Agenda item

John Nicholls - Prescribing Advisor Northampton East & South


Working for NENE CCG – work within medicines management team.


We make recommendations to doctors and work closely with hospitals. Implement national guidelines, we also deal with over the counter medicines.


TM: have issues when collecting prescriptions from the chemist. If people live far away and are on a repeat prescription, this is a very time consuming for both the patient and the surgery.


JN: This relates to the changes, the basis is other CCG’s around the country, they changed the way that people get their prescriptions. Implemented through the surgery rather than the pharmacy. This was put in place so the patients could review the medication they’ve got at home. It also helps to specify what the person needs, rather than just all items again, yes or no. Each practice does operate a bit different, but there is an option to look at an exemption for certain cases.


BO: Yes, mine is very local but one size doesn’t fit all.


BO: Is it that a repeat prescription is not now automatic and that is now done on request.

JN: Yes that is happening around the county.


TM: What is the policy for diabetes prescription? I still have to use and pay for test strips and other medication even though I am technically not diabetic as I am not allowed them on prescription to manage the condition.


BN: On set prescriptions, there is a note to say that there is a review, I’ve never been contacted by the practice for this review, are they obligated to contact me to remind me?

JN: May say you can have 6 or 12 prescriptions of that before review or certain medication you may not need a review as they can keep track through visits etc.


NS: Sign came up saying that we will not prescribe items you can buy, does this apply to pensioners.

JN: We don’t make any exemptions on age, it is purely based on if this a long or short term condition, no matter the age. It just depends if you use this regularly over a long time, rather than just a short term issue.


AT: Had friend who needed medication but chemist said she was over the age limit, told to visit the doctor who said it would be cheaper to buy from the chemist than prescribe?


Looked at 35 conditions, anticipated where people would get their medicines from a pharmacy rather than see a doctor or nurse. The main focus on this was to reduce demand on doctor’s surgeries, it would encourage them to see the pharmacist instead.


If the ailment is short term, the intent of the guidance is to reduce unnecessary appointments.

COA: medication I used to have caused me pain, so I was prescribed something else, after using it I saw that it shouldn’t be used over 70 and I am over 80.


JN: There is support for the GP’s where there are notifications and steps in place to help this succeed. Obviously in this incident you have been let down.


BO: After x ray, been told I can have a gel prescribed, but was told by the practitioner that Voltarol is the best but it has to be paid for. Why is that?

JN: That wouldn’t be my interpretation of the guidance, the original gel should be trialled first and then if this isn’t successful, then the Voltarol should be used.


BO: When you take your repeat prescriptions into the doctors, is there a time limit?

JN: Generally it should be 2/3 days unless it is the weekend, but then the pharmacy once received have their own amount of days it takes to process this.

BO: I find that the doctors deal with it pretty quick but the chemist is the one that takes the time.


JN: I used to work in community pharmacies across the town. People used to walk in with a prescription and get it then and there. With electronic this is different, they have to pull the information down and they cannot do that until you come in and request and authorise that.


NS: If you go into the supermarket it’s cheaper than in a normal pharmacy.


TM: 28 tablets, soluble aspirin for £8.80 prescription or less than £2 at the pharmacy.

JN: cost of actual drug isn’t related to the prescription charge, in the tariff, some items may cost £1 or £15 but would still be charged at £9 prescription rate.


NS: It seems that the paper prescriptions are dealt with before the electronic prescriptions.