Doctors Referral

[tesmaralda]

Telford and Wrekin PCT follow NICE guidelines which are

1.1.1.1 Bariatric surgery is recommended as a treatment option for people with obesity if all of the following criteria are fulfilled:
· they have a BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2 and other significant disease (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight
· all appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months
· the person has been receiving or will receive intensive management in a specialist obesity service
· the person is generally fit for anaesthesia and surgery
· the person commits to the need for long-term follow-up.

1.1.1.1 In addition to the criteria listed in 1.2.6.1, bariatric surgery is also recommended as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate.
1.1.1.2 In people for whom surgery is recommended as a first-line option, orlistat or sibutramine can be used to maintain or reduce weight before surgery if it is considered that the waiting time for surgery is excessive.

The implementation tools for this guideline have information about more sources of information, particularly for professional groups. They are available from www.nice.org.uk/CG043


There for a Dr has not got the right to refuse a refferal the only people who can make that decission is the surgeon or the pct

 

[cazbandy]

I think this is very notable....cheer Tes

1.1.1.1 In addition to the criteria listed in 1.2.6.1, bariatric surgery is also recommended as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate.

 

[pinkelle]

Thats great. Thanksto everyone for your help, advice and support.
I am off to bed now but will be writing a letter to the surgery manager tomorrow when I get chance and see where that gets me.

THANKS AGAIN. YOU ARE ALL STARS!! XXXXX

 

[j.u.s.t.l.i.z.]

CHANGE GP'S ASAP ! one gp's thoughts on wls isnt necaserilly anothers, have a dig around and see if anyone has been refered for wls in your area and by which gp and go with them xxx a gp hasnt really got the right not to refere a patient as its not there decision if your suitable for surgery as the ultimate final decision is down to the fully qualified nhs surgeon x

 

[mandym1]

Sounds like you need to switch Docs.. what a horrible woman!!. You were very brave to ask I remember how nervous I was but my Doctor thought it was a great idea and I got PCT approval. There are plenty of good supportive Doctors out there, just right today off and move on dont let it hold you back... Good Luck. xx

 

[pinkelle]

Just found this on here.....www.sscn.nhs.uk/.../Chatterblog - February 8th 2008.doc

"OBESITY
Those of you who saw Trevor Macdonald’s ‘Tonight’ programme on ITV on Friday 1st February will know that it featured obese patients from various parts of the country who are concerned because their requests for funding for obesity surgery have not been approved. A group of Telford and Wrekin and Shropshire County PCT patients were amongst those interviewed.

Locally, the PCT’s policy is to fund obesity surgery for the small number of people for whom other options do not work, but alongside other options aimed at intervening earlier to prevent people from becoming so obese that they need surgery. For example, the PCT has funded the new ‘Active4Health’ programme, currently being set up to support people in the community who need help to get more active and eat more healthily. Our own PCT and Telford and Wrekin PCT have funded 27 people for obesity surgery, and Shropshire County PCT is making a further £100,000 available in the next few months. We are also working with Shrewsbury and Telford Hospital Trust who are developing plans for specialist obesity clinics and a local surgery service in line with NICE guidance."

 

[pinkelle]

Morning Ladies (and any gents!)

Am up and refreshed and putting yesterday behind me. Have decided I am going to look into this as much as I can and go and see another doctor. She has not put me off but not going to let her either.

Thanks to all who posted yesterday. xxxxx

 

[j.u.s.t.l.i.z.]

good luck elle stay positive and you will get your referal xx

 

[Porpo]

Will keep my fingers crossed for you. I dont think GPs realise that by the time we build up the courage to go and see them we probably know nearly as much as they do about WLS )

I was also told that from April 09 we have patient choice, and you can ask to be refered to a different hospital/PCT area if it's more convenient. So if you can say you have family who will look after you in another area etc, dont know if that might help too.

 

[Porpo]

) should have been a smily face... doh!!

 

[zetacatty]

I am worried though as my doctor was typing away the whole time she was belittling me and if she has put something to make another doctor in the practice also say no then I am buggered BUT on the other hand, if I went to another surgery then they would see all my notes anyway. Wouldn't they?

Don't worry sweetheart - doctors don't always stick together. I think Margaret's suggestion is a good one and certainly worth a try..... good luck hun - :fingerscrossed: Marion xx

 

[tesmaralda]

I had one dr at my practice who told me under no circumstances would I be granted a bypass as my surgery have to pay for it nd he as a senior partner wouldn't agree to it. I saw another dr in the practice and 10 months down the line I have had my op and it was funded by my pct not the gp's surgery. Drs don't always know the right information and talk out of their arses when they can't be bothered to find out the correct information

 

[thinkbethin]

Take the fab advice you've been given here. Get all the info regarding your PCT criteria and how you fit this and go see another doctor in your practice and show them this. If you get no joy with this one then try another. Sooner or later one of them will listen to you and take you seriously. Good luck.

 

[j.u.s.t.l.i.z.]

elle most gp's r not clued up about wls, and they all have diff views and alot of ppl are slipping thro the net that needs this because of there gp's lack of knowledge about wls, i know as it took me 1 year off bugging the gp's to get my referal x

 

[Snowcrystal]

Hi Marion, thanks for the hug!!!
There are other doctors there but i thought it might be best if i saw her as she is my "usual" doctor and has always been so understanding in the past.
Plus there is the fact that she is a she. Have said to my partner today though that the way she spoke to me I am seriously considering changing doctors.
x

Hi there Pinkelle

You seriously need to report her to the practice manager. How dare she talk to you like that. Condescending b*tch.

Write everything she said down and present it as a complaint. This should not affect your claim for a referral in fact this might actually work in your favour.

She sounds rather judgemental and should forget about her own personal opinions towards this life saving operation.

Anyway, here's another big fat {{{hug for you}}}.

You take care, and don't give up.

{hugs}

 

[Bonita]

Pinkelle I had the same problem initially being turned down by most of the doctors at our practice. It wasn't until a Neurologist told me to go back and demand a referal that it finally happened.

If you know that you come within your PCT guidelines which with a BMI of 61 you definately do, then take the info into your doctors and demand it. Can I be cheeky and ask whereabout in Telford you are and which doctors you use because I may be able to help you with that side of things.

Whilst I was in Walsall recently there was a lady there from Telford (Leegomery) which made me laugh a bit because the same day my neice was having her operation in Telford but she comes from Hereford.

One thing thats worth noting is that Telford are in the very early days of this type of surgery and don't have a lot in the way of follow up care in place. Although my neice has healed really well she got little or no dietry advice, tablets etc that we all got from Walsall.

If you fall within the PCT guidelines you have a right to be refered so you go straight back to that woman and demand that she refers you. Its the surgeons decision as to whether you should be offered this type of surgery or not. Its a long road once you have that referal with regards to pre-ops and all the tests they do prior to surgery so you tell her that the surgeons are far more experienced and far better placed to make the decision than she is.

Just ask her if she would like to spend a week in your shoes and see if she likes it.

 

[pinkelle]

Hi Bonita,

Thanks for the post on my thread.
I am living in Dawley and I am registered at Webb Medical Practice in Dawley. Which practice are/were you with? I see they kept saying no to you.

My doctor even mentioned that another one of her patients has recently had surgery and she only referred them as she knew they would change their ways accordingly and would benefit.

Who is she to say I won't benefit from surgery??!!

Any help would be appreciated. All the other help and advice I have been getting has been fantastic and just want to make sure I am well armed so to speak when I go back!!

Thanks

 

[dreamofbeingslim]

Hi Pinkelle I think this dr is so rude and condescending. Does she not realise that PCOS causes weight gain not the other way around. With your bmi she has no excuse not to refer you for weight loss surgery. Try and find out if there is an obesity clinic at your local hospital and ask for a referal there. I know it may take longer but they are very good or the one I attended in Cambridge was brilliant. They recommended wls for me straight away but I chose to try and loose first, which I did and have since put it back on. So in the end the hospital sent a request to the pct for funding. Good luck with your journey and definately see a different dr.

 

[Bonita]

Hi Pinkelle I think this dr is so rude and condescending. Does she not realise that PCOS causes weight gain not the other way around. With your bmi she has no excuse not to refer you for weight loss surgery. Try and find out if there is an obesity clinic at your local hospital and ask for a referal there. I know it may take longer but they are very good or the one I attended in Cambridge was brilliant. They recommended wls for me straight away but I chose to try and loose first, which I did and have since put it back on. So in the end the hospital sent a request to the pct for funding. Good luck with your journey and definately see a different dr.

Thats a good idea Sharon, do it through the obesity clinic. I've PMed you Elle, not sure it helps much though.

Also with regards to what she wrote on your notes, you do have the right to read your notes and question anything thats written there that your not happy with.

Go back, keep having a go and let us know how you get on.

xx

 

[Sambucca]

Hun, first of all big hugs.

Caz has given you the best advice so far. Write to the practice manager, stating how the doctor has upset you and not taken you seriously, that you understand what a major operation this is, and that it is precisely because you cant maintain any weight loss that you need surgical intervention.

Also state that you meet the criteria of the PCT and so would appreciate a referral so that a specialist in obesity surgery can decide whether it is right for you.