Is Duraphat now off prescription?

Thus is the trouble, isn’t it? If you do t have access to an NHS dentist and your GP won’t prescribe you’re scuppered. 

The various discussions on this site really do underline what a lottery treatment is.  NHS dentistry has been a rather poor joke for a number of years….but there should, surely, be some sort of system in place for prescription medicines clinically deemed to be necessary to be delivered to patients without those patients having to be piggy in the middle between warring budgets which all adds to the stress of their treatment.  At the end of the day, we all pay towards the NHS.  It seems vastly unjust that some of us get excellent service while others are left fighting for the basics.  Toothpaste is probably the tip of a planet sized iceberg, but it’s not as if we can waltz into any branch of Boots and buy this stuff over the counter.   If I’m honest I don’t get why not.  Who would use it if they didn’t have to?  Are the risks associated with this stuff wildly greater than for common or garden toothpaste? Answers on a post card…..
Is there anything we can collectively do - or any existing initiative we could support - to try and get some consistency of approach in all this…..or are we too small a group and too widely scattered to have any impact on the ‘thinking’ which drives parts of the NHS?

Liz111 said:

Is there anything we can collectively do - or any existing initiative we could support - to try and get some consistency of approach in all this…..or are we too small a group and too widely scattered to have any impact on the ‘thinking’ which drives parts of the NHS?

I think a list of all the RT late effects clinics might be a good start. Then we have a target for our campaign. Get them to be our voice? 
Any other suggestions would be welcome. 

My GP  misdiagnosed my tonsil cancer for 2 years....if the Duraphat stops the complaint I have sitting in the draft folder will be fired off to NHS Tayside.....denying cancer sufferers essential meds is shocking treatment.

Peter

I’m away at a honey fair just now. 
When I get home I am going to write to every trust to find where the late effects clinics are and start there. 

Hi Dani

Grief….there are hundreds of them and it will take you forever…..and even if they bother to answer it will be the  usual platitude of being ‘committed ‘ to x y and z and giving you a raft of extraneous information you never asked for and telling you pretty much nothing.  (Apologies, but I am a huge cynic when it comes to ‘officialdom’)  I suspect also that the availability of late effects clinics is as  patchy as other things seem to be….and thus part of the problem. I think Nottingham is our nearest and I’m in East Yorkshire.

You are far better plugged in than I am, but do we know….or do we have any way of finding out what the extent of the problem is.and which regions or Trusts are being sticky about this…and then target them and point out, assuming this turns out to be the case, that they are outliers and should perhaps look again at the way they are treating vulnerable people? It might be that the cases are concentrated in certain areas which would make it an easier target.  If it’s down to individual GP practices across the country, then it becomes more difficult…and maybe an approach at National level perhaps through the DOH or whatever it’s called these days might help…perhaps fronted by MacMillan or in concert with MacMillan if they could be persuaded to help?  At the end of the day it’s an issue of fairness and equity of access.

Am I being hopelessly naive?!

Liz

Picking up on Dani’s point about getting a letter from the hospital.

I was given a discharge letter for my GP  by one of the consultants in the maxillofacial department which stated that I should be prescribed Duraphat ‘in perpetuity’. I found it quite amusing at the time and wondered how long that would be. Still going strong getting on for 2 years after the letter and prescription never queried by the GP. I’m in south west London.

This was my experience too…although the maxfax department sent the letter to my dentist not my GP.  This hasn’t stopped my GP prescribing it though. She has done so without question.  Nearly a year now.

Hi all. Been doing a bit more digging, including picking the brains of my neighbours who used to work for the department of health.

Their recommendation is that if people are having issues with getting items which have been prescribed, the first port of call should be the Integrated Care Board (replaced the Clinical Commissioning Groups post 2022) for their area which should be able to explain how to go about resolving issues about access to local services including prescribing.

If the prescribing authority (presumably the hospital) is in a different Trust from the one covering where  the patient lives it would be worth asking if there is a Service Level Agreement in place between the Trusts.  I would have thought this would be the case for Trusts in a hospital’s catchment area.  If there is then it should be easier to get prescriptions as this will be covered in the agreement . If not, then the ICB should be able to advise how to proceed.  I understand that where there is no SLA, the Trust issuing the prescription supplies it until a mechanism is agreed with the patient’s ICB.  I know this works for drugs in  life threatening situations Whether it would apply to toothpaste I don’t know…but as a prescription only item I can’t see why not.

For anyone unable to get their prescriptions fulfilled, it looks as if a two pronged attack: the ICB and the department issuing the prescription might be the best way forward.

I would be surprised, with the ever increasing concentration of services into centres of excellence for want of a better description, if issues like this, which are in my view, eminently foreseeable and are only going to get worse, had not been identified and addressed at the planning stage.  I suspect they may well have been, but the communication may have been patchy, resulting in the current apparently inconsistent situation.  

What may have fallen through the crack may have been long term preventative treatment for dental issues caused non dental treatments - like radiotherapy -  in the light of the virtual collapse of NHS dentistry.  In other words: us - and it’s the luck of the draw whether ‘the system’  catches us or not.

Logically we should, I suppose, be getting our ongoing Duraphat supplies via the dentistry services…but where those pretty much no longer exist there needs to be an alternative.  Fortunately some GP practices, including mine, seem to have recognised this and have picked up the baton.   I have no idea how widespread this is or how many people are being left without their prescriptions.  
Without this sort of data it is difficult to make any kind of case….or even to identify whether there is a wider case to be made.  It could be just a very small number of rogue areas or even individual practices where there is a problem which might be better tackled on an individual level.  Or it may be a huge issue affecting hundreds. It’s that guy Rumsfeld again: we don’t know what we don’t know.

if all else fails,  a letter to the MP of individuals who are being disadvantaged sometimes gets blockages in the system resolved.
Sorry…I’ve gone on a bit. Hope this makes some sort of sense to someone…

Liz

Just got a prescription from my dentist. GP always seems reluctant to prescribe