Terms & conditions

By clicking on term box “I have read and understand the terms and conditions”, you demonstrate that you agree with these, and that they represent the basis for a contract to supply medical advice and either prescriptions for topical treatments or a letter to your GP advising that these be prescribed for you.

Dr James Pimm – the doctor, shall agree to abide by certain regulations as imposed by the General Medical Council of UK.

Make the care of the patient – here restricted to eczema care – his first concern, and keep his professional knowledge and skills up to date for this. He will recognise and work within limits of competence, taking prompt action to address patient safety, dignity and comfort. He will protect and promote the general health of patients to that end.

He will treat patients with respect, considerately and respect their right to confidentiality.

He will listen to and respond to concerns and preferences, giving information regarding their health needs and in ways that they can understand, supporting their attempts to improve their skin health.

He will work with colleagues in ways that best serve their needs, which may include writing to them, advice on any prescriptions, or suggestion for onward referral.

He will prescribe effective treatments based on best available evidence, and consult with colleagues where appropriate, respecting patients’ rights to another opinion.

He will keep clinical records, including photographs, safely and securely.

He will make case studies for any discussions with colleagues for the purposes of education or revalidation in an anonymised fashion.

The service will not replace the duties and care of the patient’s NHS registered general practitioner, and in any event this practice will retain overall responsibility for care of all medical needs, rather than the limited service provided here. The service provided here is not that of a specialist dermatologist, but rather that of a general practitioner taking a special interest in the care and management of this skin condition, to assist the registered GP with specialised knowledge obtained by ongoing learning and reading within this discipline from a general practitioner’s viewpoint. If this service provision is not successful in adequately controlling or managing the eczema or dermatitis, the patient will be asked to attend either their general practitioner for onward referral to a specialist dermatologist, or in any emergency, to the accident and emergency department of their local hospital for more specialised care.

The patient or the child’s parent, where the patient is under the age of consent, or lacks the capacity to consent, must assume responsibility for engaging in the treatments proposed, where they agree to this contract. Treatments shall be provided in the first instance where possible to do so, or may be prescribed, or requested as prescriptions from the usual GP. It is the patient or parent who must make efforts to obtain prescriptions on the NHS where these may be more cost-effective to obtain, and it is not the responsibility of the service to ensure that this happens.

Where the patient or parent is unable to supply medicines prescribed on the NHS to replace initial treatments provided, they shall obtain these medicines or creams using private prescriptions supplied, aware that the chemist dispensing these may charge the patient differently to charges agreed for NHS prescriptions.

In compounding or mixing creams together, the patient is aware that such mixing can be done by the patient or parent at home safely by following good practice guidelines, but these compounded creams may only be used by the patient for which the cream is made up, and only in the manner advised for the duration advised, as indicated by the stage and severity of any eczema flare. Any use of the cream or creams outside of these specific instructions constitutes a breach of the prescribing guidelines, and may either render the topical treatment ineffective, or breach safety levels of the constituent parts, despite their being adequate dilution of ingredients in carrier emollient.

Mixed or compounded creams may be safely used within the terms of prescribing guidance, but as the individual tubes will have been opened at the stage of compounding or mixing, these will have a shelf life of six weeks during which they may be safely used. Care should be taken in storage of these creams to keep out of the reach of young children and toddlers who may not be able to read or use the creams appropriately. As the creams may contain natural oils, if any cream has separated after mixing, it should either be discarded, or advice sought on replacement. Likewise, any abnormal discolouration or odour of the compounded cream shall be treated in the same manner.

Mixed or compounded creams may be supplied in the first instance, ready mixed, but this service shall be deemed to have been mixed in the same circumstances and conditions that a patient or parent could mix or compound themselves for their own use at home. Such home mixing or compounding takes place under clean rather than sterile conditions, and care must be taken to ensure compliance with the recipe of ingredients and the methods to ensure good and even distribution of ingredients throughout the cream.

Such mixed or compounded creams are supplied in good faith that they will be used as directed, and if they contain cortico-steroids and antibiotics with emollient, in the understanding that incorrect use may jeopardise the effective use of such antibiotics in future. Topical antibiotics may not replace the need for occasional courses of antibiotic or anti-viral medicines by mouth if infection by Staph or other germs demands it.

Any sharing of experience of this service on social media or by other means shall respect the privacy of the individual child or adolescent or adult, and shall not breach their desire for privacy or their human rights. Likewise any defamatory comments posted regarding the service shall be taken down or removed upon request, should such comments on the service imply a dissatisfaction with the results of treatment.

As such, there is no guarantee of cure with atopic dermatitis or eczema, and some cases will still require the services of a hospital or specialist dermatologist. There can be no guarantee or money back in instances where the disease does not come under control despite the best efforts with topical treatments.