Confused and new to PA

Hello I was diagnosed with Psoriatic arthritis and put on methotrexate by an nhs Rhumatologist. I’ve had regular monthly blood tests at my GP’s And now they do the methotrexate prescription for me as advised by the Rhumatologist.. So I don’t understand why you cannot get this with your surgery. Maybe you need to insist. I originally went to the Rhumatologist as a private patient to get an appointment quicker but he now sees me on the NHS. Good luck

Hi Queenie, I think that is one downside of going private. Yes with good intentions the specialist can suggest treatments and for many to be put on mild medications that is probably acceptable for them to prescribe as a private prescription or recommendations to your GP. When it comes to stronger meds that require ongoing tests and follow up appts then you really need to be seen on the NHS. Maybe your private consultant can fast track you to a rheumatologist on the NHS. You may be shocked or surprised at the actual cost of methotrexate tablets, we are talking pence per tablet not exorbitant amounts like some other meds. It is the after care that you need, best on the NHS. I know when I have regular blood tests my GP surgery won't do them, I have to go to my local hospital or a clinic that has the facility, may be that is the case at your GPS. Hope you get sorted and find some relief.

I was diagnosed by a private rheumatologist (admittedly fifteen years ago) who said that I should be prescribed a DMARD - sulfasalazine. He wrote the first prescription himself as a private prescription which I had to pay market price for. However, he also wrote to my GP, who after calling me in for a meeting to confirm that I understood the nature of the drug I was taking was happy to write the prescription himself in future. Things seem to be a little different these days. I suggest looking through the document linked to here which is the protocol for prescribing DMARDS in the Isle of Wight area, but seems likely to be replicated elsewhere. http://www.iowformulary.nhs.uk/docs/2019%20DMARD%20SCA%20v4.pdf Read all of it, it will help explain things, but the key passage is below. It does make reference to the possibility that the GP may refuse to take responsibility, but I see no reason why this should be the case. Referral criteria The specialist will be responsible for the prescribing and monitoring of initial dose(s) while treatment is being titrated. The specialist will inform the patient’s GP when the patient has initially commenced treatment. The intention to share care should be explained to the patient/carer prior to starting treatment. When the specialist has confirmed the patient’s condition is stable i.e. the treatment is clinically effective, dose is stable and monitoring is stable, they will then contact the patient’s GP. They will advise that the patient is considered suitable to be managed in primary care via shared care, detailing any specific requirements and doses to be maintained. If a GP is unwilling to undertake shared-care for a particular patient they must inform the specialist as soon as possible. This is to ensure alternative arrangements can be made in good time to ensure continuity of supply. Relevant contact details are provided in this document and will be provided in the clinical letter.

Thank you so much Just being heard has a uplifting feeling. Thought I was on my own when I walked out of that room, but now I know that is not the case. Will post in the future and let you know how I get on fingers crossed