to be totally exasperated and want to know wtaf the point of this GP's referral was???

[RevoltingPeasant]

Okay, trying not to rant.

DP has had prostate pain for years. It flares up several times a year, meaning pain when he wees and causing severe erectile dysfunction because it's too painful to have sex (prob tmi, but past caring ). The pain episodes last anywhere from a few days to several months. At their worst, they hurt him when he walks.

He was told by his GP in the past that nothing could be done and he would have to put up with it. Never offered specialist referral. When we moved GPs practices recently, I encouraged him to try again. He has been 3 times since November - every time he had a serious pain episode. They refused to refer him twice, but finally, the third time, they said they would refer him to a urologist/ andrologist at local hospital. Result!

....Or so we thought. The referral letter came in the post today, and it is to these people - www.sentinelhealthcare.co.uk As far as I can make out, they are a private firm - of GPs. When I look at their clinical team they are all local GPs. So basically, no, he is not going to see a specialist. And - none of them specialise in urology. Not one.

AIBU to think this is a) ridiculous profiteering off the NHS and b) completely nonsensical as a referral?

We are waiting to start ttc but we can't because of this . We've just been put off - again - I am so sick and sad about this.

It looks like this is in line with the Gp commissioning plans put in place by the gov. Don't despair, op. although it looks like another hoop to jump through, your Gp has done the right thing and your husband will now be referred on to the right people.

It sounds to me like he has BPH.
I would look into a private initial consultation, it's usually around £150.00. and then often, the same consultant will continue to see you on the NHS at the local hospital.
Epididymytis is also worth checking out. I know it's further down, but it can affect the prostate.

i think this is the way things are going, they are a 'community interest company' which means they are not for the profit of their shareholders, which is good to know.
it looks like your DH will have to choose his specialist and this group help him through that procedure.

they are specifically for the 'commissioning of services' though so they will not send him away if he's been sent to them by his GP - this is the route to seeing a specialist.

The cynic in me thinks it is a way of getting past the 18 week wait targets That might be true, actually. Fucking outrageous if it is .

Freddos - The original appt was mid August but we are on honeymoon then. He asked to rearrange and they said no, they would send him another letter in the post - and if he couldn't make that appt, then another - etc.

Do they call that fucking efficient??? Sorry, trying to be calm.

Dawn what is BPH, please?

Also sorry Hexen clearly too hacked off to read your name properly.

Yes, add in another layer of bureaucracy - that'll make it work better.

musttidy God, you're right. ARGH.

www.bbc.co.uk/health/physical_health/conditions/bph1.shtml

Benign Prostatic Hyperplasia.

Sometimes happens in younger men. DH got it at 38. Have come across one or two around 25.

YANBU. I agree with you, can't see why it should be so difficult. Surely GPs have a responsibility to keep up to date with which department to refer to, at the very least!?

I do think it is a sneaky way round waiting times, in a sytem that seems reluctant to refer at all. A relative of mine has been pestering his GP for over a year to further investigate his problem. They kept refusing on the grounds that he has high blood pressure, which is non-responsive to medication. The irony is that the stress and worry of his other problem was nmaking his BP worse. He was on the verge of going private when he was finally referred (via A+E) He was right all along- he does have bowel cancer

Now, if your DP was a dog, he would have had a full preliminary work-up (bloods, X-rays, ultrasound, urine samples, prostatic wash) at his regular vet GP, and, if necessary, referred within weeks to a specialist (for MRI/ biopsy etc) I know people say it is the difference between private and NHS, but the initial tests really don't cost all that much to do in the great scheme of things. That depresses me.

BPH probably benign prostatic hyperplasia.

I know of other such referral review groups. I don't think they turn down many referrals but doesn't seem efficient to me and obviously frustrating to you.

Look at the performance reports on your PCT website, it'll tell you if they are meeting their target for 18 week referrals and you might find your answer.

It could of course be perfectly legitimate and due to GPs referring to secondary care inappropriately which can be a problem in some areas.

Thanks Dawn and Footy. Am not a medic myself but he doesn't have increased urge to wee or difficulty weeing - just pain - and he has a lot of symptoms that don't seem to apply to BPH, like pain after erection. So not sure if it could be?

Thanks must. I guess we should just suck it and see, but I am so sick of the bureaucracy. I grew up in the US and I really want to believe the NHS is better, more humane, but every experience I have is like this. You can see the intentions are there, but it doesn't seem to work very well.

Anywhoooooooo - maundering now - thanks all.

Sounds more like chronic prostatitis. This is a wikipedia link, OK wikipedia can be crap for health things but this seemed a reasonable overview
en.wikipedia.org/wiki/Chronic_prostatitis/chronic_pelvic_pain_syndrome
Treatment is difficult and often ineffective so if it is that there may be little a urologist can do to "cure" it anyway.
It looks as though a pain clinic and specialist physio may be as useful as a urologist as urologists are principally surgeons.

YANBU. Sadly this is typical of the NHS. There are so many stories like this these days. Very worrying.

To me it looks like a good service. All but one name have training in a speciality and can offer a good service.

I wish we had something similar here. My old GP was a rhumatology registrar before she trained as a GP. It was like having my own pet rhumatologist.

Where I live now I have another excelent GP but his interests lie elsewhere so I'm now waiting for a referal to rhumatology at the local general.

If my GP could refer me to my old GP it wouldbe more convenient for me, it would unblock my appointment with rhumatology, and it would allow my old GP to continue to practice her speciality.

I am a doctor. This is an absolute con, stopping GPs from referring people appropriately in the first place. Its job is to stop referrals.

Please complain. Patient complaints are the only thing that management will listen to.

www.kingsfund.org.uk/blog/referral_management.html

Yep, this is the new, restructured NHS. And this board is an extra layer of bureaucracy which gets to yay or nay your GP's clinical decision to refer you.

RevoltingPeasant, please don't believe this is what the NHS has to be about. This is a brand new thing for us - and sadly imported from the private insurance model of the US, where iiuc, insurance companies do precisely this and yay or nay the doctor's clinical decisions.

Welcome to the new NHS. Lots more private companies making money and wasting your time and a block to access to services... See it wasn't so bad before was it?!

Sadly yes it was bad before melbie. Dreadful waiting list fiddling for one thing.

Actually, yes, it was very bad in some areas. Inefficient and outright badly managed.

Bartlet - just caught up on this - who should I complain to? PCT? Practice manager?

2rebecca - it is chronic prostatitis, at least that is what the GP said - but we just want a diagnosis from a specialist and to be told that there really is no treatment before we resign ourselves to not being able to have DC!!

I'd check with the Practice Manager who the referral was sent to.

If it was to a Urologist, as I would imagine, then ask them who to complain to, likely to the PCT.

Sentinel (and other similar systems/groups) have been around for quite a few years now but many people wouldn't be aware of their existence having not required a referral to secondary care.

In my local area Sentinel act as a clearing house for all GP referrals. This a) helps filter out inappropriate referrals and b) makes sure that referrals are actually going to the correct department and/or hospital.

With the increase in sub-specialisations in some hospitals, it can be quite difficult for GPs to keep up with who treats what and where.

It might help to think of the letter coming from the 'Referral/Apptointment' office rather than than from another totally separate agency (i.e. Sentinel).

Having said all that, I'm still not convinced that these organisations are really giving VFM in some areas.

It does matter that it's a separate agency rather than office within the Trust, though. The intent over recent years has been to break the NHS into bite-sized pieces which can later be outsourced to private companies. This one may currently be a non-profit (not sure), but this structure permits say Serco or KPMG to get the contract.

And as someone pointed out above, it also happens to allow responsibility to disappear down the cracks.

This is already happening to disability services with ATOS and the Dept of Work & Pensions. Nothing is ATOS's fault - they don't make the decisions. Nothing is the DWP decision-maker's fault - they're not a medic.

And while I'd be surprised if refusal-quotas are part of the written contract, making clear one "share's the client's goals" is an important part of winning contracts (according to friends who prepare multimillion-pound, private-sector bids for govt contracts). If the client is the financial management of the Trust, their goals may be rather different from a doctor's.

Dear all - thanks for this - I will stop banging on and drop this thread after this :)

Bartlet thanks for the heads-up. DP and I have agreed that we will go to the appt and then complain if it doesn't have the outcome of referral to an actual specialist.

Crowning irony?? - guess who one of the 'specialist' GPs is who works at that centre? - one of our GPs!!! I guess his superior magic referral powers only work when he's doing a weekly shift in a referral management centre though