Some of you may have read a recent warning from the National Kidney Federation regarding changes to the method of prescribing immunosuppression drugs for transplant patients. Immunosuppression drugs will now be prescribed and dispensed from the patient’s renal centre. I had expected to hear more about this significant change but have heard nothing. Then again, I’m only the patient.
I decided to investigate by speaking to my local pharmacist, the transplant nursing team and NHS England. NHS England kindly and quickly sent me a copy of the 2013/14 NHS Standard Contract for Renal Transplantation (Adult) which contains notification of the change but sadly not the reasoning behind it. Speculation isn’t my forte so the only sensible reason I could come up with was that of responsibility – the patient’s renal centre currently determines which immunosuppression drugs and dosage a transplant patient is to receive so it should be responsible for the prescription and dispensing of those drugs and not my GP. Fair enough, I can understand that.
My next conversation was with the transplant nursing team and while they’re aware of the changes they have yet to decide how they would implement them. However, as they only write prescriptions for fulfilment at the hospital outpatient pharmacy, patients would have to come to hospital to collect their, and let’s not forget this, life saving drugs. In my case this would entail a round trip of over 50 miles, car parking fees and a prolonged wait in the woefully inadequate, Lloyds run, outpatient pharmacy at Salford Royal. It is only fair that I emphasise that no decisions have been made by the renal department on how they will implement the changes to immunosuppression drug prescription but it is equally fair to report that the method I’ve outlined is the only one they could implement without major changes to existing systems and processes.
The next port of call in my investigation was my ever helpful pharmacist at the small, local branch of Boots a mere 10 minutes walk away from where I live. He was unaware of the proposed changes but pointed out that he could already receive electronic prescriptions and perhaps that would be a sensible method to investigate and potentially implement as a solution to this problem.
Jeremy Hunt, Secretary of State for Health, has proposed that the NHS be “paperless” by 2018. Now I’m aware that, in the immortal words of Sir Robin Day, Mr Hunt is a here today, gone tomorrow politician, but problems such as prescriptions to out-of-area patients should be easy to implement electronically given that most of the technology and infrastructure already exists. As the NHS has created, out of economic and practical necessity, medical centres of excellence covering patients in a radius of 30 to 40 miles, then, it must also acknowledge the cost and stress of travelling to these centres. There are already reports of outpatient appointments being missed simply because patients can’t afford the cost of travelling.
My aim in writing this blog is to raise awareness of the issue of changes to the prescription of immunosuppression medication and hopefully stimulate a debate between patients and their renal centres regarding the introduction of a sensible, cost-effective and practical solution to this problem. You may be able to tell that I’m rather angry at the implications of the proposed changes, but I get even more angry when I consider that on top of the disruption and cost of these changes, I have to pay for my life-saving immunosuppression drugs, too!
