An MP requests help

[Andrew MacLean]

Per your visit to the bracing air of Glasgow has done you the world of good. You seem much more belligerent than I remember! You are becoming a Scot! (or maybe your visit to the kindred shores of Scotland has ust stirred the Viking in you!)

Andrew

[Lynn White]

The thing about Moorfields is its a specialist dedicated eye hospital and as such has obviously made decisions about solution supply. Around the country, you may be visiting a department within a general hospital and the priorities are somewhat different. Each hospital trust can arrange its finances the way it wants to. I would be intersted if anyone else has solutions paid for at other hospitals?

I assume Moorfields will supply solutions for other eye conditions as well as KC, so this is not actually a recognition of KC as needing specific supply - there IS a difference!

Per, your description of attitude towards KC after graft is so interesting! This is why whatever changes are made, it has to be with full knowledge of the condition.

Lynn

[Andrew MacLean]

Lynn

That is exactly what Rosemary was saying: the service you get depends on the place you live. a.k.a. Post Code Lottery

Politicians speak about the Health Service as if it was 'National' and then they organize it to be regional or even local.

Andrew

[chrism]

Ciba Vision Clear Care (For my softperm + soft lens)
Boston Simplicity Plus (For my piggy back RGP)
Saline (I'm not picky)
Genteal (Moderate) (1st choice)
Refresh Tears (2nd choice)
Systane (3rd choice)
Refresh PM/Lacralube (occationally)

[Ali Akay]

I can just about remember the days when hard lens solutions like Contactasol and Contactasoak used to be on the medicines list and hence freely prescribed by GPs.Then they were removed I think about the time when a lot of restructuring took place in the NHS and NHS glasses scrapped and replaced with the voucher system.BUT, the arrangements brought in for supply of contact lenses by HES made provisions for hospitals to supply the necessary cleaning solutions as part of the ongoing care of the patient. I probably got the original paperwork somewhere if it will help. In other words,hospitals supplying contact lenses are already obliged by law to supply the solution as well. The pharmacies at the hospitals I attend stock a limited range of solutions and it works fairly well.Although they are only supposed to dispense 28 days supply, there is an unwritten rule of issuing 3 months supply.If I have a patient returning every 6 months I am allowed to issue a post dated prescription which the patient can bring to the hospital pharmacy in 3 months time.I believe the reason someone was issued only 1 month's supply of Celluvisc at MEH is that it's already on the medicines list and can be supplied by GPs unlike CL solutions.

It'll obviously be much better if solutions could be put back on the medicines list but it won't be easy.The Alcon rep tells me that the reason systane isnt available on prescription is to do with licensing ie it is not a "Pharmacy Medicine" and Alcon havent tried to license it as a "P" medicine due to cost of licensing.I may be wrong but this was the explanation given.As no CL solution has "P" classification it may not be possible to have them on the medicines list. We probably need to get professional advice on this.

It's obvious that not all hospitals are issuing solutions at present and this is certainly something that should be tackled as the rules are already in force for this.It's quite possible that the eye clinic or pharmacy staff arent aware of it, especially in smaller clinics. Getting GPs to prescribe them would be a bigger hurdle and the current NHS funding crisis won't help unfortunately.



It would be much better

[Christine Wright]

You're right, solutions should be available on prescription to people who are getting NHS lenses in hospital (ie medically necessary), but they have to be obtained from the hospital Pharmacy.
This is certainly the case at Birmingham & Midland Eye Hospital, Heart of England and Solihull.At Solihull, I find that people who are exempt from prescription charges use this system (understandably!) but those who have to pay prescription charges find there's no advantage - and usually opt for the convenience of buying the solutions elsewhere.
There are certainly some hospitals who don't do this, and this may be where this group could put pressure on them to meet their obligations. It would be great if Ali could find the paperwork to back this up - I've never seen it, I've just heard it verbally from our representatives in London

[Lynn White]

Ali...

Thanks for that, as I was wondering what other hospitals did. I think this is something that has slipped through various nets, as many of my patients whose contacts were/are supplied by hospitals were not aware of this.

I really do not blame companies for not applying for licences as the cost of doing so with the accompanying research requirements to prove efficacy etc is not worth it.

As you say, trying to get solutions on the P list is going to be hard work so really initially, hospitals should be made aware of their current responsibilities. However, this still does not cover KC patients who are not under hospital supervision for their contacts. I can imagine the nightmare if they were all referred back to the HES!! And in fact it is plainly not equitable if patients who make arrangements for contact lens supply through a private practitioner with an HES form then lose out on solution supply.

It is clear from replies here that even at Moorfields, some patients get their solutions through the NHS and other have no idea its even possible. Hopefully this thread will at least start to address some of these inequalities!

Lynn

[Andrew MacLean]

In Edlinburgh they have no hospital clinic, but the hospital contracts a priovate optometrist to provide these services on the NHS so that the patient pays only for lenses AS IF they had been presecribed and dispensed by a hospital.

Are those patients in the same position, in relation to the supply of solutions, as patients who are sen by an in-house contact lens clinic?

Andrew

[GarethB]

Christine,

I go to the Cov and Warwick which is in the West Midlands so I would thought under the same area as Birmingham & Midland Eye Hospital, Heart of England and Solihull. However when I got my lenses they came witha starter pack of solutions. I asked if it was possible to get solutions on presecription or a reduced rate and got a flat NO.

Why might this be?

I live in Warwickshire that has no eye specialist unit.

I know the same hospital does IVF and is the closest hospital for such treatment. As live in Warwickshire I was not entitled to IVF on the NHS, but if I lived 6 miles close to Coventry, I would be in the West Midlands and would qualify.

If this is the reason, surely what you are entitled to should not be down to your address, but the hospital you are being treated at.

[Lynn White]

Christine and I posted at nearly the same time I see, which accounts for us both saying essentially the same thing!

Andrew, I honestly have to say I don't know! I have prescribed contact lenses using HES forms in private practice and it never crossed my mind that solutions could be supplied as well as we were never told we could.

Theoretically, we are not medical practitioners, we merely contract out to the hospital SO if any solutions were available, it would mean having to have an authorisation from the hospital, I would think. So yes, this is definitely something that should be taken up.

Lynn