new mater hospital policy

horse7

I have been informed by the rheumatology dept in the mater public hospital that they no longer issue repeat prescriptions by post. As you know scripts are only 6 months max in length,and patients do not get hospital appointments within this period to get another script. Normally one could phone the hospital dept and request a script,which would be posted out. But now the hospital want you to go to your gp to get your script ,even though the hospital will send a script for high tec meds which the gp can not prescribe, the hospital are saying, spend another 60euro on your gp because we do not want to write a prescription for what we are treating you for . Can anyone understand this . I am only 30 years attending this hospital and this is a new low.

palmcut

horse7 wrote: »

I have been informed by the rheumatology dept in the mater public hospital that they no longer issue repeat prescriptions by post. As you know scripts are only 6 months max in length,and patients do not get hospital appointments within this period to get another script. Normally one could phone the hospital dept and request a script,which would be posted out. But now the hospital want you to go to your gp to get your script ,even though the hospital will send a script for high tec meds which the gp can not prescribe, the hospital are saying, spend another 60euro on your gp because we do not want to write a prescription for what we are treating you for . Can anyone understand this . I am only 30 years attending this hospital and this is a new low.

Your GP can write a script for High Tech meds once the initial prescription has been issued by a consultant.

It would be irresponsible of a hospital doctor to issue a script for a patient that she/he has not seen for over 6 months.

Your GP can decide if you need to repeat the medication. A medical review every 6 months is a sensible thing to do.

Your real beef appears to be the 60 euro charge to see a doctor. The charge is not unreasonable.

horse7

The beef as you call it is you can not get an appointment within the expiry date of the prescription,and a gp can not prescribe high tec meds. As regards the gp visit fee, i have been paying the full monthly fee for a lifetime,and yes i may not be able to pay for a gp visit and will need to be hospitalised. Do you have any long term hospital experience yourself?

locum-motion

horse7 wrote: »

... a gp can not prescribe high tec meds...

INcorrect. A GP CAN issue a High Tech prescription.
The treatment should be INITIATED by a Consultant, but it can be continued by a GP/

echo beach

The OP says the Mater will continue to post out scripts for Hi-Tech meds, the ones that require close monitoring by a team of healthcare professionals, but will insist you see your GP to get a new prescription for other drugs. That simply doesn't make sense.
This policy has nothing to do with patient care. If they cared about the patients they would schedule appointments as required, but not longer than six months apart to comply with the legal requirements for prescribing prescription only medicines, requirements that have been put in place to ensure patient safety. Insisting on a trip to your GP, or more likely a phone call to their receptionist, is complying with the letter of the law while ignoring the spirit of the law, the reason it exists.

Gael23

locum-motion is correct here.
Once you have been initially prescribed high tech drugs by a Consultant, your GP can continue your treatment on it.

horse7

Not according to the mater rheumatoid dept, hum era only scripted by consultant, Where are you getting your facts from. I suppose it would be wonderful if gp,s could be used for all treatments. The hospitals would run much smoother. There would be no need for outpatient deptments.

his_dudeness

echo beach wrote: »

.This policy has nothing to do with patient care. If they cared about the patients they would schedule appointments as required, but not longer than six months apart to comply with the legal requirements for prescribing prescription only medicines, requirements that have been put in place to ensure patient safety.

Scheduling visits just to comply with legislation is not the proper way appointments should be scheduled. Appointments should, and usually are, scheduled on the basis on medical need. If you don't need to be seen for a year, then you don't need an appointment any sooner, no?

echo beach

his_dudeness wrote: »

If you don't need to be seen for a year, then you don't need an appointment any sooner, no?

If you are taking medication the drugs have been tested and licensed on the basis that their effect will be reviewed regularly at least every six months. That is the condition under which they are prescribed.
How often you need to be seen is a clinical decision for your doctor but medical conditions, even apparently stable ones, can change suddenly or very gradually. What may happen is unpredictable. There has to be a balance between seeing patients too often or not enough. Six months, like any other interval, is arbitrary but works well in practice. Many condition have seasonal variations so an annual review may not be ideal.

angeldelight

horse7 wrote: »

Not according to the mater rheumatoid dept, hum era only scripted by consultant, Where are you getting your facts from. I suppose it would be wonderful if gp,s could be used for all treatments. The hospitals would run much smoother. There would be no need for outpatient deptments.

As stated above, High Tech drugs eg Humira must be initiated and prescribed by a consultant in the first instance. Thereafter repeat prescriptions for high tech drugs can be written by a GP.

Where am I getting my facts from? I'm a pharmacist, as are some of the other people above who have answered your query

Gael23

I have a Dermatology condition and am currently at a sort of crossroads with my treatment. My GP does however have an interest in Dermatology and one day I was in with him I was talking about different treatments that I could use. He did say that he wouldn't prescribe certain things without a Consultants advice. But, as a medical card holder I only get a 3 month prescription so its not realistic for me to have to see a Dermatologist on each occasion.
If he does change my medication, he will say to my GP I have put this Patient on xxx and thats it sorted.

echo beach

angeldelight wrote: »

As stated above, High Tech drugs eg Humira must be initiated and prescribed by a consultant in the first instance. Thereafter repeat prescriptions for high tech drugs can be written by a GP.

Angel is correct, however because a GP CAN write a repeat prescription for a high tech drug they doesn't mean they HAVE to and many will rightly refuse to prescribe a drug they aren't familiar with and don't have access to the facilities (blood test, scans, etc.) to monitor correctly.

In an ideal world the GP and the consultant and specialised nurses who may be qualified to prescribe would work together with other healthcare professionals in a multi-disciplinary team and communicate regularly to provide 'seamless care' to the patient. I don't know of any cases where this happens in Ireland but would love to know if these teams exist outside of the imagination of some HSE official.

locum-motion

horse7 wrote: »

...Where are you getting your facts from...

I'm not sure if this is aimed at me, but...

Would you consider my 18 years as a pharmacist to be a sufficiently robust source?

locum-motion

his_dudeness wrote: »

... If you don't need to be seen for a year, then you don't need an appointment any sooner, no?

1. How soon the consultant wants to see you again is a matter for him to decide based on his clinical assessment of your medical need for that condition.
2. It would be good practice for the GP to give you a check up regularly for any other conditions, and also to keep a second eye on the condition for which you are seeing the consultant (especially if the consultant isn't going to see you for quite a while).
3. The law says that there is no such thing as a prescription that is valid for more than six months from the date it was written.

The reason for 3. is to facilitate 2.

horse7

Thank you echo beach,someone seems to understand the growing problems in the hospitals today,and it does not help when this particular dept has no registrar plus the consultant is on holidays.