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Campral and GP prescriptions

Posted , 6 users are following.

RHGB
RHGB

Well, in about a week's time I should have the definitive answer on this one.

I've sent an email to the GMC asking if a GP is allowed to prescribe acamprosate or is it against GMC rules.

I didn't name names, I only signed the email off with my last name, which is the most common surname in Britain.

I gave them a bit of history, about me, about Adddaction and the state my liver is in and how my GP has said they can't prescribe, go back to Addaction. They can't say I didn't give it ago first time around as I spoke to their clinical direct at head office.

So, we will know once and for all, whether we have to go private, or we can shove a bit of paper infront of the GP's nose and see what he has to say to that.

2 likes, 30 replies

30 Replies

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  • RHGB
    RHGB

    Posted

    Well, I had my reply from the GMC, which didn't tell me much.

    "Thank you for your email regarding your recent experience and issues obtaining a prescription.

    I can appreciate that this must be a difficult time for you. However, I am afraid I cannot help you, as the matter you raise falls outside our jurisdiction.

    It might help if I explain that the GMC is the statutory regulatory body for medical doctors in the UK. Our responsibilities include setting standards for medical education, granting registration with a licence to practise to suitably qualified people, promoting good medical practice, and taking appropriate action where doubts arise about a doctor's fitness to practise.

    You may wish to contact PALS, the Patient Advice and Liaison Service, or NICE for further assistance.

    I am sorry that we cannot help at this time."

    So I sent one back, saying I didn't want to bounce around departments, who did she suggest would be the best person to speak to. And I got this reply from a senior contact advisor.

    "Dear Sir / Madam

    Thank you for your email.

    You may wish to contact NICE who will be able to assist you further.

    If you would like to discuss this further, please reply to my email or call me on the number below."

    I'm going to call him later today, as I think a phonecall will get to the root of the problem and who to speak to the quickest. Meanwhile I have sent an email to the Coventry and Warwickshire (my county) Area Prescribing Committee:

    'Dear Sir or Madam,

    Is the CWAPC responsible for deciding which drugs/medications GPs can prescribe directly to a patient without referral to an outside partnership such as Addaction?

    If so, can you give me an email address of someone (not a general address, a specific person that I may communicate with) directly responsible for setting these guidelines, as there are some serious shortcomings.

    Yours faithfully'

    Somewhere, somehow, I'm going to find out who is responsible for this and give them a good shake. I have all the reasons documented, and the help that I was not offered. I am going to give Addaction (different branch) another go, this time it is for the Campral not diazepam, half expecting them to fail, but that will just be another nail in the coffin, as I will document it all. Of course that is why I have bought my own Campril, should I need a back up plan.

    I will update the thread as and when I have new information.

    • Joanna-SMUKLtd
      Joanna-SMUKLtd RHGB

      Posted

      I don't expect NICE will be able to help you with this one, as they make their decisions on what medications should be provided on the NHS.

      The NHS have a legal responsibility to assess you for any medications that NICE approve, but how that is done is a matter for each individual area prescribing committee.

      So, yes I believe getting a contact at the CWAPC is the next step for you.

      In addition, all the pathways (procedures) that are set in place by the CWAPC are supposed to be used as guidelines - in the sense that doctors who have experience in alcohol addictions could, if they wish, prescribe any NICE approved medication if they are willing to take on the responsibility for doing so, which obviously includes any providing any additional proceedures that NICE recommends.

       

    • RHGB
      RHGB Joanna-SMUKLtd

      Posted

      Yes,I didn't think it would be NICE, as they are a national organisation and this is a regional problem (plus down to the individual GP). But I don't think it will do any harm if the senior help guy at the GMC has offered to let me call him directly, he might have some good pointers.

      From a personal point of view, I could ask my GP to do a referral back to my hepatologist at Warwick hospital, and the fact that I went jaundiced, had hepatic failure and ascities with 10 litres drained from me, would probably get the boxes ticked by him as a specialist.

      But I want to try and sort this out for everybody, not just look after myself.

  • vickylou
    vickylou RHGB

    Posted

    RHGB

    i hope you've not been using naughty words again!!

    Seriously though, I hope you get the answers to the questions you've asked. You must get ten out of ten for your persistence and determination.

    Look forward to reading how things develop.

    • RHGB
      RHGB vickylou

      Posted

      There were no profanities, no links, and nothing in the second one that could in anyway be misconstrued as in need of moderation, hence my test message to see if all my messages were being sent to moderation.
    • vickylou
      vickylou RHGB

      Posted

      That seems very strange indeed! Can you request a reason from the mods?
  • RHGB
    RHGB

    Posted

    Well, the first batch of 180 tablets of acamprosate turned up today. Time to book an appointment with the doctor, to see if there are any tests they want to run on me first, LFT, renal etc - erm... but also just for the badness of waving it in her face and saying no, I have been nowhere near Addaction and no, I am not telling you where I got them from, but it wasn't from down the loacal market.

    The other lot should be here anyday now, aswell. I can see this is going to be an interesting visit, especially when I ask for a referral to the hepatologist. Never fallen out with any of my doctors previously, but I feel that is about to change. But that's what happens when you hang someone out to dry and leave them at the mercy of Addaction.

  • RHGB
    RHGB

    Posted

    Well I got a reply back from the area prescribing committee today and I will follow it up tomorrow as the guy sounds very helpful. But here was the important part of the email.

    'The decisions around what is included in the guidance and the rating, green, amber or red, is made by the committee as a whole which has representation from across the health organisations in Coventry and Warwickshire including the Coventry and Warwickshire Partnership Trust.

     

    The APC guidance is however advisory and individual medical practitioners can prescribe any medicine available to the NHS as appropriate to the patient needs after clinical assessment.'

    What my GP said.

    'This is out of our area of expertise and it is important that this is done in the most effective way possible. Despite your troubles with them, the Recovery Partnership do have the relevant expertise and we don’t; these drugs work better with supervision and expertise. I am sure they will have taken your previous comments into consideration. I would recommend engaging with them for consideration of acamprosate.'

    I wrote a review of The Recovery Partnertship on NHS Choices, but I am not allowed to post a direct link, if you Google the following 'nhs choices recovery partnership leamington spa'

    Or if you PM me, I can give you a direct link.

    • Joanna-SMUKLtd
      Joanna-SMUKLtd RHGB

      Posted

      Thanks for this, RHGB.  I knew I had read it somewhere about it being guidance and that GP's who are confident in AUD could prescribe any approved medicine if they so wished!

       

  • vickylou
    vickylou RHGB

    Posted

    RHGB

    if I've read this correctly, at the end of the day provided you meet the necessary criteria, your GP could prescribe campral for you?

    When I was prescribed campral, there was no one else involved, I wasn't

    receiving counselling or seeing any third party. It was just my GP.

    Pleased to hear your first lot of medication has arrived, and as I've said previously, I admire the lengths you have gone to in order to get campral.

    look forward to hearing the outcome and response from your GP!

    • RHGB
      RHGB vickylou

      Posted

      My GP has outright said no. Now that I have had an email from the area prescribing committee, telling me that it is advisory only and my GP can take it on (prescribing) directly, they are quite able to do so, my GP has changed their answer from 'can not' to 'will not', because they don't have the relevant experience.

      I have literally just sent an email to the APC guy, because he seems to be very helpful (I didn't publish his whole letter on the forum, 'cause I'm always getting modded).

      I am just about to send an email to the clinical director of Addaction and see if he wants to arrange an appointment for me with another local branch, and that they will prescribe acamprosate immediately, because it is meant to be given as soon as you have detoxed, which is almost three weeks ago for me.

      I am not expecting a positive outcome, but I must be seen to have explored all avenues, before I can start the complaint process.

    • vickylou
      vickylou RHGB

      Posted

      The positive from this dreadful situation you're in, is that no one could ever doubt your determination and commitment in remaining sober.

       You should feel very proud of yourself in not drinking during such a vulnerable time. As you say, campral should have been prescribed for you immediately following your detox. The fact that neither addaction or your GP have done this is dreadful. Very few people, if any, wouldn't have been able to cope with this and would have started drinking again.

      You have certainly explored all avenues, to the extent that you have purchased the medication yourself.

      Good luck and well done.

    • RHGB
      RHGB vickylou

      Posted

      I haven't started the Campral yet, it is sitting on the table right next to me. I was hoping that the GP would at least have said, come in and run some tests on you (the usual LFT, kidneys etc.)  prior to me starting on them, but no. I have asked for a referral to my hepatologist, to which they have said they will do, just in case he has anymore common sense than my GP.

      But, in the next day or so, I will start on the Campral. I know every medication affects others in different ways and I am taking other medications that you are not. But are there are there any side effects that I should expect, whether just for the first few days or continuously whilst taking them.

      I have of course read all the NHS pages on possible side effects, but I find first hand experience is the best.

  • vickylou
    vickylou RHGB

    Posted

    Hi

    Your saga gets worse by the day! The only test I had prior to starting campral was an LFT.

    Hand on heart, I can honestly say I had no side effects. I do suffer from bad indigestion and don't have a good diet.  However I'm sure you're supposed to take two tablets after food. After a week I saw my GP who quizzed me about my diet and stressed how important it was to take them after food.

    I'd be very interested in following your epic journey and also how you feel after starting them.

    I had a quick look in the latest BNF book and there doesn't seem to be any contra-indications about taking other medications.

    Each day, a step nearer to actually taking the tablets you should have been given a month ago

  • RHGB
    RHGB

    Posted

    Well, my other packet of Campral just turned up. Tomorrow I'm going to take all my medication, that means my 8 daily prescribed meds with me. If the meeting starts to get bogged down, weeks of therapy needed before medication blah blah, I shall put them on the counter and explain what they do, like one to stop ascites, one for congestive heart failure, one for hepatic encephalopathy, one for blood pressure, one for esophageal varices, plus the usual thiamine, vitamin B compound strong and folic acid.

    If that doesn't get their attention, it didn't last time. I shall pull out a packet of diazepam and nearly three hundred tablets of Campral and say, 'it's a good thing I made provisions for circumstances like this'.

    I will look at her face not what she says, it's a great trick, it tells you a lot more about their thought process than actually listening to them - the brain will pick that up, but just dealy it for a couple of seconds, but it just gives you a few seconds to take in what they're thinking before you hear what they say.

    She will probably ask where the hell I got all of them, and I will say, they were all prescribed, except for the Campral, which was obtained legally and is not a controlled substance like diazepam. And, if you write me a prescription or a letter to take to my GP, for Campral, I won't have to use the imported ones, but if you say no, or 8 - 12 weeks, you will leave me with no choice.

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