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Help wanted

Help wanted

Help wanted

In England, Department of Health rules do not allow doctors to prescribe medicines for six months at a time. The rules do not normally specify any particular period for prescriptions, as that decision is best made by the patient's GP, taking into account her or his detailed knowledge of the patient's medical history and current medical condition.

All of which seems fair. Most doctors would recognise that there are patients on stable long term therapy where a prescription covering up to three months would be appropriate, and times when a shorter period is much more sensible.

Yet all over England authorities are enforcing a 'one-month only' rule. The reason put forward is that this is in the best interests of the patients, and saves money. Quite what the evidence is for either assertion is uncertain. Bandolier has been bombarded with demands from patients and professionals for the supporting evidence, and hasn't found any.

First, it isn't Bandolier's fault; we think it's daft too. Second, we could find no evidence from literature searching or asking folk who should know. The best information we have come across so far is that an old lady died and was found to have £18,000 worth of drugs in her cupboards. That may be so, but it is unclear that such heroic hoarding would have been aborted by monthly collections.

Now it is unusual for so many people to be so cross. The more they know about the impact the crosser they are. Patients are inconvenienced requesting and picking up prescriptions every month instead of every three, practice staff are frazzled, repeat prescription requests soar alongside dispensing costs. Adherence rates may be falling, and some patients are wondering why they are bothering.

So who has the evidence? What is its nature? Are the benefits in cost saving worth so much anger and hassle? How is this policy in the best interests of patients? Who decided it, and when?

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