Repeat Prescriptions

You can request medication that you have had from us previously and that has been agreed as a repeat drug via a number of means:

• Order via the NHS APP.  This can be done 24/7
• By contacting reception by telephone on the main contact number
• By visiting us in person during normal opening hours

Allow 48 hours (week day) – though we aim for 24 hours.

If you have never had the medication from us previously or the medication is 12 months old or was only intended for one off use, you may need to make an appointment with one of our clinical team.

Medication Reviews

Patients on repeat medication will be asked to see a member of our clinical team at least once a year to review these regular medications. Please ensure that you book an appropriate appointment to avoid unnecessary delays to further prescriptions.

ADHD

The following information is for patients with an established diagnosis of ADHD and who have already been started and stabilised on ADHD medication. Patients who are concerned that they may have ADHD, (but do not have an established diagnosis) should contact reception for further information and receive the detailed practice ADHD pack.

ADHD medication is a controlled drug which can only be prescribed in primary care under shared care (which means you need to remain under the care of a UK specialist).

Your previous specialist is responsible for providing medication until you have been accepted onto shared care in Nottingham, even if your GP was previously issuing this medication. Please therefore ensure you have an adequate supply of your medication. This is especially important when you are coming to the UK from abroad.

As a practice we do not share care with private providers but will arrange for requests to share care are sent to the local specialist NHS team at Nottinghamshire Neurodevelopmental Specialist Service (NeSS). More information can be found here: Shared Care Information for Patients

Prescriptions Charges and Exemptions

Extensive exemption and remission arrangements protect those likely to have difficulty in paying charges (NHS prescription and dental charges, optical and hospital travel costs).

The NHS prescription charge is a flat-rate amount charged per item.  Prescription prepayment certificates (PPCs) offer real savings for people who need extensive medication.

There is further information about prescription exemptions and fees on the NHS website

Prescribing Policy For Patients Travelling Abroad

By law, the NHS ceases to have responsibility for the medical care of patients when they leave the UK.  In addition GPs are able to provide prescriptions for the treatment of a condition that is not present and may arise while the patient is abroad.

The NHS does accept responsibility for supplying ongoing medication for temporary periods abroad of up to 3 months. However, if a person is going to be abroad for more than 3 months, then they are only entitled (at NHS expense) to a sufficient supply of regular medication in order to get to their destination, where they should the find an alternative supply of that medication.

Patients residing abroad for a period of more than 3 months are legally required to be removed from the practice list.

They will also be removed from our patient list. We will be pleased to re-register patients on their return to residence in the UK and can reassure patient that their electronic notes are kept on file for reference on your return.

Patients and relatives should not seek medication for themselves while they are abroad as this constitutes NHS fraud.

Private Healthcare Requests

We understand that some people will chose to access health care privately, which is a choice you are entitled to make. However there are a few things that you need to be aware of before making this decision.

NHS guidance states:

Patients can pay for additional private healthcare while continuing to receive care from the NHS.

However, in order to ensure that there is no risk of the NHS subsidising private care:

• It should always be clear whether an individual procedure or treatment is privately funded or NHS funded.
• Private and NHS care should be kept as clearly separate as possible.
• The patient should bear the full costs of any private services. NHS resources should never be used to subsidise the use of private care.
• The arrangements put in place to deliver additional private care should be designed to ensure as clear a separation as possible of funding, legal status, liability and accountability between NHS care and any private care that a patient receives

Organising tests requested by private providers

Sometimes we receive requests from private providers to arrange tests or investigations, for patients that they have seen privately. We appreciate that this may be to save you the cost of these investigations, however complying with this request is outside the scope of NHS general practice work and NHS guidance above.

Our NHS guidance states that a GP practice should only carry out investigations and prescribe medication for a patient where the GP is the responsible doctor and it is necessary for the care of the patient. This means that the GP has had the full consultation with the patient themselves and has agreed, with the patient, the investigations that are needed.

The reason for this is to ensure it falls within the scope of NHS general practice and also to ensure we have the knowledge, resource or capacity to be able to perform these tests on behalf of private providers. When we get these requests will advise you and the private provider that these services do not fall within NHS primary medical services and suggest they make alternative arrangements to get the investigations done.

Prescribing medication requested by a private provider

GMC Good Medical Practice states that doctors in the NHS and private sector should “prescribe drugs or treatment, including repeat prescriptions, only when they have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs.”

If a private consultant requests that a GP starts or continues to prescribe medications, and if the GP agrees with this advice, then this could be appropriate.

However, if the practice does not feel competent to prescribe the requested medication, or they do not know if the medication best serves the patient’s need, the GP should inform the private provider that the prescriptions should be provided by a specialist. This is also true for off licence recommendations for medications, which is where medications are being suggested to be used outside of their product licence.

Referring to an NHS service following a private consultation

Sometimes, after a private consultation, the private specialist may suggest that you are referred to an NHS service.

Please note that private providers can make referrals to NHS services, without referral back to the GP, provided the patient would be eligible for NHS referral. Any patients referred should be treated based on clinical need. Read NHS England guidance around consultant-to-consultant referrals within the NHS.  GPSC_Working_better_together_0323.pdf  If we receive private requests for referral to an NHS service, we will kindly ask the private provider to make the referral themselves.

“Shared Care” with private providers

Sometimes the care of a patient is shared between two doctors, usually a GP and a specialist, and there is a formalised written ‘shared care agreement’ setting out the position of each, to which both parties have willingly agreed. Where these arrangements are in place, GP providers can arrange the prescriptions and appropriate investigations, and the results are fully dealt with by clinicians with the necessary competence under the shared care arrangement.

All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds. The responsibility for the patient’s care and ongoing prescribing then remains the responsibility of the private provider.