GP & medication issue.

Hi , I am desperate for some advice regarding my usual medication. I was diagnosed with Reumatoid arthritis in 2015 . I was referred via my GP to the local Reumatatoligy department and was put on a course of Methotrexate and Sulfasalazine which have worked extremely well and has largely managed my condition successfully so much so that I have been able to continue my work as a joiner.

I had regular blood tests at my GP and had yearly consultations at the Hospital Reumatatoligy department. However just before Christmas last year I received a letter from my consultant that I was being referred back to my GP because of a missed appointment. I did not in fact receive a letter informing me of the appointment in the first instance - I don't know if it was a clerical error or as a result of the on going industrial dispute at the Royal mail.

I thought it would be easily resolved via the GP, after the Christmas holidays I called in on the Doctors surgery to settle the problem and collect my usual monthly prescription from the in-house Pharmacy.I was then told that the earliest appointment to see the Doctor was three weeks later which wasn't an issue as such so I discussed the problem with the receptionist who informed me that I was on a joint care package between my GP and Reumatatoligy department and that I would have to be referred back to the hospital because I had been referred back to my Surgery due to the missed appointment which wasn't my fault as I have attended all previous appointments without fail.i thought it would be a simple process to reopen my case . When I then went to the pharmacy to collect my meds . I was informed by the pharmacy that I couldn't have the Methotrexate and Sulfasalazine as I had been referred back and I needed the hospital to authorise the prescription.

I then telephoned the Reumatatoligy nurse who informed me that that should not be a problem as long as I provided my recent blood test results.The surgery emailed the results over some 20 days later. In the meantime l attended the GP appointment and he said he couldn't prescribe my usual medication without Reumatatoligys authorisation and prescribed Naproxen as I was by now experiencing painful flare ups as I had now gone almost a month without my tablets .

Unfortunately the pain was quite bad in my hands & Fingers that I was unable to work and subsequently have lost my job with the company I have worked for 27 years because I couldn't carry out my duties as a joiner, this I feel was a direct result of inflexibility of the joint care package.

I have now gone almost three months without any medication as the two parties just do not communicate as they are I two different local health trusts. I have tried unsuccessfully to resolve the medication issue using the hospital PALS department as they say it's down to the GP to prescribe and the GP contradicts and says it's up to the GP to prescribe!

I am completely at my wits end with the system leaving me in considerable pain without employment and no resolution in sight . My right hand has now developed a claw like grip which I increasingly have trouble using on every day tasks.

I feel that the whole situation could have been easily avoided but seem like I have been completely disregarded by the current system, whilst still awaiting my new referral request back at the Reumatatoligy department.

I would be very grateful if there is any practical advice you could offer .

Yours faithfully,

Stephen Cavill.

email address:


  • jonr
    jonr Member Posts: 398

    What a sorry tale of bureaucracy and slopy-shoulder syndrome Stephen and so totally unavoidable, I think everybody who reads your post will fully sympathise with your plight.

    Having read it a couple of times it's only my personal opinion but I think all roads lead back to the Hospital. If they provide their authorisation to your GP then it should be game on. Whilst it is obvious the mysterious missed appointment was the catalyst for your plight, 3 months on it clearly isn't relevant.

    I think if it were me I'd contact the Hospital first, say I'd been without meds for over 3 months due to a clerical error not of my making and ask my consultant to give his or her permission asap because without them I'm in pain 24x7, have practically zero quality or life and on top of mental anguish I can't work either. If they won't play ball I'd get on the blower to my GP surgery and ask for an emergency appointment and I wouldn't care if it were my GP or a different one, time is of the essence. The receptionist will want to know why so I'd say "look, due to an administrative error I've been without my usual medication for over 3 months now and whilst I'm waiting for the hospital to re-give their permission for my prescription I need to have something far stronger than what I've been on. No it can't wait because I can't work, I'm in pain 24x7 and my mental wellbeing is taking a battering".

    The only other option might be to register with Connect Health that are a bit of a fast track service for the NHS and have an MSK department. After speaking with them I had a consultant appointment at a local private hospital in less than 5 days and following that, an MRI scan 3 days later. Some people have found them rubbish but like many things it's down to the individuals so that might be worth looking at too.

    Apologies for the essay, hope some of this may prove helpful to you and you get back on track.

    All the best,


  • helpline_team
    helpline_team Posts: 3,482
    edited 22. Mar 2023, 17:31

    Dear @sjcavill1

    I cannot agree more with what jonr says. Your case is really shocking. I just wonder if you still might contact the hospital and leave a message for your rheumatologist via their medical secretary to see if human common sense might not prevail?

    Has your GP really used all of their efforts to contact Rheumatology directly and via any of their contacts at the hospital?

    I would encourage you to contact your MP as this clearly needs to raised.

    As a dear old friend of mine reminds me 'it's the squeaky wheel that gets oiled' so put another way - making a fuss and being persistent is what's needed when the admin systems fail.

    I would have thought what you might explore with PALS is why the injustice of you being discharged by Rheumatology was not challenged/reversed. I'd still be inclined to pick that up, but see what your MP thinks.

    How to campaign | Resources | Versus Arthritis

    I'd really encourage you to ring us here at the Helpline, so we can go over in more detail some options for you. Our freephone number is 0800 5200 520

    all the best

    Guy - Helpline team

  • Trish9556
    Trish9556 Member Posts: 519


    It might be worth while asking your consultants admin team to make sure that all your appointments are sent electronically via a secure link on a text message. We have had these in Bucks/Oxon for a long time and it 's so simple. Also ask them what date they sent the letter to you and put in a complaint to Royal Mail for missed mail and stress the importance of what has subsequently happened to you and the consequences caused by their strikes.

    We are still waiiting for cards to arrive that were sent for my husbands birthday and which have never arrived. We know there's no gifts in them so pointless tracking them.

    Trish x

  • jamieA
    jamieA Member Posts: 698

    Hi @sjcavill1

    I can only suggest that you put everything you've described in writing to both your GP and rheumatology department and have them hand delivered if possible. I had problems with my first rheumatology consultant's lack of concern for finding a treatment that worked for me and I put everything in writing and handed it to him. A week later I was being tested for a move to biologic medication and 3 weeks later was taking it.

    By putting it in writing there can be no dispute of the conversation whereas verbal communication can be forgotten/ignored.

    I'd also agree that you should get your MP involved.

    I still cannot understand why the NHS continues to use the postal service for every appointment when they ask if you've got a mobile phone and email address. My health authority, GP and dentist all send me a text the day before an appointment to remind me and the fact that missed appointments cost the NHS £135.

    I hope you get a resolution quickly.