Why do I need a consultation for something I have taken for years?
Because a prescription is a clinical decision each time it is made, and that is a GMC requirement rather than a policy of ours.
In practice the review usually finds something worth knowing: a dose that could come down, monitoring that is overdue, a side effect being tolerated unnecessarily, or a medicine that is no longer needed. A review that changes nothing still confirms the treatment is right, which is not nothing.
Can you just do it without an appointment?
On pay-as-you-go, no. On membership, yes — repeat prescriptions are included without booking a consultation, provided it is clinically appropriate and you are within your monitoring interval.
For anyone on regular long-term medication, that is usually the more economical arrangement.
What will you not reissue?
- Controlled drugs — opioids, benzodiazepines, z-drugs and stimulants. Without exception, outside an agreed shared care arrangement
- Anything with overdue monitoring, until the bloods are done
- Medicines where the underlying condition has not been reviewed in years
- Anything where the original indication is unclear and cannot be established
My NHS practice has run out and I am going away.
A common and entirely reasonable reason to book. Have your repeat slip and the boxes to hand, and allow time before you fly — pharmacies do not always stock everything, and if you are taking medication abroad you may also want a travel letter.
Can you continue something a private clinic started?
Often, after assessment. Bring evidence of what you are on — the clinic letter, the boxes, recent monitoring.
Where a treatment requires monitoring we cannot take on trust, or where we consider the regime unsafe, we will say so rather than continue it. That applies particularly to testosterone and to weight-loss prescribing.
What monitoring does my medicine actually need?
Depends on the drug, and it is worth knowing rather than assuming:
- Levothyroxine — thyroid function, usually annually once stable
- ACE inhibitors, ARBs and diuretics — kidney function and electrolytes
- Statins — liver function, and lipids to check effect
- Metformin — kidney function, and B12 with long-term use
- Lithium, methotrexate, amiodarone, DMARDs — regular and non-negotiable
I want to come off something. Can you help?
Yes, and it is a good reason to book. What matters is doing it properly rather than stopping one day.
Several common medicines cause genuine harm if stopped abruptly — steroids, beta blockers, antidepressants, anti-epileptics, and benzodiazepines especially. A tapering plan takes one appointment to write. More on which and why.
Is a private prescription more expensive?
Not always, and the answer surprises people. The NHS charge in England is a flat fee per item whatever the drug costs, so for inexpensive generics a private prescription can come to less.
If you are exempt from NHS charges, hold a prepayment certificate, or live in Wales, the NHS route will be cheaper and we will say so.