"Prescribing Disparities Greater Glasgow and Clyde"

My mum has been suffering back pain for a number of years now. She had effective pain management medication that she'd been taking for many years when she lived in North Ayrshire and came under NHS Ayrshire & Arran. Her medication was regularly reviewed and renewed, as it was a treatment that was working well for her. When she moved to a new area and registered with a new GP within the NHS Greater Glasgow and Clyde the treatment was abruptly stopped. She was advised by the GP practice that the medication she was taking was not on the GG&C formulary. Since then her pain management has been nothing short of abysmal.

The alternative medications offered to her are all significantly stronger than the medication she had previously received. She tried each of these as her pain was intolerable, however the side effects were severe and debilitating and left her feeling extremely sedated, nauseous, drowsy and dizzy. My mum is the sole carer for her husband who has substantial brain damage following a stroke. These adverse side effects were not an option for her and why should they be for anyone, especially with the knowledge there is another medication that helped to manage the pain without any of the above side effects.

My mum was referred to the pain management service who prescribed another potent analgesic that caused her to feel like a zombie. She attempted to speak to the Doctor from the service about the original medication she had been taking, but was met with the same response: it is not on the formulary therefore it cannot be prescribed.

I wrote to the Scottish Government Chief Medical Officer, and the Chief Medical Officer for GGC. Both responded by clarifying that health boards may prescribe outwith their formulary when they believe it would be beneficial to their patient. I passed on this information to the practice & pain management service, I was advised that they had conducted inquiries with Ayrshire and Arran & they rarely use the medication my mum was taking anymore.

Subsequently, I submitted FOI requests to GGC & Ayrshire & Arran separately, seeking information on the number of prescriptions for this medication issued by a GP within each health board. The information I received showed that not only are Ayrshire & Arran still prescribing it, but that there are GP's within GG&C who are also issuing this.

This is all a very condensed version of what has been happening, I could write a short story on this saga and how long it has dragged on for. At the heart of it is my mother, who is now in her early 70s who can now barely walk, struggles to sleep, is socially isolated, depressed and anxious. I appear to be the only one that cares about the likelihood of this contributing to further health problems and deterioration. Healthcare shouldn’t only be reactive, but preventative. None of this appears to have been considered.

I am at a loss as to how, in a health board that is fundamentally meant to be patient-centred, a person can be treated like this purely due to their postcode. I am also at loss as to how when a patient prefers to continue treatment with a milder opioid, GG&C, is instead prescribing significantly stronger opioids?

It's extremely distressing to watch someone you love suffer, it is angering to realise that this suffering could be partly alleviated if they lived in a different postcode. I find my own mental health suffering from what feels like an injustice, and I'm not the one that has to contend with the physical pain. How can it be deemed acceptable to have such a significant disparity in patient care solely based on geographical location?

I believe that my mother has received an exceptionally inadequate standard of care from NHS Greater Glasgow and Clyde concerning the management of her pain, and has been badly let down.