Author Topic: Script tied in to group work  (Read 7574 times)

Filskit

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Re: Script tied in to group work
« Reply #15 on: June 06, 2014, 11:44:01 AM »
Funny you should say that, our old DSP prescriber a believer in HR, maintenance & all the things that DSP's are forgetting about these day's ran a busy meth clinic with a lot of people on theraputic doses & above. Some users were just increased until they either stopped using or at least used considerably less. Thing's worked well.

Now that Dr. is unavailable to his patients & so we have been left with what appears to be not only an ill-mannered but quite ignorant locum. When I first saw him my dose of 115ml was described as " vast " & I was given the impression that I didn't have long to live because of the effects that & other medication taken for pain relief was having on my respiratory function. I tried to reason with the man, mentioning the Orange Guidlines......( silly me, they are just guidlines & he doesn't have to even know about them  ::)  ) .

Over the months I have noticed many people asking to be reduced to really quite small doses (20ml or there-abouts ) then asking to stay on that dose. All these people have increased their use of the poor quality dope sold on the street's & their 20ml is just really a back-up. To be honest I don't blame them as this NHS locum is messing around with other medications that I have been on for many years without any problems. If I wasn't on such a " vast " amount of meth then I would love to tell him where he could stick it.

I went to the pharmacy the other day to get my weekly pick-up along with other meds on repeat & was told that my anti-depressants weren't there because they surgery wouldn't supply the prescription ? Obviously this Dr. is just using this as a reason for me to make an appointment with him so he can harrass me about other issues which I am waiting to see the Dr. in charge of clinical governance for the area about.
I'm really quite shocked at the difference one person can make to a DSP, previously I thought my NHS shared care system worked well. Now I'm wishing that I was back in the old DSP where he could only of had anything to do with my meth script.

sapphire

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Re: Script tied in to group work
« Reply #16 on: June 06, 2014, 12:32:04 PM »
Do you know why they have stopped the antidepressants? Antidepressants are one of the meds that should not be abruptly stopped, especially if they are tricyclic or SSRI's, as they both have an abstinence syndrome attached.

Filskit

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Re: Script tied in to group work
« Reply #17 on: June 08, 2014, 01:16:37 PM »
I know not why . The pharmacist said that the script hadn't come & that they were to be reviewed ? I can only think that this is some ploy by new precriber " Flabba " to mess with my head & other meds. I didn't get to my last appointment as I was working. I did give 24hrs notice & was told that it wasn't a problem as appointments were scarce. His assistant also told me that my script lasts till the 10th of this month. I told her that I wasn't wanting to have any changes to my medications till my meeting with his boss. The DR in charge of clinical governance & that I wanted my key to accompany me to my next appointment with old Flabba ( certainly the most ignorant prescriber I've met when it comes to OST ). I haven't recieved any letter inviting me to another appointment with him yet & am prescribed mirtazapine which I don't imagine is a walk in the park if stopped when on max. dose ? For all he knows I may be in withdrawls. Saying that he has implied to me before that this is a med that I may be taking for recreation ?! Idiot of a man. I take it last thing at night as all it does is make me feel groggy as well as fat ! I am wondering though if this could be in my favour now after speaking to key. Witholding medication without any prior warning. Possibly the icing on the cake for a formal complaint ? There is no point in me complaining about his ill-manner as I would just be told it is because of language with him being from another country. It has to be something more specific that has a paper trail to document it. Or so I've been told. I'd be interested to hear your views on the subject ? Anybodies views in fact. So many people in the area have had problems with Flabba the hut. Not just substance user's but everyday MH patient's are refusing to see him. One lad down the road from me has been asking to reduce his meth for months now from 26ml. He's drinking a bottle of vodka a day which I would think is good reason to get him of meth. Flabba on the other hand think's he should remain on meth until he get's his alcohol problem under control   :o Asphyxiation ? This man is a bloody danger & if possible I never want to see him again.  Bit of a rant ! Sorry.   ::)

sapphire

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Re: Script tied in to group work
« Reply #18 on: June 09, 2014, 01:43:48 PM »
WTF?! He thinks you're abusing them?! This Flabba really must be one of the most ignorant Drs we have had the misfortune to hear about in recent times.

Medications like antidepressants certainly should not be stopped abruptly, and definitely not without the consent of the patient and with no prior warning.

This idiot Dr sounds like he believes everything he reads in the Daily Fail, and that all people in MMT are abusing every medication they are prescribed, even antibiotics and contraceptives!

I would definitely be complaining formally, as I think that if you don't, he'll be after your other meds next. Also, if you don't ay anything, it sort of confirms to him that he's right when he's thinking you don't really need them, iyswim?

Scallywag

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Re: Script tied in to group work
« Reply #19 on: June 09, 2014, 01:51:45 PM »
That sounds pretty crap to me. Perhaps what should have been explored is transferring them back to your Gp. Our service used to initiate lots of AD prescribing because often we were the only service clients could get.
However, over time that 'bill' cuts in to our budget, so we transferred them back to Gp's without any problems, so continuity of care was maintained.

Perhaps you should discuss that. If they were clinically indicated to start with, they can't say they are not now unless you've been reviewed or assessed as not being depressed.


Filskit

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Re: Script tied in to group work
« Reply #20 on: June 09, 2014, 06:33:35 PM »
This is the problem I think. I live in a rural area & beforehand it was my GP of many years that ran & was the backbone of our clinic. For years he prescribed for a charitable DSP then it was taken over by the NHS surgery that he is a GP at. Everything worked well, then because of some in-house politics a complaint was made against the GP regarding the pain relief (2x60mg dhc) I was receiving while on a meth script. Since then this most ill-mannered psych. has taken over ALL my prescribing & none of the other GP's will get involved. I often got embarassed when NHS big-wigs sat in on my appointments as the GP would use me as an example of a stable MMT patient, employed with a mortgage & thriving, happy family. Now I feel like the public enemy number one. My key say's that they're getting loads of complaints about this most ignorant of prescribers & although I keep in contact with my old GP I don't think he's able to help me make a formal complaint because the original complaint about my medication involved his prescribing. I'm waiting for a call from our local CAB service, that will be friday at the earliest. Pick-up day tomorrow.....that's if there is anything to pick up. I've had no contact from the service to explain why my ad's have been stopped or asked in for an appointment & I'm not contacting them until I've heard from C.A.B. I don't think I could even speak to the man , the thought of him makes my blood boil !   >:( >:( >:(

sapphire

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Re: Script tied in to group work
« Reply #21 on: June 10, 2014, 12:55:54 PM »
That's what I was going to suggest, that the surgery tale back responsibility for all prescriptions other than the methadone, as none of then are addiction related.

I can see the principle as to why your old doctor was writing the scripts, but for this Flabba to be doing it seems really wrong, as all he seems interested in is trying to catch people out, when I doubt that many people are doing anything wrong in the first place!

Scallywag

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Re: Script tied in to group work
« Reply #22 on: June 10, 2014, 02:26:36 PM »
Hi Sapphire.
This imo was a result of drug services taking all the responsibility for users because many Gp's saw them as troublesome or too complex to manage in primary care.
Drug services took over the prescribing of benzo's because of double scripting and the demanding behaviour of users looking for their Gp to prescribe them. Now, 'we're' left holding the baby and the Gp's are reluctant to take them back.

Without necessarily meaning to we have supported Gp's in opting out of their care because CDT's would do it all. In this instance, it makes perfect sense to transfer to Gp. It's not specialist prescribing so can't see the difficulty.

Filskit

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Re: Script tied in to group work
« Reply #23 on: June 10, 2014, 10:23:21 PM »
Thanks for the replies. Strangely enough my ad's were there with everything else that is prescribed. If it wasn't for the other items I might of left it a day or two. The pharmacist would've been very worried as I never miss a script. For all the psych knew I may of been hanging from a rope for the last week.
One less user to bother him! Something which I still intend to do, I'm still going ahead with my complaint, it's cruel to screw with people's heads & meds. For no reason at all.
My benzo script has been in place for years before I was prescribed meth & always been supplied by the NHS. So I think that's the road I'm going to aim for.
My meth script can come from the substance mis-use service ( Flabba ) & with any luck they will deal with the rest in mainstream surgery prescribing as they have never been a mis-use problem.
Thanks for all your replies, it's appreciated when you're as isolated as I am.
I'll let you know of any future developments...it's not over yet I fear.

sapphire

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Re: Script tied in to group work
« Reply #24 on: June 11, 2014, 01:07:57 PM »
I know that some DSP's have taken responsibility for benzo prescribing, but for things like AD's and pain relief, any GP should be doing it really.

TBH, I think it's a cop out on  the part of a lot of GP's. I know that you do get the odd service user that is going to be drug seeking, but the vast majority of patients in treatment are not like that. In fact often many are scared to see their GP about analgesia/insomnia/anxiety, and they fear being seen as drug seeking.

Are other people that are now having to see Flabba the locum also having problems? If he's doing dangerous things like stopping scripts abruptly to other people, the more people that formally complain, the more seriously the trust would have to take it, especially if no one was complaining before he started his little fiefdom!!

Filskit

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Re: Script tied in to group work
« Reply #25 on: June 13, 2014, 10:22:39 AM »
Yes the other GP's working from the same surgery for the last few years have never wanted anything to do with the OST clinic, a total cop-out if you ask me. The only time we've ever had another GP help out was a few years back. Both of these GP's have been from western european countries & both very good. Treating patients in a non-judgemental manner as well as being as helpful as possible, in my experience anyway.
I think that the other GP's especially the British one's should be ashamed of themselves, as they obviously don't want to have anything to do with substance users. Not one of them will even help out when our previous prescriber goes on holiday meaning that GP would spend many hours preparing everybody's scripts so nobody went without. I've witnessed the GP still arranging things with the pharmacy while technically already on holiday & wouldn't be surprised if the phone calls carry on right through his time off.

So no support from any colleagues at all. A total cop-out.

Yes others are complaining, some MH patients refusing to see Flabba also. As usual though I appear to be the patient that knows that there is something very wrong with my treatment & though keys are telling people to complain they are not supporting them to do so. I will complain though & I think that they know I will so are leaving me to get on with it.

sapphire

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Re: Script tied in to group work
« Reply #26 on: June 13, 2014, 12:21:45 PM »
That's terrible that people are wanting to complain by are not being supported by their keyworkers. If people want to, they can always contact us and we can complain for them, or support them in doing so themselves.

So as far as signing the OST scripts where you are, is it only Flabba that can do it?

Scallywag

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Re: Script tied in to group work
« Reply #27 on: June 13, 2014, 01:58:37 PM »
The keyworker (if a nurse) has a duty to assist the client in making a complaint, even if it was against them. They should provide the information on how to, who to and assist as appropriate.
I think with privatised services, they can make up their own polices as they wish. Try PALS, but they are less effective now and are no more than an arm of the services now and not so patient focused.

simon

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Re: Script tied in to group work
« Reply #28 on: June 13, 2014, 02:29:59 PM »
The keyworker (if a nurse) has a duty to assist the client in making a complaint, even if it was against them. They should provide the information on how to, who to and assist as appropriate.
I think with privatised services, they can make up their own polices as they wish. Try PALS, but they are less effective now and are no more than an arm of the services now and not so patient focused.
There you go.
http://www.nmc-uk.org/Publications/Standards/The-code/Introduction/

Filskit

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Re: Script tied in to group work
« Reply #29 on: June 14, 2014, 10:47:43 AM »
Yes my GP who used to write all the scripts for any kind of substance substitution has been taken out the picture since the initial complaint. Last time I spoke with him he wasn't worried at all as we both know that he's done nothing wrong. He's still practicing from the surgery, so I think I'll pay him a visit.
The keys who are telling people ( me ) to complain, are from our old charitable DSP where the same GP used to prescribe from, so none of them are nurses & now the contract is with the NHS they are running out of funding fast. So Flabba is the only person in my area signing OST scripts. The nurses working with him have remained the same though I have a funny feeling that the one who usually deals with me was the person who made the complaint in the first place(?). I know that the GP was very unhappy when the nurse informed the DVLA of everyone in receipt of a script. A lot of people dropped out of treatment, he wasn't very happy about this then the nurse was signed off with stress. When the nurse returned seemed to be when the complaint against the GP was made.
I may be wrong but it does seem very coincidental & I don't trust that nurse one bit.
What a bloody mess & I'm still waiting for CAB to phone me !