Jump to content


  • Tweets

  • Posts

    • love the extra £1000 charge for confidentialy there BF   Also OP even if they don't offer OOC it doesn't mean your claim isn't good. I had 3 against EVRi that were heard over the last 3 weeks. They sent me emails asking me to discontinue as I wouldn't win. Went infront of a judge and won all 3.    Just remember the law is on your side. The judges will be aware of this.   Where you can its important to try to point out at the hearing the specific part of the contract they breached. I found this was very helpful and the Judge made reference to it when they gave their judgements and it seemed this was pretty important as once you have identified a specific breach the matter turns straight to liability. From there its a case of pointing out the unlawfullness of their insurance and then that should be it.
    • I know dx and thanks again for yours and others help. I was 99.999% certain last payment was over six years ago if not longer.  👍
    • Paragraph 23 – "standard industry practice" – put this in bold type. They are stupid to rely on this and we might as well carry on emphasising how stupid they are. I wonder why they could even have begun to think some kind of compelling argument – "the other boys do it so I do it as well…" Same with paragraph 26   Paragraph 45 – The Defendants have so far been unable to produce any judgements at any level which disagree with the three judgements…  …court, but I would respectfully request…   Just the few amendments above – and I think it's fine. I think you should stick to the format that you are using. This has been used lots of times and has even been applauded by judges for being meticulous and clear. You aren't a professional. Nobody is expecting professional standards and although it's important that you understand exactly what you are doing – you don't really want to come over to the judge that you have done this kind of thing before. As a litigant in person you get a certain licence/leeway from judges and that is helpful to you – especially if you are facing a professional advocate. The way this is laid out is far clearer than the mess that you will get from EVRi. Quite frankly they undermine their own credibility by trying to say that they should win simply because it is "standard industry practice". It wouldn't at all surprise me if EVRi make you a last moment offer of the entire value of your claim partly to avoid judgement and also partly to avoid the embarrassment of having this kind of rubbish exposed in court. If they do happen to do that, then you should make sure that they pay everything. If they suddenly make you an out-of-court offer and this means that they are worried that they are going to lose and so you must make sure that you get every penny – interest, costs – everything you claimed. Finally, if they do make you an out-of-court offer they will try to sign you up to a confidentiality agreement. The answer to that is absolutely – No. It's not part of the claim and if they want to settle then they settle the claim as it stands and don't try add anything on. If they want confidentiality then that will cost an extra £1000. If they don't like it then they can go do the other thing. Once you have made the amendments suggested above – it should be the final version. court,. I don't think we are going to make any more changes. Your next job good to make sure that you are completely familiar with it all. That you understand the arguments. Have you made a court familiarisation visit?
    • just type no need to keep hitting quote... as has already been said, they use their own criteria. if a person is not stated as linked to you on your file then no cant hurt you. not all creditors use every CRA provider, there are only 3 main credit file providers mind, the rest are just 3rd party data sharers. if you already have revolving credit on your file there is no need to apply for anything just 'because' you need to show you can handle money. if you have bank account(s) and a mortgage which you are servicing (paying) then nothing more can improve your score, despite what these 'scam' sites claiml  its all a CON!!  
  • Recommended Topics

  • Our picks

    • If you are buying a used car – you need to read this survival guide.
      • 1 reply
    • Hello,

      On 15/1/24 booked appointment with Big Motoring World (BMW) to view a mini on 17/1/24 at 8pm at their Enfield dealership.  

      Car was dirty and test drive was two circuits of roundabout on entry to the showroom.  Was p/x my car and rushed by sales exec and a manager into buying the mini and a 3yr warranty that night, sale all wrapped up by 10pm.  They strongly advised me taking warranty out on car that age (2017) and confirmed it was honoured at over 500 UK registered garages.

      The next day, 18/1/24 noticed amber engine warning light on dashboard , immediately phoned BMW aftercare team to ask for it to be investigated asap at nearest garage to me. After 15 mins on hold was told only their 5 service centres across the UK can deal with car issues with earliest date for inspection in March ! Said I’m not happy with that given what sales team advised or driving car. Told an amber warning light only advisory so to drive with caution and call back when light goes red.

      I’m not happy to do this, drive the car or with the after care experience (a sign of further stresses to come) so want a refund and to return the car asap.

      Please can you advise what I need to do today to get this done. 
       

      Many thanks 
      • 81 replies
    • Housing Association property flooding. https://www.consumeractiongroup.co.uk/topic/438641-housing-association-property-flooding/&do=findComment&comment=5124299
      • 160 replies
    • We have finally managed to obtain the transcript of this case.

      The judge's reasoning is very useful and will certainly be helpful in any other cases relating to third-party rights where the customer has contracted with the courier company by using a broker.
      This is generally speaking the problem with using PackLink who are domiciled in Spain and very conveniently out of reach of the British justice system.

      Frankly I don't think that is any accident.

      One of the points that the judge made was that the customers contract with the broker specifically refers to the courier – and it is clear that the courier knows that they are acting for a third party. There is no need to name the third party. They just have to be recognisably part of a class of person – such as a sender or a recipient of the parcel.

      Please note that a recent case against UPS failed on exactly the same issue with the judge held that the Contracts (Rights of Third Parties) Act 1999 did not apply.

      We will be getting that transcript very soon. We will look at it and we will understand how the judge made such catastrophic mistakes. It was a very poor judgement.
      We will be recommending that people do include this adverse judgement in their bundle so that when they go to county court the judge will see both sides and see the arguments against this adverse judgement.
      Also, we will be to demonstrate to the judge that we are fair-minded and that we don't mind bringing everything to the attention of the judge even if it is against our own interests.
      This is good ethical practice.

      It would be very nice if the parcel delivery companies – including EVRi – practised this kind of thing as well.

       

      OT APPROVED, 365MC637, FAROOQ, EVRi, 12.07.23 (BRENT) - J v4.pdf
        • Like
  • Recommended Topics

Medicines 'red list'


reallymadwoman
style="text-align: center;">  

Thread Locked

because no one has posted on it for the last 2548 days.

If you need to add something to this thread then

 

Please click the "Report " link

 

at the bottom of one of the posts.

 

If you want to post a new story then

Please

Start your own new thread

That way you will attract more attention to your story and get more visitors and more help 

 

Thanks

Recommended Posts

I have been told by my GP surgery that a medication I have been on for 6+ years and which is life-preserving is now on the 'red list' and has to be prescribed by the hospital. It was originally prescribed by a consultant after extenisve testing, and I was discharged to GP care about 3 years later when they were happy that they'd got the right dose. Since then I've had annual blood tests to ensure the dose is still ok, though it's very unlikely to change and will be required for the rest of my life.

 

Can anyone tell me what this means? They can't or won't say if that means I need (another) letter from the hospital or whether I'll have to go every two months to get a prescription or even if they'll now refuse to prescribe it at all. There is no alternative drug, but I know it is really expensive, about £200 a month, and I'm terrified.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

You rang, HB? ;)

 

"Red lists" are an attempt to control costs.

It doesn't mean the medicine can't be prescribed, but that the CCG (Clinical Commisioning Group) (if in England) has to approve it.

 

So, your approach should be:

1) get your GP "on board" ; let them know you are happy with the current medicine and ask them if they can suggest a better alternative.

If not : can you help with the CCG process? Did they want you to contact / see your hospital consultant??

2) if you haven't been seen by your hospital consultant (or their team) within the last year they MIGHT insist on you being referred by your GP again for the consultant to become involved.

However, there is no harm in "testing the water" & seeking advice from the Consultant's secretary. If the Consultant is looking to avoid repeat referrals they might be willing to help straight off, and either way you'll be able to say to the GP "I sought informal advice & this is what they said" (be that "they are willing to write a letter of support" or "they say I'd need to be referred again".

It won't harm your position to mention to the Consultant's secretary that one way of proceeding your GP might consider would be to refer you to the hospital to get them to prescribe it ...... that might increase the chance they'd help find a different solution like the CCG agreeing the GP could prescribe it.

 

One of the key people will be the pharmacy lead at the CCG, who will want to avoid "Community" pharmacy expenditure : you want to balance this with "but the CCG and Commisioning Trusts will also want to avoid "Hospital" expenditure ......"

 

I'm aware of a situation where a great deal of time / planning went into keeping a patient out of hospital with an antibiotic that then got put onto a PCT (as was, then!) 'red list'. The GP was all for prescribing it but their hands were "tied" by the PCT.

The PCT wouldn't budge.

 

In the end the antibiotic was prescribed from the hospital pharmacy, by one of the hospital doctors (the microbiology Consultant), but it took some arranging (who was responsible for the monitoring for side effects and so on), as usually this is the responsibility of the prescriber, but the GP (who had been responsible!) was still the best placed to do so. Fortunately they agreed to continue to do so.

 

The bizarre twist? This antibiotic was only available from hospital pharmacies anyway, so all that changed was it used to be dispensed from there on a prescription from the GP, but ended up being prescribed from the hospital.

Your situation is somewhat different in that your need would be ongoing, while the example I am aware of the details for was for an antibiotic needed only for a defined period.

Link to post
Share on other sites

Unfortunately my previous consultant is no longer working in this area and may have retired altogether. There is only one consultant for this specialty at a hospital 30 miles away and he currently has a 22 week waiting list. GP surgery have been less than useless and won't or can't tell me anything other than they can't prescribe any more. I can't wait 22 weeks for another prescription, I have less than 3 weeks medication remaining.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

By "GP surgery have been less than useless" ;

Have you:

A) Seen a GP (rather than the practice staff), and

B) asked them "what are you prescribing instead then?" ?

 

Is there a support group for the condition where the experiences of others might add useful info?

Link to post
Share on other sites

22 week waiting list?

In an ironic way that is useful!

 

Inform the CCG that if your GP can't prescribe it or an alternative, you need a referral.

If the GP doesn't refer you urgently, as the local referral wait exceeds 18 weeks, you want a referral elsewhere, and the CCG will have to pay for it (and your travel costs / arrange travel)

https://www.england.nhs.uk/resources/rtt/

 

Then see if they prefer to pay for a referral or agree the red listed drug.

You'll have to see if the GP proposes an alternative, or refers you urgently, first, though.

  • Haha 1
Link to post
Share on other sites

To add to the complications, I'm doing this long distance. I'm currently assisting my other half in clearing his Dad's flat and we won't be back for another week.

 

I originally spoke to the surgery staff - I imagine one of the clerical staff - last Friday at 6pm when they told me my repeat prescription has been refused as the medication is now on the red list. I was given a telephone appointment with a GP (one I hate, but beggars can't be choosers) for today. He says I have to get all future prescriptions from the hospital and the practice can do nothing to help other than refer me. He told me there's a 22 week wait.

 

I'm in such a state at the moment that I can't really take in what's happening or what I have to do next/when I get home (by which time I'll have only a few days medication left. There is no alternative drug, as confirmed by the support group I already belong to.

 

I'll come back for another read in the morning and see if anything makes more sense.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

If you are away from home see if the local CCG also has that drug on a 'red list'. If not see if a local practice will see you as a "temporary resident" : you may be able to get a short supply that buys you some more time for a definitive solution.

Link to post
Share on other sites

I am a bit out of touch but what is the name of this drug and what is it's classification P, POM, GSL?

Was it prescribed as part of a trial or awaiting NICE approval?

Many CCGs are trying to reduce costs by advising GPs on what 'normal' drugs they can prescribe, but I heard recently that may be contrary to GP Contract.

£200 /28 days may be high, but not excessive.

Several years ago I was selling into hospitals, a treatment for a blood Cancer that cost ~£2000 per 6 week treatment. At best it prob only extended life expectancy for a few months.

Link to post
Share on other sites

Okay, this is the official definition and reasoning for a drug being categorised as red.

 

The Red List is an advisory list where it is considered by the Drugs & Therapeutics Group which drugs should remain completely under the prescribing responsibility of the consultant or specialist clinician.

 

It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for the supply via a home care company. However, there may be circumstances where supply may be made using prescriptions and in such circumstances liaison with a nominated community pharmacist is mandatory.

 

Careful consideration must be given to the risks associated with this option e.g. around existing purchases arrangements, safe storage or formulation issues. Some medicines may exist under more than one colour depending upon the experience and skills of the individual practitioner involved. These will be listed as red but could be prescribed by some prescribers as green products. Criteria used to demonstrate that a drug meets the RED criteria includes Specialist medicines included within Formulary with one or more of the following criteria should be categorised as RED

 

1 Unlicensed products except solely for reasons of formulation.

2 Unlicensed indications without widespread acceptance of authoritative body of recommended opinion.

3 Unlicensed doses without widespread acceptance of authoritative body of recommended opinion. 4 Medicines without a substantive wholesale body of support unless in BNF or Children’s BNF.

5 Medicines by manufacturer’s recommendation or without wholesale opinion as being specialist only.

6 Medicines whose monitoring or control remains within secondary care.

7 The individual GP is unable to monitor therapy sufficiently to oversee treatment or adjust the dose where necessary to ensure patient safety.

8 Intravenous drugs agreed as not an appropriate drug for primary care prescribing (some of these can appropriately be waived in certain situations e.g. palliative care, paediatrics or cystic fibrosis).

9 The specialist medicine, dressing or appliance is only available through a hospital.

10 Similar but less familiar medicines to another recommended product.

My views are my own and are not representative of any organisation. if you've found my post helpful please click on the star below.

Link to post
Share on other sites

I was listening to Inside Health the other day and they mentioned that everyday medicines like anti-histamines, painkillers and nit treatment may no longer be available on prescription. I assume people go to the doctors for such things because they are entitled to free prescriptions, although the cost of the process of issuing that prescription, (including the doctor's time), to the NHS must be many times more than purchase over-the-counter at the pharmacist.

Link to post
Share on other sites

If you are away from home see if the local CCG also has that drug on a 'red list'. If not see if a local practice will see you as a "temporary resident" : you may be able to get a short supply that buys you some more time for a definitive solution.

 

Unfortunately I'm not even in the UK and whilst allegedly this drug is available without prescription here, I've been warned that it won't be the same quality and may actually be harmful.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

I am a bit out of touch but what is the name of this drug and what is it's classification P, POM, GSL?

Was it prescribed as part of a trial or awaiting NICE approval?

Many CCGs are trying to reduce costs by advising GPs on what 'normal' drugs they can prescribe, but I heard recently that may be contrary to GP Contract.

£200 /28 days may be high, but not excessive.

Several years ago I was selling into hospitals, a treatment for a blood Cancer that cost ~£2000 per 6 week treatment. At best it prob only extended life expectancy for a few months.

 

I have no idea what the classification of the drug is, it's liothyronine (T3) which is a hormone replacement essential for people like me who cannot convert the standard drug, levothyroxine (T4) to T3. It's been in use for decades however it seems that the NHS only has one supplier who has recently really hiked the price even though it's available from other suppliers for pennies and that is the sole reason for it being placed on the red list.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

Okay, this is the official definition and reasoning for a drug being categorised as red.

 

The Red List is an advisory list where it is considered by the Drugs & Therapeutics Group which drugs should remain completely under the prescribing responsibility of the consultant or specialist clinician.

 

It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for the supply via a home care company. However, there may be circumstances where supply may be made using prescriptions and in such circumstances liaison with a nominated community pharmacist is mandatory.

 

Careful consideration must be given to the risks associated with this option e.g. around existing purchases arrangements, safe storage or formulation issues. Some medicines may exist under more than one colour depending upon the experience and skills of the individual practitioner involved. These will be listed as red but could be prescribed by some prescribers as green products. Criteria used to demonstrate that a drug meets the RED criteria includes Specialist medicines included within Formulary with one or more of the following criteria should be categorised as RED

 

1 Unlicensed products except solely for reasons of formulation.

2 Unlicensed indications without widespread acceptance of authoritative body of recommended opinion.

3 Unlicensed doses without widespread acceptance of authoritative body of recommended opinion. 4 Medicines without a substantive wholesale body of support unless in BNF or Children’s BNF.

5 Medicines by manufacturer’s recommendation or without wholesale opinion as being specialist only.

6 Medicines whose monitoring or control remains within secondary care.

7 The individual GP is unable to monitor therapy sufficiently to oversee treatment or adjust the dose where necessary to ensure patient safety.

8 Intravenous drugs agreed as not an appropriate drug for primary care prescribing (some of these can appropriately be waived in certain situations e.g. palliative care, paediatrics or cystic fibrosis).

9 The specialist medicine, dressing or appliance is only available through a hospital.

10 Similar but less familiar medicines to another recommended product.

 

As I said above, it appears that the only reason this drug has been put on the red list is because of the price. It does originally need to be prescribed by a consultant because only they have access to the necessary genetic test to confirm the need for it. However, once it has been prescribed GP surgeries are perfectly capable of monitoring the dose, which would only need adjustment in fairly extreme circumstances anyway. I'm completely baffled as to why it appears I will now have to see a consultant every 3 months minimum just to get a prescription for something I will need for the rest of my life. 4 consultant appointments per year surely far outweighs the cost of the damn drug anyway!

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

Many, many thanks for all the contributions. Despite the possible risks, I have obtained a small supply 'over the counter' just in case it's needed, however a back door method also available after we're back in the UK is to visit someone out of the area and 'accidentally' forget my medication as it seems my area is the only one to red list this drug.

Longer term, I'm getting advice from my support group as they have quite a few people either already or likely to be in the same situation. I'll keep posting updates in case it helps anyone else.

 

As an aside, this issue has already caused me many sleepless nights and totally wrecked the following days when I've been able to do pretty much nothing. I'm terrified that at best I'll go back to counting any day where I stay awake for longer than 2 hours at a time as good and gaining half a stone a month whilst eating next to nothing. Long term, lack of the drug won't kill me quickly, but I will slowly decline to the point where I'm not actually living at all, just sleeping.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

  • 1 month later...

To keep this thread updated, things are still rolling along with no end in sight yet.

 

GP surgery have now been told by the consultant to keep prescribing as stopping the drug suddenly (or at all!) is likely to cost the NHS a fortune regardless of the effect on my health due to my condition becoming extremely unstable.

 

With the help of a national support group and the British Thyroid Association, I'm collecting evidence from the GP surgery (not very forthcoming!) and the CCG (even less forthcoming, keep spouting the standard gumpf without actually saying anything) to try and work out what has gone on because I'm being fed two completely different and mutually exclusive stories about when and why the sudden change to prescriptions happened.

 

Does anyone know if/how I can force the surgery to give me information which doesn't directly relate to me, i.e. instructions from the CCG re prescribing this drug? Ditto for the CCG, they just keep fobbing me off rather than telling me exactly what the instructions to primary care are.

 

Ultimately, if I can't work out who is telling porkies, does it matter? Can I complain about them both and let someone else sort it out?

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

Write to your CCG asking under FOIA for their BRAG list and the minutes of the drugs and therapeutics group meetings.

My views are my own and are not representative of any organisation. if you've found my post helpful please click on the star below.

Link to post
Share on other sites

FOI (freedom of information) request to the CCG for all meeting notes regarding that drug, the decision to red list it, and consequent instructions to surgeries.

 

If there are other suppliers who provide it cheaper : could you agree importing it with the GP +/- CCG ? (If there are others the British Thyroid Assiciation are aware of : could a group effort be made?).

Could the GP write a private script that you could then legally use to import the medicine for your personal use.

 

If all else fails : can you buy the drug from a foreign website (currently this remains legal, providing it is for personal use if the foreign site states a doctor reviews the sale, but it is a grey are!

1) the law (or its interpretation!) may change

2) if legal, it is only for personal use : don't try and use this yourself to help anyone else in the same boat (though you can tell them about it, just not arrange it for someone else)

3) being a 'grey area' there are few guarantees of the quality / provenance of the medicines!

 

Ultimately, if no solution is being provided and your health will be harmed : write to both Consultant and GP asking if meeting with them both would help as "you value everything they have both done for you, and appreciate that they are in a difficult situation not of their making, but are worried that your health will suffer as a result of these events, and need them to clarify a solution or who is responsible ..... so that if a solution isn't found you don't refer the wrong person to the GMC for allowing your health to be threatened."

 

It it a pretty end-stage / 'nuclear' option though! I've tried to phrase it as "I'm trying not to refer to the GMC", but it is still pretty clear that "someone is going to be referred"!

Link to post
Share on other sites

Write to your CCG asking under FOIA for their BRAG list and the minutes of the drugs and therapeutics group meetings.

 

I agree ; think about it posted this while I was composing my (slightly longer!) reply that included this approach.

Link to post
Share on other sites

Thank you, will do.

 

For the immediate future, my GP is still prescribing pending an appointment with an NHS consultant.

 

For my own protection, I have also arranged a private consultation (with the same Consultant as the NHS referral, there aren't many of them around!) to discuss the way forward. I didn't realise that I could legally import the stuff, so that remains an option though I have concerns about the quality from some countries - I did buy some whilst abroad, but it really is for emergency use only. Are there any restricitons on which country I could import from if I have a prescription?

 

In the meantime I will get on with doing the FOI request.

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

At present : there are no restrictions on where you can import from, (only for your personal use) if bought on the web, if signed off by a doctor on that website.

It remains a 'grey area' though, as previously mentioned.

 

Additionally (just to clarify!): whilst this applies to prescription only medicines, controlled drugs aren't legally importable by this method.

Link to post
Share on other sites

  • 4 weeks later...

Current situation

1. Consultant whom I saw privately and is the same one I would have seen through the NHS if I'd been prepared to wait long enough says the rules for prescribing this drug haven't changed - existing patients can continue with GP prescriptions/monitoring, but for new patients it's red listed and they have to get individual funding agreed. He is writing to my GP practice to spell this out, so I shouldn't have any further problems.

2. FOI response received which suggests the last guidance issued to GP practices was in 2014, and tallies with what the consultant said.

 

On the surface, it would appear that an over-eager GP (not mine, he's apparently in charge of prescribing matters for the whole practice) has spotted a potential red list item and not bothered checking further before pressing the panic button. I can accept that people do make mistakes, however the surgery have had ample time to have realised their mistake and put things right, but have not done so. Quite apart from the £125 it cost me to see the consultant, I've had a pretty nightmare couple of months worrying about this and I am going to complain as this is not the first mistake the practice have made, in fact there have been a catalogue of mistakes and something the FOI information also revealed is that they made a complete hash of my treatment before the consultant was involved.

 

I will also be changing practice, any opinions on whether it is best to do this before I make my complaint and/or whether I should wait for a definitive 'we've put it back on your repeat list' from the GP so it's hopefully there when the new practice get my notes?

RMW

"If you want my parking space, please take my disability" Common car park sign in France.

Link to post
Share on other sites

A GP lead for prescribing isn’t unusual, in fact it’d be more worrying if they didn’t have one. You say in an earlier post that your GP was continuing to prescribe until you’d seen an NHS consultant, whilst I can understand that you’d want the security of the private appointment but it seems in hindsight a bit unnecessary as your post of 12th March says that the consultant had told the GP practice to keep prescribing anyway.

 

I do however totally understand your frustration, it can be frightening when medication you’re reliant on changes, I’ve personal experience of this and it’s not nice. My question though is what you hope to achieve by changing practice? There’s been an error, yes. However you’d be going from somewhere which is now familiar with your case, your medication and the relationship with your consultant to where no-one knows any of this. In England at the moment it’s taking months to transfer paperwork and notes and in the interim you’d be reliant on perhaps a printed summary of your main conditions, history and medication and the clinical judgement of someone you’ve never met before.

 

Please do think carefully about why you’re changing and what you hope to achieve from it. The grass isn’t always greener and the opportunity to put right what’s gone wrong is far more useful for you and your GP’s therapeutic relationship.

My views are my own and are not representative of any organisation. if you've found my post helpful please click on the star below.

Link to post
Share on other sites

  • Recently Browsing   0 Caggers

    • No registered users viewing this page.

  • Have we helped you ...?


×
×
  • Create New...