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No no no funding for gingernutter

G

gingernutter

New Member
No funding for me!

After 17 weeks gathering dust in the PCT hands my application has been turned down again!!!!

Can you believe it!

What do they want from me? I am almost disabled by my obesity! I dont know what they want.

I am going to appeal again has anyone got any good ideas?

My BMI is 50.3 and I have a list as long as your arm of related health problems.
 
gingernutter said:
No funding for me!

After 17 weeks gathering dust in the PCT hands my application has been turned down again!!!!

Can you believe it!

What do they want from me? I am almost disabled by my obesity! I dont know what they want.

I am going to appeal again has anyone got any good ideas?

My BMI is 50.3 and I have a list as long as your arm of related health problems.
Click to expand...


Hi, Sarah,
Sorry to hear your news. :( What PCT are you under? Your BMI is very high for you to be turned down. Do you have high blood pressure, or high cholesterol as well? These conditions help when it comes to funding.
 
hi hun sorry you got turned down i got turned down twice by PCT before they finally accepted me. i'd say deffinately appeal it also helps if you have a GP backing you and a dietician like i did as they both wrote letters to PCT saying how i really needed the funding and how it was basically the only option i had left. Don't know if this helps but good luck with your appeal i really do hope you get accepted
vicky
x
 
I am under Luton PCT.

I have high blood pressure and cholesterol along with many other health problems as you might expect with a BMI of 50.3

I am so angry!!!!!!
 
So Gingernutter whats the plan now ?
Have you got :
Letter from GP
written down proof of your problems
history of weight loss through diet and pills etc...
any other letters of support
What is your PCT requirement ?
I am trying to think of anything else can anyone else think of what woudl help ?
 
I am angry too hun! I seem to recall when I returned to this forum in Nov last year, someone else was having the same issue (Helen, I *think*) and between some people, Shelbel included (I *think*), a fabulous letter of appeal or the like was put together.

Am sure Shel will be along at some point.

Never, ever, give in. :hug99:
 
SO sorry to hear your news Sarah. I cannot believe they have done this to you.

I recall the letter that Red is talking about, but I am sorry I cannot remember who had written it.

It is such a postcode lottery and so unfair that some people can get WLS with no health problems and a BMI of 40, and yet here you are suffering with health probs and a BMI of 50 and can't get the yes that you desperately need.
 
Sarah,

Did you actually appear before the panel, cos I contacted PALS and they forwarded me some details on how to appeal directly to the panel. I decided against it as it was tearing me to bits and self-funded but might be worth contacting PALS if you haven't already x x x
 
Hi again, I know this is for central Lancs PCT, but don't know if it will help, this is what PALS sent me

2. IMPLEMENTATION
2.1 [FONT=Arial,Arial][FONT=Arial,Arial]Appeals to the Commissioning Appeals Panel should be made in writing, addressed to the Chief Executive of Central Lancashire PCT and be made by, or on behalf of, the patient and set out the basis of the Appeal.
[/FONT][/FONT]2.2 [FONT=Arial,Arial][FONT=Arial,Arial]If the Appeal appears to provide substantially fresh evidence which was not apparently available to the Commissioning Panel, the Commissioning Appeals Panel may pass the matter back to the original Panel for fresh determination.
[/FONT][/FONT]2.3 [FONT=Arial,Arial][FONT=Arial,Arial]Prior to the Hearing, the Commissioning Appeals Panel will read and consider the papers relating to the original Panel decision and all documents submitted by, or on behalf of, the patient.
[/FONT][/FONT]2.4 [FONT=Arial,Arial][FONT=Arial,Arial]At the hearing, the patient may attend alone or in the company of a friend or advocate (clinical or non-clinical). The process will be as follows: -
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]a. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]A representative of the Commissioning Panel will set out, orally, the basis of that Panel’s decision.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]b. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The patient or their friend / advocate may ask relevant questions of that representative.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]Page 3 of 4 [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The current version of this policy is held on the PCT Internet. Check with Internet that this printed copy is latest issue[/FONT][/FONT]Central Lancashire PCT Commissioning Appeals Panel Policy
[FONT=Arial,Arial][FONT=Arial,Arial]c. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]Each of the members of the Commissioning Appeals Panel may also ask questions of that representative.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]d. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The patient or their friend / advocate may then set out orally the basis of the Appeal and any other relevant factors which the patient wishes the Commissioning Appeals Panel to take into account. [A patient may choose not to speak but to rely upon written submissions.]
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]e. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The representative of the Commissioning Panel may ask relevant questions of the patient.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]f. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]Each of the members of the Commissioning Appeals Panel may also ask questions of the patient.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]g. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The members of the Commissioning Appeals Panel will then adjourn the hearing to make their decision.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]h. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The decision of the Commissioning Appeals Panel will be communicated in writing to the parties within 14 days of it being made and the decision shall provide reasons.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]i. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]At any stage of the hearing, members of the Commissioning Appeals Panel may seek advice from the Panel’s chosen clinical expert. At any stage during the hearing or during the decision- making process the Panel may instruct its Legal Advisor to provide legal advice or assistance.
[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]j. [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]The decision of the Chair of the Commissioning Appeals Panel regarding process and relevance shall be final.
[/FONT][/FONT]
 
So sorry to hear this, what was the actual reason they turned you down?

I would keep appealing. Go back to GP and get them totally on your side and keep going.

I know you must be angry but use those emotions and keep fired up about this and badger them to death.
 
I have just called LUTON PCT (or Luton NHS as they like to be known now) direct and asked for their criteria for weight loss surgery and to begin with I got passed from pillar to post, so I can see why you are getting really frustrated with them. It seems like they have the communications skills of twigs.

I was told the lady, that I needed to speak to in commisioning was at lunch, so I waited and called back after 2pm as requested and got this answer...

BMI over 40, with diabetes type 1 or 2 and sleep apnea. You have to have all three or they will not fund.
 
Last edited:
cazbandy said:
I have just called LUTON PCT (or Luton NHS as they like to be known now) direct and asked for their criteria for weight loss surgery and to begin with I got passed from pillar to post, so I can see why you are getting really frustrated with them. It seems like they have the communications skills of twigs.

I was told the lady, Sharon Kember that I needed to speak to in commisioning was at lunch, so I waited and called back after 2pm as requested and got this answer...

BMI over 40, with diabetes type 1 or 2 and sleep apnea. You have to have all three or they will not fund.

Maybe you could call and speak to this Sharon Kember on 01582 ****** and ask why you are being turned down.

Also they referred me to this site:-

http://www.escg.nhs.uk/default.asp?id=100
Click to expand...

Totally excellent support, Caz - you're a star.

I know everyone else here would join me in offering to do anything we can to help you. Maybe emailing your MP?

It seems completely mad that they seem to be altering things to adhere to NICE guidelines but at the same time completely ignoring them in your case.

Lx
 
Last edited:
Hello everyone,

Thank you all for your ideas and specail thanks to caz! wow! girl power!

As yet I do not know why I was turned down. Today I have wrote to the CE of the Luton PCT and I have asked her why. I also sent her a copy of a letter I had from a consultant who told me I am in danger of decreased longevity or sudden death because of my obesity. Strong stuff! I also told her I deserve to live and without this surgery the future is bleak.

Luton PCT will fund if I have a BMI of 40+ with sleep apnea or diabetes. I do not have these but I do have mobilaty problems due to arthritis in my knee and hip, high blood pressure, high cholesterol and a long list of other obesity related problems too long to list. My BMI is 50+ but this still isn't enough for the LUTON PCT.

I have my MP involved already. My GP has been fantastic.

So I am sitting here waiting for the PCT letter to arrive. I have asked the PCT why they have ignored the NICE guidelines which says I should have automatic access however I have already done all the drugs and pathways and this is my last resort. I haven't asked for surgery as my first port of call like some people do.

Thanks for all the support.
 
I'm not too sure how much practical advice I can give. It really seams to have been covered mostly by others.

I still would really like to offer you my condolences, as you really seam to be someone who NEEDS this surgery rather than simply WANTS it.

Why bother having the NICE guidelines if the PCT's simply ignore them just to fit into a neat little budget!
 
Sarah surely the letter to your GP advising funding was refused should give the reasons why, if not your GP should be contacting them direct to find out why....they cannot just say "no". It is not just your fight they should be fighting with you and finding out the information without you having to write and wait for replies....get pushing chick...xx
 
Charlie girl as you know I have been walking in your footsteps. I hope it works for me as it did for you.

I believe the letter has not yet been writen as they are being very carefull. I will have to wait and see what they have say. The PCT have told my GP it is a NO and a letter to follow this week.

T thank you hun..
 
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