Prescriptions

You can usually collect your prescription from the pharmacy 5-7 working days after you have ordered it.

We are a dispensing practice and can therefore normally dispense for all our patients provided that they do not live within a mile of a chemist.  For more information about this see our Dispensary page 

If you have questions about your medicine, your local pharmacists can answer these. They can also answer questions on medicines you can buy without a prescription.

The NHS website has information on how your medicine works, how and when to take it, possible side effects and answers to your common questions.

• Go to Medicines A to Z (nhs.uk)

If you would like to speak to someone at the GP surgery about your prescription, please call the practice between 10am and 5pm Monday to Friday.

Dear Patients,

At Quay Lane Surgery, we are proud to serve the community of St. Germans, Downderry and the surrounding catchment area in East Cornwall. As a small rural dispensing GP practice, we not only provide medical care but also supply essential medications directly to many of our patients — a service that is especially important in an area where pharmacy access is limited.

In recent years, online pharmacies such as Pharmacy 2U, Simply Meds, Pharmacy Online and others have promoted their services to patients, offering free delivery of medications by post. While these options may appear convenient at first glance, we want to explain why we are unable to support these requests, and why this choice has real implications for the future of our local services.

Why Dispensing Matters at Quay Lane Surgery

Dispensing prescriptions to our patients is a vital part of how we operate. For rural practices like ours, the income generated from dispensing medications helps fund:

• GP and nurse appointments
• Chronic disease monitoring and prevention
• Home visits for housebound patients
• Emergency medication supply
• A full range of NHS services provided locally

Without this income, it would be extremely difficult — if not impossible — to maintain the level of care we currently provide to the local community. Our ability to remain open and sustainable is closely tied to our ability to dispense.

Why We Have Chosen Not to Offer EPS (Electronic Prescription Service)

You may have heard of the Electronic Prescription Service (EPS), which allows prescriptions to be sent digitally to a nominated pharmacy.

At Quay Lane Surgery, we have made the decision not to enable EPS. This is because, in rural dispensing practices, EPS presents serious risks:

• It enables pharmacies and online pharmacies to approach patients directly, often encouraging them to switch providers.
• Prescriptions can be diverted without full understanding of the consequences.
• Once a prescription is nominated to a pharmacy or on online pharmacy, we lose the ability to dispense it locally, and the associated funding is lost.

We have no control or oversight of this process once EPS is enabled, and patients are often unaware that their decisions can affect the long-term viability of their local surgery.

Clarifying Misleading Claims from Online Pharmacies

We are aware that some online pharmacies suggest they are working in partnership with local GP practices, or imply that we support or recommend their services. This can be confusing and misleading.

To be clear: Quay Lane Surgery does not work in partnership with any online pharmacy. We do not endorse or collaborate with them, and we do not share patient information or prescription details beyond the standard NHS processes.

If you receive a message, letter, email or phone call from an online pharmacy suggesting otherwise, we encourage you to treat it with caution and speak to us if you have any concerns. Patients have told us they believed the pharmacy was working with us — only to find their prescriptions had been diverted and were no longer available locally.

We Respect Patient Choice — But Ask You to Be Fully Informed

We completely respect that you have the right to choose where and how your prescriptions are dispensed. If an online pharmacy is the right choice for you, that is entirely your decision. 

However, we ask that you make this choice fully informed and with an understanding that moving your prescriptions away from our surgery means:

• We are no longer able to dispense your medications at the practice
• We lose funding that supports your care
• The viability of our rural practice becomes increasingly at risk
• You will need to manage sending your prescriptions to your chosen pharmacy yourself 

What may feel like a personal convenience can — when repeated by many patients — result in the loss of a vital community service.

How You Can Help

• If you’re happy with our service, please continue to collect your prescriptions from Quay Lane Surgery.
• If you receive a message from an online pharmacy, you are under no obligation to respond or agree to transfer your prescription.
• If you need help with medication collection or have difficulty attending the surgery, please speak to us first, we may be able to help.

Thank You for Supporting Your Local Surgery

We are proud to be part of the St. Germans and East Cornwall community, and we remain committed to providing accessible, compassionate, and high-quality healthcare to our patients.

By continuing to collect your prescriptions from Quay Lane Surgery, you are directly supporting the sustainability of your local health service — helping us remain here, for you and your neighbours, now and in the future.

If you have any questions or concerns, please don’t hesitate to contact us.

With thanks and best wishes,

The Quay Lane Surgery Team

If you have a repeat prescription, we may ask you to come in for a regular review. We will be in touch when you need to come in for a review.

Find out more about prescription charges (nhs.uk).

What to Do with Your Old Medicines

Proper disposal of old or unused medicines is crucial for safety and environmental reasons. Please follow these guidelines:

1. Return to Pharmacy or Surgery: In the first instance, it is important to return any old or unused medication to the pharmacy or surgery where they were obtained. This ensures safe and appropriate disposal.
2. Medicines from Quay Lane Surgery: If your medicines were dispensed by Quay Lane Surgery, please return them directly to the dispensary at Quay Lane Surgery.
3. Hospital Medications: If you have medications from a hospital, such as cytotoxic or chemotherapy drugs, please return them to the hospital pharmacy. These medications require special handling.
4. Controlled Drugs and Sharps: If you have controlled drugs (CDs) or sharp items, please inform our dispensary team. These items must be returned to the place that provided the controlled drug or sharps box to ensure they are disposed of safely.
5. Do Not Dispose in Household Waste: Please do not put any medications in your household bin or flush them down the toilet, as this can harm the environment.

If you have any queries about returning medication or are unsure about the process, please discuss with a member of the dispensary team.

By following these steps, you help ensure the safe disposal of medications and contribute to a safer community. 

Private Prescriptions for Weight Loss Injections

Many patients are now sourcing prescriptions for weight loss medication from private providers.

When we are informed of this, we inform these providers that we are unable to review your medical history on their behalf safety and for contraindications. The practice is under substantial pressure to provide NHS care and is not resourced to review notes on behalf of private providers. We advise them to ask the patient to access their notes online/via the NHS app, and you can go through these with you themselves.

Alternatively, you can request copies of your medical records to share with them. We also inform them, for the avoidance of doubt, the medicolegal liability for ensuring that there are no contraindications to your prescribing lies entirely with them, and they should not assume that the lack of a positive reply from us means that no contraindications exist.

Indications for weight loss injectable medications:

Tirzepatide (Mounjaro) when used together with reduced-calorie diet and increased physical activity for weight loss and to help keep the weight under control in adults, who have at the start of treatment:

·          a BMI of 30 kg/m² or greater (obesity) or

·          a BMI of at least 27 kg/m² but less than 30 kg/m² (overweight) and weight-related

·          health problems (such as prediabetes, type 2 diabetes, high blood pressure, abnormal levels of fats in the blood, breathing problems during sleep called ‘obstructive sleep apnoea’ (OSA) or a history of heart attack, stroke or blood vessel problems) ³

·          Wegovy (Semaglutide) is used for weight loss and weight maintenance in addition to diet and physical activity in adults, who have at the start of treatment:

·          a BMI of 30 kg/m² or greater (with obesity) or

·          a BMI of 27 kg/m² and less than 30 kg/m² (overweight) and weight-related health problems. ⁴

Important notice for patients using weight loss medications and taking the pill or HRT

These medications work partly by slowing down how your stomach empties — which can affect how well other medicines (like the contraceptive pill or HRT tablets) are absorbed by your body.

If you take the contraceptive pill:

Tirzepatide (Mounjaro)

This medicine may reduce how well the pill works.

You should:

·          Use a non-oral method (e.g. coil or implant) or

·          Add a barrier method (like condoms) for 4 weeks after starting or increasing the dose.

Use extra protection (like condoms) if you have vomiting or diarrhoea and follow the missed pill rules (see the patient information leaflet which comes with your pill) if you vomit within 3 hours of taking the pill or have diarrhoea for more than 24 hours.

Semaglutide (Ozempic, Wegovy, Rybelsus) and others

·          These do not appear to reduce the effectiveness of the pill.

·          But side effects like vomiting or diarrhoea can still reduce how well the pill is absorbed. So, use extra protection (like condoms) if you have vomiting or diarrhoea and follow the missed pill rules (see the patient information leaflet which comes with your pill) if you vomit within 3 hours of taking the pill or have diarrhoea for more than 24 hours Please see further information here: Patient-information-GLP-1-agonists-and-contraception.pdf

If you’re taking Hormone Replacement Therapy (HRT):

This applies if your HRT includes progesterone tablets like:

·          Progesterone or Utrogestan

·          Norethisterone

·          Medroxyprogesterone acetate

There is some concern that weight loss medications – such as Tirzepatide (Mounjaro) and Semaglutide (Ozempic, Wegovy, Rybelsus) – may reduce how well these tablets are absorbed. This could lead to irregular bleeding and may affect the protection of your womb lining (potentially leading to an increased risk of endometrial cancer).

What are the options?

Please contact us to talk through the best choice for you.

Options include:

Mirena coil (IUS):

·          The ideal option in most cases.

·          Works for 5 years as part of HRT and is also contraceptive.

Combined HRT patch:

·          Contains both hormones (oestrogen + progestogen) and bypasses the stomach. Increase oral progesterone dose:

Your GP may recommend a higher dose for 4 weeks after starting or increasing

REFERENCES:

      1.      https://www.themdu.com/guidance-and-advice/latest-updates-and-advice/advice-on-disclosing-information-for-patients-weight-loss-medication  [accessed 02/07/25] 2.

      2.      https://www.pharmacyregulation.org/pharmacies/standards-and-guidance-registered-pharmacies/providing-weight-management-services-faqs  [accessed 02/07/25]

      3.Mounjaro PIL via emc https://www.medicines.org.uk/emc/product/15481/pil#gref [accessed 02/07/25]

      4.Wegovy PIL via emc https://www.medicines.org.uk/emc/product/13799/pil   [accessed 02/07/25]

As qualified healthcare professionals, pharmacists can offer advice on minor illnesses such as:

• coughs
• colds
• sore throats
• tummy trouble
• aches and pains

They can also advise on medicine that you can buy without a prescription.

• Find a pharmacy (nhs.uk)

Many pharmacies are open until late and at weekends. You do not need an appointment.

Most pharmacies have a private consultation room where you can discuss issues with pharmacy staff without being overheard.

Benzodiazepines (e.g.Diazepam/Lorazepam/Temazepam/Alprazolam/ Clonazepam) are drugs which have been in use since the 1960s for treatment of a wide range of conditions including alcohol withdrawal, agitation and restlessness, anxiety, epilepsy and seizures, neurological disorders. muscle spasms, psychiatric disorders and sleep disturbance.

Initial use of benzodiazepines, including the well-known Diazepam also known as ‘Valium’, was enthusiastic and they were hailed as a wonder drug. However, it became increasingly clear that, as well as having short term harmful effects on memory, co-ordination, concentration and reaction times, they were also addictive if used for a long time, with withdrawal leading to fits, hallucinations, agitation and confusion, and further had long-term effects on cognition and balance. Unfortunately, benzodiazepines have also become a widely used drug of abuse since they first came on the market. Because of these reasons the use of benzodiazepines has been a lot more controlled around the world since the 1980-90s, especially in the UK. Diazepam in the UK is a Class C/Schedule IV controlled drug. The following short guide outlines the issues surrounding its use with regards to flying and why the surgery no longer prescribes such medications for this purpose.

People often come to us requesting the doctor or nurse to prescribe diazepam for fear of flying or assist with sleep during flights. Diazepam is a sedative, which means it makes you sleepy and more relaxed. There are a number of very good reasons why prescribing this drug is not recommended.

• According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) in treating phobic states. It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate Your doctor would be 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 and not going on a flight.
• NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorders. In more significant anxiety related states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed. Benzodiazepines are only advised for the short term use for a crisis in generalised anxiety disorder in which case they are not fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
• Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times for patients taking Diazepam which could pose a significant risk of not being able to react in a manner which could save their life in the event of an emergency on board necessitating evacuation.
• The use of such 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 an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours, the amount of time which has been shown to increase the risk of developing DVT whether in an aeroplane or elsewhere.
• Whilst most people find 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 which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.
• A study published in 1997 from the Stanford University School of Medicine showed that there is evidence use of Benzodiazepines stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates and may increase anxiety in the long term, especially if used repeatedly.
• Diazepam and similar controlled drugs are illegal in a number of countries. They may be confiscated, or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the homeward bound journey and/or other legs of the journey.
• 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.
• It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.

Given the above we will no longer be providing Diazepam or similar drugs for flight anxiety and instead suggest the below aviation industry recommended flight anxiety courses.

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this.  Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.

For further information:

• The Fear of Flying
• Fearless Flyer
• Flying with Confidence
• Flying without Fear
• British National Formulary – Diazepam
• British National Formulary – Hypnotics and anxiolytics
• Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline
• Travel Health Pro; Medicines and Travel; Carrying medication abroad and advice regarding falsified medication