An MP requests help

[Andrew MacLean]

Sean!

Good to see you. Welcome to the forum

Andrew

[Anne Klepacz]

Ali - I've been trying to follow the discussion on this thread on behalf of the committee and have ended up thoroughly confused! Yes, please do print off and send me the directives you've found (to PO Box 26251 London W3 9WQ). But I am right in thinking this means that currently only hospital eye depts can prescribe the necessary solutions? (and of course we know that most of them don't). And I take it that there's no reference to the minimum period any prescription covers? So even if we were able to get HESs all over the country to follow the guidance, cash strapped authorities could insist on only giving 1 months supply rather than 3 or 6, and people would end up paying more in prescription charges than the solutions cost? Or am I being too cynical here?
And of course, that doesn't cover all the people who don't get their lenses through a hospital, so trying to get solutions prescribable by GPs still seems worth attempting.
Lynn - you seemed to be saying in an earlier post that the chances of that were higher than trying to get solutions on a voucher system because it would need less change to the current systems. Have I got that right? Though I can see that the voucher system might give more flexibility. But how would it work? Who would be able to issue vouchers?
Apologies to you both for all the questions!
Anne

[Ali Akay]

Hi Anne
will send the stuff to you in the next few days.Yes, my understanding is that at present only hospitals can prescribe and solutions can only be dispensed by hospital pharmacy.I agree much better if GPs could precribe but I only pointed out that I didnt think it would be easy to achieve this, certainly worth trying. There's no mention of how much can be prescribed, so in theory hospital pharmacies could insist on following the 28 day rule but I think this is unlikley. It would mean patients could request a repeat prescription every month which would be unworkable. The sensible thing would be for patients to be given enough solutions to last until the next appointment, but this would be too costly for the hospital for patients attending annually.Ideally we need DOH to issue a revised notice to address these issues. I know from experience that hospitals are reluctant to change their practices, especially if it involves extra expenditure as most are in the red! I think most of the current practices are purely historical, evolved over a period of time, but it's interesting that most hospitals that supply solutions dispense 3 months supply although it's not written anywhere.Probably they've copied what MEH have been doing.

[Andrew MacLean]

Health was a devolved issue when the Scottish Parliament was restored. I'll ask my GP when next I see him if he is able to prescribe contact lens fluids. he knows I can't wear lenses any more, so won't be tempted to reach for his pad.

Andrew

[Lynn White]

Yes Anne...

I do feel that if hospital prescriptions are already an option.. which Ali has now proved they are - then that would be the immediate thing to push for - ie proper implementation. This needs mere enforcement rather than any major changes in prodedure.

However, this will only actually cover lenses provided by hospitals so people who attend private optoms will not be covered if their original lenses did not originate from hospital.

Vouchers are covered by a totally different system - the GOS - General Ophthalmic Services. These would have to be authorised by Govnt which is why I said it would be a much harder job. For this to happen, it would have to be accepted that KC was a recognised condition that needed special categories like diabetes, glaucoma etc..

This latter is a long term aim I should think but one worth pursuing at the moment due to changes in the Health Bill going through as we speak. You never know until you try.

I don't blame you being confused as you can see even we optoms had to rely on Ali's hoarding nature to unearth the Hosp regs!!

Well done Ali and a round of applause!

Lynn

[Andrew MacLean]

Hear hear. Good on you Ali!

A

edit -- I keyed in this post and then wondered where the expression "hear hear" comes from and what it means. It turns out that it is an abbreviation of "hear, all ye good people, hear what this brilliant and eloquent speaker has to say!"

I think that just about sums up my agreement with Lynn's last post, even if it wasn't spoken

Andrew

[rosemary johnson]

Interestng to note...... that if one reads Ali's unearthed documents very strictly, the implications is that we should be supplied with *cleaning* or *sterilising* solutions only - ie. not wetting solutions or saline.
SO, on a very strict reading, the pharmacy could supply me with boston cleaner, which I don't use, but niether Boston wetting solution nor Amidose.
(Nor the good old K-Lens, were that ever to be re=issued.)

But presumably not Fairy Liquid.....

Am I being over-pedantic here? Ali, do you follow where I'm coming from here? Does the rest of the documentation (beyond the paragraphs you quoted) make it more inclusive than the above?

Rosemary

[Andrew MacLean]

Over pedantic? I have no idea what that could mean Rosemary. I recognize a category "Not pedantic enough"

Thi is all very muddeling. I guess that if they can get out of supplying solutions, they probably will. In all the time I was having lenses dispensed by the hospital, I think I was given one or two starter packs of allergan wetting and cleaning fluids.]

Andrew

[Lynn White]

Well, that could be one interpretation. On the positive side, this is just a generic term and since contact lens solutions change formulation regularly, it could also be taken to be whatever solution is required to maintain lens hygeine and comfort of lenses.

I rather feel there might be a postcode lottery on that one,...

Lynn

[Ali Akay]

Rosemary
Once a hospital decides to supply the solutions I am sure they'll ask the advice of their contact lens practitioner in deciding what solutions the pharmacy should stock, so I wouldnt worry too much about the distinction between cleaning, soaking solutions etc.

Every hospital currently have their own medicines list based on the personal preferences of the doctors working there.For example only a relatively small selection of glaucoma drugs are stocked and if a doctor wishes to prescribe a drop not normally stocked by the hospital pharmacy they need to issue an outside prescription.I guess this is for logistic and cost reasons which is understandable. It would be a mammoth task for hospital pharmacies to stock all the medicines in the BNF, and hence it would be unrealistic to expect them to stock a vast range of contact lens solutions.I'd think Boston Cleaner , Soaking Solution and Unique ph multipurpose for RGPs;a multipurpose and a peroxide based system for soft lenses would serve the needs of most patients.