Can you insist on being referred to a specialist via GP?

[BostonIvy]

My partner has suffered from chronic acid reflux/indigestion for years and has to take medication daily, and will for the rest of his life.

The last time he visited the doctor a few years ago he was fobbed off and told to double up on the medication.


The NHS website advises referral to a specialist who can talk through potential procedures, can we insist he is referred?

Thanks

[thenightsky]

yes you can. I am a PA to a Consultant in a hospital and we get many referrals from GPs every week.

[NoMarymary]

In your DHs case I think it's reasonable for him to insist.

I doubt if someone could just insist on being seen by a specialist unless there was something actually wrong with them. So I guess it's to do with need.

[WorriedMutha]

It is for your GP to determine whether you should be referred to a consultant and the decision is based on clinical need. You can't self refer or circumvent this process. GPs are also increasingly criticised if they make inappropriate referrals (and equally when they fail to refer or refer later and something goes wrong).
I would suggest you go back and say that the symptoms are undiminished. It may well be that you just need further explanation of the rationale behind the GP's reasoning. At the very least have a frank discussion as it sounds as if you have been left confused by the advice.

[BostonIvy]

Thanks for all your replies.

He doesn't want to be on medication for the rest of his life as it has side effects.

There are several procedures that can be performed. He'd like to talk to a specialist who can discuss the pros and cons of each.

[NoMarymary]

My BIL has gone through the same process and the hospital consultant says he will need to be on medication for the rest of his life! I don't know of any procedures that don't involve major surgery.

[Sidge]

Even after surgery (I'm assuming you mean a fundoplication?) patients often need to remain on medication. And the surgery is pretty major and has risks of it's own.

If he hasn't seen a GP for a medication review in the last few years then he really should do - but he can't demand a referral without a GP agreeing it's clinically appropriate. You could of course request a private referral.

[Thumbwitch]

You can insist, but it's my understanding that they might have budgetary restrictions that could make them reluctant to oblige. In which case you might be better to try a different GP and insist again.

[Musicaltheatremum]

I would rather the medication than the risks of major surgery. Agree a medication review but there are guidelines that have to be followed before referral. Has he tried dietary changes (loosing weight if needed or reviewing what types of foods he is eating) does he smoke? Or drink excess alcohol. I'm sure you have been over all these things but sometimes simple changes can make all the difference. Saying that, if all this is done and you are still experiencing symptoms that aren't controlled a referral would be appropriate.

[Redcherries]

I've had the fundoplication. I still take daily meds and my operation went wrong meaning I also take antibiotics everyday for life so it's not clear sailing after the surgery - however my reflux was horrific with constant regurgitation and my quality if life is much improved.

I would push for. Referral but if you are on face book have a look for the nissen fundoplication group and ask to join. There are lots of people who are waiting for or have had the surgery who cN answer questions and give an idea of success rates etc

[Sidge]

But why would someone be thinking about asking for major surgery when they haven't seen their GP for a few years? If they are suffering daily and the medication isn't effective or acceptable to them they'd have seen the doctor sooner, surely?

[Kundry]

Surgery is nowadays a rare option. It usually don't stop you needing medication either.