An MP requests help

[Andrew MacLean]

For me it really was never a problem. I bought my solutions and protein remover tablets from the supermarket. Now I can't wear lenses so the problem has gone away. but if some of the folk on more limited incomes are having to shell out for fluids att he same rate as I used to do, then they must be in real trouble.

Andrew

[Christine Wright]

Gareth
I used to work at the Cov and Warks so I can confirm solutions were not offered on prescription there. At that stage I didn't know any other system. I think it's historical - Birmingham have done it for years and C&W have never done it and the funding has been set up accordingly. Heart of England and Solihull Optometry Depts were both set up by former employees of BMEH so they got the system set up with Pharmacy from the start.

I wonder what Cov & Warks reaction would be if you raised the subject? As I said in the previous post, it would be nice to be able to quote chapter and verse from the Dept of Health regulations - which I don't have. The other Optometry Dept in your area is at Warwick Hospital - I wonder what they do?

[Andrew MacLean]

I tried to find something on the NHS WebSie, but I am afraid that I dreew a blank

Andrew

[GarethB]

Thanks for that Christine.

I was lead to beleive the optmetry dept at Warwick was the same as that at St Cross Rugby. The unit is part of moutpatients and is not geared for the more complex eye conditions such as KC.

I know the three optoms I see at Cov & Warwick also work at St Cross too as they are part of the Walsgrave NHS trust.

It would me nice if all the hospitals in one area worked the same, it would be far less confusing.

My appt is about 3 weeks away, so will ask then.

[Andrew MacLean]

All the best Gareth

[Ali Akay]

Christine,
I'll look for the relevant paperwork,fairly confident I've still got it somewhere.

Andrew: unfortunately there are no provisions as far as I know for supply of solutions to patients who get their lenses from a community optometrist contracted to fit lenses on behalf of the eye clinic. These patients need to obtain their solutions privately at present, but, this is offset by not enduring long waits in the hospital clinic, parking problems, being able to see the same practitioner every time etc.

[rosemary johnson]

Lynn asked how the solutions on prescription works:

Well!
I have check-up appointments every 6-9 months, and generally get asked "Do you want any solutions?" before I go.
I then get a slip which hopefully has a) the right things for what I want, and b) what the pharmacy will dispense written on it.
THe slips are about the same size as a "With compliments" slip - a third of a sheet of A4 - and come in books of carbonless copies. THe third copy is white and stays i the book in the practitioner's cubicle. The top copy is pastel green and the second sky blue.
You take the green and blue copies to the pharmacy, take a numbered ticket from the ticket dispenser machine and wait for ages and ages till your number comes up.
You then go to the window, hand over the slips, and iether your UB40, season ticket, hard cash, or whatever, and they tell you to take a seat and wait.
eventually they then call you back again (by name) and hand over a bag, or loadsa boxes, which generally aren't what you want, and you ahve a long argument with them, during which they tell you their colleague couldn't possibly have said that, you're a liar and the guys inthe cubicles don't know what they're talking about and a lot more.
If you're lucky, they then ask you if you want a carrier bag, and you lug all that lot home in a plastic bag labelled "Moorfields Pharmacy2 with a green cross, which must make you a number 1 target for bag snatchers in search of drugs.

The MEH pharmacy supplies drugs for all the eye conditions the hosptial covers, and judging from the posters on the walls inthe corridor where you grow old hanging around waiting, one of their "best sellers" are drops for glaucoma.
I presume that people who get prescribed contacts by MEH for other conditions than KC would also go there for their solutions, but I don't know about that.

The blue slip is given back to you with the boxes, bottles, etc. The idea, according to who you as, is either that you give it to your GP who can write you out another prescriptoin for any more you need, or that you take it with you when you go to the GP's, and if s/he decides s/he needs to prescribe you anything for your eyes, you have it written down what it was you were given before (either to check the new stuff doesn't conflict, or so the GP can see how to spell more of the same - this assumes anyone can by then read the practitioner's writing on a carbonlss copy that by then has been in the bottom of th ehandbag for a while....!)

You can only get a prescription at MEH when you have an appointment.
The prescriptions are for "three months supply" - except Celluvisc, as beforementioned, and see below.
If you only have appointmnets every 6-9 months, you need more meanwhile.
MEH view is: yu take the blue slip to your GP and the GP writes you a prescription for the next 3 months.
This must mean that MEH are under the impression that GPs *are* allowed to prescribe contact lens solutions (I haven't tried this, other than Celluvisc).
Well, let us assume they think this, and aren't deliberately tryng to hoodwink us!

THe point about only being allowed to get a prescription when you have an apointment is itself daft, because it means you can't get one when you get a new lens - which may, if it's a new type require new solutions. This means either: 1. you get the solutions the previous appointment, and if it takes months and months to get the new lens(es), the stock pile could have gone out of date by the time you get the lenses, or 2. you don't get the solutions till your next appointment, by which time you could have had the lens(es) sitting in the cupboard unused till your appointment, and effectively you are "wasting" an appointment because the practitioner can't see how you're getting on with them, or 3. you insist on having an official appointment to pick up (a) new len(es), which clogs up appointment schedule if all you need to do is roll up and pick up a new lens, or box of lenses.
If it's a common stuff, of the same as you had before for the old lens, it's not a problem. But if it's a new stuff you don't know what it is, or what it looks like, or what a commercial alternative is, and local supermarkets don't stock it, you could be stymied. It would be far more sensible to let one pick up a prescription ofr new solutions to go with your new lenses when you pick up the lenses.

I've never yet tried getting my GP to prescribe Boston/B&L or other stuff for me, though MEH seem to think they all will. Personally, I doubt it! I had no doubt that no-one in my GP's practice would have any idea about those blue slips when the person in Pharmacy at MEH said they would, and really only went in with it to prove I'd get nothing but blank looks (a long wait I could have done without!!!!)
MEH pharmacy say you can always buy the stuff over the counter. Well, round here you can't - when I went in with a GP prescription they had to order it specially as they didn't have it normally, and told me to come back on Thursday.

It is true that I had heard rumours of solutions on prescription from MEH for some time before anyone actually started asking me what I wanted. In those days it didn't worry me as I could afford to buy COntactasol, and had a friend who made up and sterilised isotonic saline for me. But now, with money much tighter, it is cheaper to get a season ticket at certain times a year, and get the lens stuff and the asthma inhalers and anything else on the season ticket.

Incidentally, about the Celluvisc: one of the people in MEH Pharmacy said the reason they only gave out one month's supply of Celluvisc at a time was "we don't have the space here to stock lots of contact lens things" so ration everyone to one month's supply to keep their storage requirements donw.
This sounds extraordinary to me!!! - and possibly fraudulent if the official quantity per prescription charge is more, and they charge a full charge for a lesser supply than is both permitted and what is actually specified by the practitioner (my forms fromt he practitioners said 3 months supply).
No doubt someone from MEH pharmacy would deny I was ever told this!!!
It is of course possible the official limit is 1 month's supply and pharmacy were right for the wrong reason. In fact, the first person I spoke to there said I couldhave 3 month's supply if I brought three chits and paid three charges - as I had a season ticket, I didn't care about the three charges! - though needless to say, someone else denied she'd ever said this.
Oddly, the GP who wrote me a prescription for"the rest" also reckoned she could only write a scrip for one month - but that was one month's supply *for each eye*, which worked out as two months, as I only use it in one eye. very odd.

INcidentally, are Contactasol/Contactasoak still available, even if not on the medicines list?

Oddly again, not least in view of their claims they limit supply due to lack of storage space, the other thing I usually have to do with MEH pharmacy is to make them unpack the Boston "Three months" boxes and take the cleaner back, as I don't want or use it, and don't want to have to lug it home. I've also had them try to charge me for it, thinking "boston" covers both wetter and cleaner, even though the cleaner isn't specified. It does occur to me to wonder how often the season ticket has had charges for the cleaner applied to it, despite the fact it was prescribed, wasn't wanted, and I made them take it out and didn't take it away with me!

What was the other question someone asked? - i forgot it..
Rosemary

[rosemary johnson]

Christine,
I'll look for the relevant paperwork,fairly confident I've still got it somewhere.

Andrew: unfortunately there are no provisions as far as I know for supply of solutions to patients who get their lenses from a community optometrist contracted to fit lenses on behalf of the eye clinic. These patients need to obtain their solutions privately at present, but, this is offset by not enduring long waits in the hospital clinic, parking problems, being able to see the same practitioner every time etc.

COugh, splutter!!

This is the system I had when I used to live on Merseyside. The (then) hospital eye section didn't have any of the contact lens/optometrists facilities itself,a nd contracted them out.

It worked OK - but no waiting times? No queues? No parking problems??? You gotta be kidding!
OK, the waiting room may have been less dark gloomy and depressing than at the hospital, but the journey was longer, the parking was worse, and I certainly remember waiting there - sometimes, because the practitioner couldn't find anywhere to park either and was driving round Hamilton square 8 times looking for a space.
Oh, and they sold us Contactasol and, IIRR, K-Lens. Ah, K-Lens! Can we have that back and on prescription too???!
Rosemary

[Ali Akay]

Rosemary
Hospital prescription forms usually say maximum 28days supply can be dispensed. This is OK for prescribed drugs as patients can get repeats from GP, but they extend this to 3 months supply for CL solutions as GPs arent able to prescribe them (although you've been given the impression that they can). Perhaps a MEH patient could write to the pharmacy dept. and ask for clarification of these issues.

Re: contactasol and contactasok I am afraid they were discontinued many many years ago

[Ali Akay]

Rosemary
I guess no system is perfect! I know of one fairly large hospital who issue a HES(P) form needed to get lenses from a community optometrist at NHS rate, and told they can take it to ANY optician of their choice.This is great for patient choice and you could take the form to the nearest optician with the smartest waiting room and easiest parking, BUT the optom fitting you with lenses may have very little experience in the type of work! Hence hospitals usually prefer to work with a particular practitioner they know and trust and if that practice happens to be a long way away, it's basically bad luck! At least you're hopefully getting good clinical care.