do not do so. I think they are also prevented from continuing the prescription if a review to too overdue.
Reviews are also necessary to check that the prescription is still appropriate, and not wasting NHS resources.

I know on the face of it, a T1 is always going to need insulin, but there is so much more to take into account. A medication review allows the surgery to see that how the patient is doing, and allows an assessment of the whole situation. It is an opportunity for the patient to make requests for changes, discuss issues (such as whether all those lancets are really necessary), and is a way for the surgery to 'prove' that they haven't just let a patient disappear for years with a potentially lethal medication with no monitoring at all. Remember, they are not always informed of every decision made by a consultant or clinic.

Reviews are built into the NICE guidelines

https://www.nice.org.uk/guidance/qs120/chapter/quality-statement-6-structured-medication-review

https://www.sps.nhs.uk/wp-content/u...CCG-Medication-Review-Practice-Guide-2014.pdf

https://ebpcooh.org.uk/get-your-medicines-reviewed/

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I agree that it’s very important to keep an eye on how patients are doing. The review is often a time to look at overall health, suggest approaches, keep up with new developments, change insulins, and all the stuff a good DSN or doctor will be keeping an eye on. In this instance though it seems very drastic to have denied a T1 their insulin. Without a little more background information it’s hard to comment on the absolute rights and wrongs of the case.
Personally I’d be relieved if any T1 related health niggles caused the DSN to want to see me to help resolve them.

pab99c said:

Hi thanks for the responses. This time around it’s because I was due to schedule my annual review and I hadn’t responded to their letter within 1 week. So they refused to allow any repeats to go through online until I phoned them for an appointment.

It feels like they occasionally withhold insulin as a technique to ensure I phone them.

Other times are just a mystery until I phone and complain and reorder.

It happens about once every 3 months or so.

P.

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Hi,

Yep, I appreciate your frustration. I tend to get a reminder crop up on the previous script?

I've been called into a back room of the chemist by the pharmacist to "tick boxes" regarding my knowledge on the use of the meds prescribed & all its associated paraphanalia.. It was quick & painless. Satisfied. I was on my way with the script.

Normally it's a disinterested & almost embarrassed to do it paperwork excersise by the GP.. Regarding a med review. Lol, they know it's a "no brainier" with the insulin & strips..

It's not just about insulin. All patients (whatever condition.) under go a periodical med review..
Off the top of my head, what if someone was repeatedly prescribed strong painkillers & had an addiction issue?
Some folk do slip through the net & receive inappropriate treatment.
It's part of making sure the right care is there...

kev-w said:

In my opinion as a long term T1 that's a load of rubbish as we're entitled to our meds as and when needed. Very poor advice from a mod

My advice would be to go to the surgery and demand the prescription for the meds you need and don't move till you get it, but then I go all militant when having to deal with systems.

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Whatever action one chooses to take. Also make sure your prescription charge excemption certificate is also up to date?
https://www.nhsbsa.nhs.uk/exemption-certificates/medical-exemption-certificates

Hi. I guess I'm lucky with my surgery. My DN approves my meds for another year when I see her for a review. This next review date appears on my script and enables me to call off my meds online with no one asking for a 'meds review'. My surgery receptionists are not teenagers and are very helpful with any issues. My local Lloyds is very supportive if there is any issue. I'm on the surgery PPG, which does not influence the service I get, but be aware that all surgeries are supposed to have PPGs and as a patient you can always raise surgery process issues with any member. At our PPG meetings we have the Practice manager and a retired surgery GP present so these is some communication going on. You can always complain to the Practice Manager and if that doesn't work the CCG may be able to sort them out.

My surgery changed their online repeat prescription system and all my stuff defaulted to "28 day supply". Luckily there is a space for notes when making an online request so I've pointed out the 28 days is incorrect.

My medication is set by the hospital not the GP. I have my reviews with the hospital too. If be furious if my GP tried to limit any of my supplies!

Tom.thomas61 said:

Mine is the same, they used to say I am using much more than another diabetic they have at there surgery....

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how annoying! The only issue I have like that is having to remember to reapply for my card saying I need free prescriptions - I mean it's not likely I'm going to stop needing insulin ever is it?!

I went to collect my prescription just before Xmas and was told by the pharmacist that I need to contact my surgery as the Fiasp I was collecting was the last one on my repeats.....Going to phone the GP surgery now, this could be an interesting call!!!!! Hope the receptionist is helpful

Well that went to plan.......receptionist said I need to see the Dr to review why I need insulin!!!!! Exact reply off me was "To live!"
She put me on hold and after a long wait she came back on and said I do not need to see the Dr as it will be sorted. I think I better put my repeat in early for next month!!!

Until there is some sort of Brexit strategy decided by UK government (by 29 March); you will need to plan for the worst (and hope for the best) and stock up as much as possible.

I had the same situation, but with my tee2 test strips..

rmz80 said:

Until there is some sort of Brexit strategy decided by UK government (by 29 March); you will need to plan for the worst (and hope for the best) and stock up as much as possible.

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If lots of people did that, there is more likely to be a shortage.
I agree with having some in reserve but that’s not just for Brexit: that’s for any potential shortage for example due to manufacturing problems, adverse weather conditions, fuel strike.
But let’s keep it in perspective and not cause a problem for those unable to plan ahead.

At my surgery I sign an exemption form for the annual review to confirm that I receive my checks elsewhere.
I have had problems when I was sent insulin in bottles rather than cartridges for my basal pen (pre Pump and with 3 small kids so hard to sort out the error). Tried to manage on bolus doses alone and ended up with ketoacidosis (2 hours of acute care plus overnight hospital stay was not a cheap mistake).
Generally though my GP surgery and pharmacist are great and help me out in an emergency.

I have been told by a GP that they are unable to prescribe different insulin for me. It takes a consultant at the hospital to authorise that. They are unable to suggest anything intelligent to help me in any way. I am intolerant of statins and have this recorded on my hospital notes, but the GP/practice nurse system seems unable to record this, so the same comment that I need statins is repeated every time I see them. Ace Inhibitors (the preferred treatment for raised BP in diabetics) caused me a stomach ulcer, but I am also told I should be taking them on every visit. GPs are not experienced in dealing with type 1 diabetics and their knowledge of type 1 is limited. Most admit to me that I have more knowledge than they do. A hospital clinic does my reviews.

I have recently met the latest practice nurse. The usual issues of statins and Ace-Inhibitors arose. She then told me I needed to book an appointment to have my eyes and feet checked,to which I responded that as this had already been done, she had the results available to her. She checked and found them. Her final comment was that she supposed I knew that as a diabetic, I needed to avoid all sugar and all fat at all costs. I left before I lost my patience and said what I thought. She is of no use to me.
I normally get one of the GPs to move my review date forward when I make an appointment for some non diabetes-related issue. They are quite happy to do this, as they have access to all my hospital test results and recent letters. A review with a practice nurse is a complete waste of time, both for her and for me.

I would consider removing my insulins from my repeatable list a personal attack. I do everything the surgery asks, but I expect to be treated as a responsible adult, not as a child. I too, would have sat in the surgery until the insulins I depend on were again made available to me.