How can i get PCT funding for my bypass?

[Gentlegiant]

Hello all,

I am 23stones and i have tried everything possible to loose weight. Even locked my jaws permanently for 3 month (3 times) to loose weight but i never really loose enough before i start to gain it back and i know my only option for a normal weight would be gastric bypass or banding.

I initially discussed this with my GP who was very unhelpful, then i changed surgery and had this doctor that was God sent. Was willing to see it through that i get funding for the surgery.

Unfortunately, he has now left the surgery nd i now have a new doctor who is again reluctant to help even though the endriconolgist has confirmed that i need the surgery.

A formal letter was sent to the luton and dunstable hospital on my behalf and true to the endriconologists prediction, i was declined on the fact that i am not diabetic (yet) even though my BMI is 40 and i have a family history of diabetes. I am now in the process of appealing but like i said, my new doctor is not showing much interest in helping me which is really frustrating to me. So for those who have been successful in getting the PCT funding, could you please advise what i can do to make this dream come true for me? I have written a personal letter to the doctor already, explaining what difference the weight loss will make to my life in general. you know not being judged by my looks first before anything else....

so please i need help here as i am desperate and i cany afford to pay for the surgery myself...

 

[Glenville]

Hi GG
I am confused as to why WLS has been refused. With a BMI of 40 you do not need co-morbidities to qualify for WLS. If you were between 35 and 40 then you would need CMs.
In any case, you would need to show that you have exhausted all other methods or losing weight, but your jaw wiring would have shown that I would have thought.
I would think you appeal looks very promising.

Good luck!

 

[Gentlegiant]

thank you for your email glenville. i am quite surprised too and i have been on reductil and xenical for 2 years now.. and the doctors have my record. I am 32 years old. I just believe that my gp could support me better then what he is doing right now.. he is just reluctant to help you would think im asking him to pay for the surgery. I am still chasing him though as he has promised to write the appeal letter on my behalf.....

 

[SOON SLIM SUE]

Hi, on my first appt i met people there who said the hardest bit was getting the funding and had to appeal a few times befor it was granted.
So don't give up, because in the end you must win.
If you don't get any where this time, change doctors again.
Make a pest of yourself, keep going to dr's with aches and pains, tell them your fed up with taking pills, you need action now.


keep in touch here, people here will encourage you to keep going (we have been through it ourselves).
Yours sue.

 

[fat-girl-slim08]

Hiya,
Sorry i can't help with your question but Just wanted to say welcome to minimins, But keep fighting it & Good luck on your weightloss journey!

 

[tesmaralda]

Hi Luton are one of the hardest PCTs to get funding from. The Nice guidelines are just guidelines that the lcal pcts use in any way they see fit. A lot of PCT's add extra crieteria you need to meet as a way of cutting out a lot of people from being eligable for funding.

Having said that don't give up, here's my advice on what to do next.

You need to write to Luton aand ask them for written confirmation of their criteria for bariatric funding along with a copy of your case notes and reasons why funding has been denied.

You then need to match all your medical conditions and reasons for needing surgery to Luton's criteria. And appeal the decission, it may help to get your Mp involved in the case and have a letter of support from them(however from speaking to others under your pct it alone will not pursuade the pct to change their minds).

You cn find a full copy of the NICE guidelines here Obesity. Then you need to state how you meet the NICE guidelines and finally how your weight is affecting your life and also all the things you have tried to lose weight and how it will change your life by being given a weight loss tool and understand that it is going to need a huge lifestyle change but you are willing to do what it takes.

Hope this helps - If you need anymore information just give us a shout.

xXXx