News

MIND THE GAP CAMPAIGN

On the 1st September 2025, the GP ’Mind the Gap’ campaign commenced in Oldham, aligning with similar actions taken both nationally and across Greater Manchester.

 

This campaign is about and for you, our patients. It aims to enhance patient care and safety by resolving inappropriate transfer of work to primary care, and to identify and help push for gaps in services that are unfunded.

 

Over the years, General Practice has taken on many non-contracted roles and done excess work for other services for too long. This has led to unmanageable workloads for General Practice and practices across the country and pushing back so we can do what we need to do and are paid to do – looking after you.

 

In Oldham, we have asked for commissioning gaps to be resolved. These include enabling services like Dermatology and ADHD service providers to be able to request and prescribe their own medications rather than passing to General Practice to do. This not only causes delays to patients but also increases GP workload in actioning and following up the hundreds of requests we get every week.

 

We have written to the hospitals and ask that they

  • -          Request their own tests (e.g. blood tests and x-rays)
  • -          Action results for their own tests
  • -          Do not ask GPs to repeat tests within 4 weeks as they should be arranged by the hospital
  • -          Do not ask to chase hospital results
  • -          Provide fit (sick) notes for their patients for the necessary duration
  • -          Prescribe medication from hospital including new medications (GPs can continue, if necessary, once started)
  • -          Discharge patients with a minimum of 2 weeks medication
  • -          Do not ask GPs to refer to other specialties / consultants or departments (hospitals can do themselves)

 

We have also written to community services and ask that they

-        Maternity

o   Do not ask for GP to prescribe instead of their own team or employer

o   Do not send test results to GP instead of the hospital or their employer

-        Podiatry            

o   Do not send requests for prescriptions

o   Do not ask us to chase results of swabs

-        District Nurses

o   Do not send prescription requests

o   Request the use of authorisation forms other than for end-of-life medications

 

Other requests

Shared care – practices are not funded to prescribe and monitor higher risk medications and so have the right to refuse. We are seeking funding but, in the meantime, hospitals or other services providers will remain responsible for prescribing and monitoring.

 

We appreciate that some of these changes may take time to get right and may be frustrating. We are grateful for all the support our patients have already given and will continue to give us so we can reduce the amount of work we do unnecessarily and without any funding so that we can do what we are paid to do and improve the care we provide.


Published on 8th Sep 2025

Diazepam prescribing for Fear of Flying or Medical Procedures

Fear of Flying

After careful consideration CH Medical will no longer prescribe benzodiazepines or sedatives (such as diazepam) for patients experiencing fear of flying. Many other GP practices have adopted similar policies.

Patients sometimes request diazepam to help manage a fear of flying or to aid sleep during flights.

Initially introduced in the 1960s, benzodiazepines – such as Diazepam were considered revolutionary. However, over time it became increasingly clear that they have significant drawbacks. Short-term effects include memory impairment, reduced coordination, decreased concentration, and slower reaction times. Long-term use can lead to addiction, with withdrawal symptoms such as seizures, hallucinations, agitation, and confusion. There are also long-term risks, including impacts on cognition and balance. Unfortunately, benzodiazepines have become widely misused and are now a common drug of abuse.

Because of these issues, the use of benzodiazepines has been increasingly restricted worldwide since the 1980s and 1990s—particularly in the UK.

In the UK, Diazepam is classified as a Class C / Schedule IV controlled drug.

The following guide outlines why this medication is no longer prescribed by our practice for flying-related anxiety:

Why Diazepam Is Not Prescribed for Flying Anxiety

  • Safety Risk in Emergencies: Benzodiazepines cause delayed reaction times and slower thinking. In the event of an in-flight emergency, this could impair your ability to respond appropriately, putting your safety—and that of others—at risk.
  • Increased Risk of Blood Clots: Although Diazepam may help you fall asleep during a flight, it induces non-REM sleep, which reduces natural movement. This immobility increases the risk of blood clots (deep vein thrombosis, or DVT), particularly on flights longer than four hours. Such clots can be life-threatening.
  • Paradoxical Reactions: While Diazepam is usually sedating, a small percentage of individuals experience the opposite effect: agitation, aggression, or disinhibition. These behaviours could endanger yourself and others, and may lead to legal consequences.
  • Increased Risks with Alcohol: The combination of benzodiazepines and alcohol magnifies all the risks outlined above.
  • Guideline Restrictions: The British National Formulary (BNF) contraindicates the use of Diazepam for treating phobic states and discourages its use for short-term, mild anxiety. Prescribing against these guidelines may expose your doctor to legal liability.
  • NICE Guidance: According to NICE guidelines, medications should not be used for mild, self-limiting mental health disorders. In more significant anxiety-related conditions, benzodiazepines, sedating antihistamines, or antipsychotics are also not recommended.
  • Legal Risks Abroad: In some countries, including parts of the Middle East, it is illegal to import benzodiazepines. They may be confiscated, and you could face legal repercussions.
  • Workplace Drug Testing: Diazepam remains in your system for an extended period. If your employment involves drug testing, you could fail a test after taking it.
  • Link to Dementia: Long-term benzodiazepine use has been associated with an increased risk of developing dementia.

Alternative Support

Given the above concerns, we will no longer prescribe Diazepam for flight anxiety. Instead, we recommend either self-referral to NHS Talking Therapies (https://www.penninecare.nhs.uk/oldhamtalk), hypnotherapy or the following aviation industry-approved flight anxiety courses, which are widely accessible:

Please note: Flight anxiety is not covered under General Medical Services as defined by the NHS GP contract. Therefore, we are not obligated to prescribe medication for this condition.

Medical Procedures

CH Medical has also decided not to prescribe diazepam or any sedative for medical procedures, including MRI scans and dental treatments.

Some patients have previously received prescriptions for sedatives like diazepam to manage anxiety or claustrophobia during these procedures. However, this practice is no longer considered safe, for the following reasons:

  • Responsibility: GPs typically do not request MRI scans—these are usually ordered by hospital teams. If anxiety prevents you from attending your scan, please speak to the requesting department, not your GP practice.
  • Inappropriate Sedation: GPs are not trained to administer procedural sedation. Administering too little sedation may be ineffective; too much may dangerously depress breathing or consciousness and lead to cancellation of the procedure. Safe sedation requires monitoring, which we cannot provide in general practice.
  • Paradoxical Effects: Diazepam can occasionally cause agitation rather than sedation, increasing risk during procedures.
  • Delays in Procedure Timing: Hospital procedures and scans are often delayed. The sedation should be provided by the clinical team conducting the scan to ensure effectiveness at the correct time.
  • Radiology Safety Guidelines: The Royal College of Radiologists has strict protocols on sedating patients for CT and MRI scans. Prescribing a sedative without on-site monitoring is considered unsafe. If complications arise and the radiology team is unaware of a sedative you’ve taken, this could be extremely dangerous.
  • Surgeon or Dentist Responsibility: If sedation is needed for dental treatment or operations (e.g., cataract surgery), it is the responsibility of the treating clinician to provide it. We do not prescribe sedatives for these purposes.

If you are concerned about undergoing a scan or procedure due to anxiety or claustrophobia, please contact the requesting department or radiology service directly.


Published on 4th Sep 2025

NHSGM Mounjaro Information

Mounjaro for weight loss - Information

Please see important information below regarding the weight loss injection Mounjaro


Published on 30th Jun 2025

Page last reviewed: 08 September 2025
Page created: 12 December 2023