Exclusive: Overdose warning prompts GPC prescribing investigation

Calls for an overhaul of prescribing rules that can leave vulnerable patients facing either multiple charges for medicines or at risk of overdose have triggered a GPC investigation.

Dr Dominique Thomson: prescribing rules must change (Photo: JH Lancy)
Dr Dominique Thomson: prescribing rules must change (Photo: JH Lancy)

The GPC prescribing sub-committee is to consider how vulnerable patients who are prescribed antidepressants can be protected from potential overdoses, without being charged many times over for medicines.

GPC prescribing sub-committee chairman Dr Andrew Green promised that his committee would look at solutions to a problem raised with him by a GP who works with students at Bristol University.

Dr Dominique Thompson, who runs the student health service at the university, said at-risk patients have been recorded taking massive overdoses of their prescribed drugs to self-harm. But if they are written prescriptions for smaller batches of drugs, the patient has to pay £8.05 each time they are dispensed, assuming the patient is not exempt from prescription charges.

Read more: University practices on the brink

Dr Thompson said patients were effectively paying for their mental health problem, and a Bristol project on which she sits, Services and Trusts Integration to Improve Care in Self-Harm (STITCH), wrote to health minister Earl Howe asking for a change to legislation.

He responded by suggesting that patients could buy a three-month PPC certificate for £29.10, which allows them limitless prescriptions at no extra cost for that three-month period.

But Dr Green said this may not be much help.

‘At the moment the only solution to this is to buy a pre-pay certificate, but that can be a considerable expense for many young people who are already under a considerable amount of pressure,’ he said.

‘I fear that the only longer-term solution will involve legislation, but as a committee this issue will become part of our workstream.’

Scottish solution

Over just a two-month period, STITCH recorded that patients were admitted to intensive care in Bristol having taken, among other drugs, three months’ worth of opiod painkiller tramadol, 54 tablets of antipsychotic quetiapine, and 40 times the normal daily dose of venlafaxine.

In Scotland, GPs can write prescriptions for drugs to be dispensed in instalments for just one prescription fee, but the regulations are different in England.

Dr Thompson writes prescriptions out long-hand for at-risk patients with specific dates on which amounts of drugs can be dispensed. But this is time-consuming, and it relies on individual GPs to be aware that this is possible.

‘We need to send out a clear message to all GPs that these are patients that we value and they can be helped and protected by a change in the regulations,’ she said.

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