Prescriptions

These charges apply in England only. In Northern Ireland, Scotland and Wales prescriptions are free of charge.

• Prescription (per item): £9.65
• 12-month prepayment certificate (PPC): £111.60
• 3-month PPC: £31.25

If you will have to pay for four or more prescription items in three months or more than 14 items in 12 months, you may find it cheaper to buy a PPC.

• Telephone advice and order line 0845 850 0030
• General Public – Buy or Renew a PPC On-line

There is further information about prescription exemptions and fees on the NHS website.

Monkfield Medical Practice does not prescribe sedatives such as Diazepam for medical procedures, scans or dental appointments. This is a practice policy which has been updated following available guidance and agreed by all GP partners. 

• GPs are not regularly involved, skilled, trained or appraised in sedation skills. As a result, GPs are not trained to provide the correct level of sedation for procedures or scans. Providing too little sedation won’t relax/sedate you but providing too much sedation can make you too drowsy/sleepy, which could lead to the procedure or scan being cancelled.
• After taking sedation, you will need to be closely monitored to keep you safe. This responsibility lies with the person prescribing the sedation, so they need to be present before, during and after the procedure/scan.
• Hospital procedures and scans can be delayed, therefore the team performing the procedure or scan should provide the sedation, to ensure you become sleepy and relaxed at the right time.
• All hospital consultants, including those requesting and carrying out scans/procedures have access to the same prescribing abilities as GPs. If you need sedation to enable a scan or procedure to go ahead, they are just as well positioned to provide a prescription.
• Similarly, for any dental procedures, it is the responsibility of the dentist to prescribe any sedation they think you might need.
• The Royal College of Radiologists‘ own guidelines on sedation for procedures/scans does not mention GP involvement and stresses the importance of experienced, appropriately trained staff administering and monitoring sedated patients. This guidance can be found here: Sedation, analgesia and anaesthesia in the radiology department, second edition. (rcr.ac.uk)

We understand that hospital procedures, scans and dental appointments can make you feel frightened, anxious or claustrophobic but unfortunately, for the reasons outlined above, the responsibility to provide sedation does not lie with the GP. You should contact the department who requested the medical procedure or scan, the Radiology department or their dentist to discuss your options.

Monkfield Medical Practice have reviewed their benzodiazepine prescribing and established a policy not to prescribe benzodiazepines or sedatives (such as diazepam) to patients for fear of flying or travel reasons.

This policy decision has been made by the GP Partners on review of evidence and guidance. The reasons for this can be found below:

• Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for the you and those around them.
• Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than four hours.
• Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
• According to the prescribing guidelines doctors follow (BNF) Benzodiazepines are contraindicated (not allowed) in phobias. The prescriber is taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health.
• Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
• Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
• Any alcohol taken around the time of the benzodiazepine will likely potentiate the effects and increase the above side effects.
• We appreciate that fear of flying is a real problem for some people. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines and some examples are shown below.

Easy Jet www.fearlessflyer.easyjet.com Tel 0203 8131644

British Airways www.flyingwithconfidence.com  Tel 01252 793250

Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.