Prescriptions

Ordering repeat prescriptions

The easiest ways to order repeat prescriptions are:

• using your NHS account (through the NHS website or in the NHS App)
• using the GP online system: SystmOnline

We also operate an automatic ordering service for some patients. Please ask the dispenser if you are suitable for this service.

Please avoid collecting your prescriptions outside opening hours.

Collecting your prescription

You will need to choose a pharmacy to collect your prescription from. We call this nominating a pharmacy.

You can change your nominated pharmacy at any time:

• on the app or website where you order repeat prescriptions
• fill out a nominate a pharmacy or other dispenser form
• at any pharmacy that accepts repeat prescriptions

Text service

We now offer a texting service where we can text information regarding your prescriptions, including:

• When your prescription is ready to collect
• If there is a problem with your repeat order
• When your prescription has been sent to the chemist and any other useful information

There is a prescription collection service operated by three local pharmacies if we do not dispense your medication.

Specialist medications

Doctors working in other settings (i.e. hospitals, Mental Health teams) frequently suggest the use of specialist medications which they may ask GPs to prescribe. Following a specialist appointment, they may send a letter to the practice. The practice then has 14 days to review the letter and decide whether the medications recommended are suitable for GPs to prescribe. 

Medications that need to be started urgently (within 14 days) are the responsibility of the hospital. There is no obligation for GPs to prescribe a medication that was recommended by or started by another clinician. A GP must be satisfied that any prescription is safe and appropriate, in line with NHS guidelines and their prescribing competencies. 

Some specialist medications (e.g. stimulants for ADHD and immunosuppressants) require a “shared care agreement”. This allows GPs to prescribe specialist medications under the oversight of a specialist, who continues to review the patient’s treatment on an ongoing basis. 

Although there are established local shared care agreements with NHS specialists, these are not in place for private prescribers and so we do not accept shared care agreements with private specialists. This means that any medication requiring a shared care agreement that is initiated by a private clinician will need be prescribed directly by that private clinician. If specialist care is accessed privately, it is the responsibility of the private clinician to provide prescriptions. Medications started privately will only be continued to be prescribed by a GP if they are:

• in line with NHS treatment guidelines
• in line with the local prescribing policy
• are deemed to be safe and appropriate for the patient being treated
• might normally be prescribed by a GP (i.e. not a specialist medication or one requiring Shared care)
• The GP feels it is within their competency

Stimulants for Attention Deficit Hyperactivity Disorder (ADHD) in adults

Stimulants (e.g. lisdexamphetamine [Elvanse] and methylphenidate [Medikinet/Xaggitin/Concerta/Delmosart]) are specialist medications used to treat ADHD. 

These medications are always started by an ADHD specialist and require continued monitoring and review by specialists in accordance with national guidelines. GPs sometimes prescribe these medications as part of a “Shared care agreement” where a GP agrees to provide a prescription for a medication that is monitored by a specialist.

Patients are now not being regularly reviewed in clinic, as is required by national guidelines. This means that these are effectively no longer shared care, and that GPs take on the risks of prescribing medications that are outside of their competencies. Because of these issues Old Mill & Millgates Medical Practice is not taking on shared care agreements for stimulant medications for any new patients starting these medications with local NHS services. We also do not take on shared care agreements with private providers (see above). This means that stimulant medication prescriptions must be provided directly by specialist services (either NHS or private).

Neurodiversity in Adults – Norfolk & Waveney Integrated Care System (ICS

Unused medicines

Please do not store unused medicines, they can be returned to the surgery for safe disposal.

Questions about your prescription

If you have questions about your medicine, your local pharmacists can answer these. They can also answer questions on medicines you can buy without a prescription.

The NHS website has information on how your medicine works, how and when to take it, possible side effects and answers to your common questions.

Go to Medicines A to Z (nhs.uk)

If you would like to speak to someone at the GP surgery about your prescription:

• phone us on Old Mill Surgery, Poringland 01508 492929 or Millgates Surgery, Hempnall 01508 499333

Medication reviews

Patients on repeat medication will be asked to see a doctor, nurse practitioner or practice nurse at least once a year to review these regular medications and notification should appear on your repeat slip.

Please ensure that you book an appropriate appointment to avoid unnecessary delays to further prescriptions.

Prescription charges

Find out more about prescription charges (nhs.uk).

Pharmacy First/About pharmacists

As qualified healthcare professionals, pharmacists can offer advice on minor illnesses such as:

• coughs
• colds
• sore throats
• tummy trouble
• aches and pains

They can also advise on medicine that you can buy without a prescription.

Most local pharmacies have signed up to treat people for seven common, minor conditions without them needing to see a GP. The Pharmacy First scheme is making it easier for people to quickly get the help they need while freeing up millions of GP appointments. The seven common conditions that pharmacists can help people with under the Pharmacy First scheme are:

• Sinusitis (adults and children aged 12 years and over)
• Sore throat (adults and children aged 5 years and over)
• Earache (children and young adults aged 1 to 17 years)
• Infected insect bite (adults and children aged 1 year and over)
• Impetigo (adults and children aged 1 year and over)
• Shingles (adults aged 18 years and over)
• Uncomplicated urinary tract infections, like cystitis (women aged 16 to 64 years).

Anyone who thinks they might have one of these conditions can go to a pharmacy and ask for a consultation with and help from a pharmacist. If a pharmacist thinks you needs urgent help instead, they’ll refer you to a GP surgery or a local urgent or emergency care service. The NHS has created a video with a community pharmacist to explain the benefits of the Pharmacy First scheme to patients.

Find a pharmacy (nhs.uk)

Many pharmacies are open until late and at weekends. You do not need an appointment.

Most pharmacies have a private room where you can discuss issues with pharmacy staff.