PRIVATE PRESCRIPTIONS

Private prescriptions are written for medications which your private Doctor/Consultant has recommend for you.  A private prescription is not an NHS prescription and so it is not paid for by the NHS.

A prescription is a legal document.  The prescriber takes responsibility for the patient's use of that medication and for its monitoring.  Hardwicke House Group Practice does not have an obligation to convert privately issued prescriptions to NHS prescriptions.  If a private opinion is sought by a patient, any recommended medications would need to be prescribed as a private prescription by the private doctor.

You should take a privately-issued prescription to any pharmacy and bear the cost yourself.  Please note that the cost will be the price of the medication and NOT the standard NHS prescription fee.

BLOOD TESTS

Hardwicke House Group Practice follows the following guidance regarding requests for blood tests from a private provider.  The private provider is responsible for managing every aspect of their healthcare.  For that reason, private providers should not be asking GP's to arrange any tests that they deem necessary and intend to use to make a diagnosis and recommend a course of treatment with.

It is the private provider's responsibility to arrange tests for patients whose care they are managing, and the patient's responsibility to pay for them.

Practice Policy: Diazepam for Flight Anxiety and Before Medical Procedures

Our practice position

Following a review of the evidence, prescribing guidance and patient safety considerations, the practice has decided that we will not prescribe diazepam or other benzodiazepines solely for flight anxiety, fear of flying, or to help patients tolerate medical procedures such as MRI scans, CT scans, dental procedures or minor surgery.

We recognise that anxiety and fear of flying can be very distressing, and we understand why patients may request medication to help them manage these situations. Our decision is based on safety, appropriate prescribing and ensuring that patients receive the most appropriate treatment for their underlying anxiety.

Why we do not prescribe diazepam for fear of flying

Diazepam is a benzodiazepine with sedative effects. Official guidelines state that benzodiazepines (the drug family diazepam belongs to) should not be used for isolated phobias like a fear of flying.

Although diazepam may reduce anxiety in the short term, it can also cause:

• Drowsiness and reduced alertness.
• Slower reaction times and impaired coordination.
• Reduced concentration and impaired judgement.
• Memory impairment.
• Unpredictable reactions, including agitation or disinhibition in some individuals.
• Respiratory depression, particularly when combined with alcohol or other sedative medicines.

These effects are particularly relevant during air travel. In the unlikely event of an emergency, a sedated passenger may be less able to understand instructions, react quickly or assist themselves and others.

For patients experiencing fear of flying, we recommend:

• Fear-of-flying courses: Patients may benefit from recognised courses specifically designed to help people understand and overcome their fear of flying. These are available through some airlines and specialist organisations:

EasyJet Fearless Flyer: https://fearlessflyer.easyjet.com
Tel: 0203 813 1644

British Airways Flying with Confidence: https://flyingwithconfidence.com
Tel: 01252 793250

• Cognitive behavioural therapy (CBT): CBT, including gradual exposure to feared situations, is an evidence-based treatment for specific phobias such as fear of flying. Patients in England can self-refer to NHS Talking Therapies for assessment and treatment. https://www.wellbeingnands.co.uk/suffolk/self-help/phobias/

Why we do not prescribe diazepam before scans or other medical procedures

Patients may sometimes request diazepam before an MRI scan, CT scan, dental treatment, surgery or another procedure because of anxiety or claustrophobia.

We believe that where sedation is clinically necessary, it should generally be assessed and provided by the clinical team responsible for the procedure.

Sedation can affect consciousness, breathing, blood pressure and coordination. If medication is prescribed in advance by the GP, the timing and degree of sedation can be unpredictable. The patient may also require monitoring or additional treatment that is not available in a routine GP setting.

For procedures such as MRI scans, the hospital or radiology team is best placed to assess the patient's individual needs and determine whether sedation is appropriate and, if so, what form it should take

Patients who are anxious about an upcoming procedure should therefore contact the department undertaking the procedure in advance. The clinical team can discuss reasonable adjustments, additional support or, where appropriate, a suitable sedation pathway.

This decision is based on patient safety, appropriate prescribing, the risks associated with benzodiazepines, and the availability of safer and more appropriate approaches to managing anxiety.

Where sedation may genuinely be required for a medical procedure, the team undertaking the procedure should assess and manage this need.