To think the NHS could/should trust us to make our own referrals in some circumstances

[Normalisavariantofcrazy]

In the same manner that I can phone the school nurse and say 'can you do a hearing test for my dc' and she toddles off to the school and does one, why should I as an adult not be able to do that for myself but instead need to make a GP appointment before seeing a nurse to check my ears to then be referred to audiology?

Same thing for continence services, one PCT I lived in it was a self referral service, this PCT it's a GP referral service. Again with this one why is it not also automatically linked into gynae? So you have your baby, they then put you on a list to get a letter 12-18 months later inviting you to a check up and advice service if you want to take them up you do if not no harm no foul. With that I wonder if a lot of things can be nipped in the bud with early physio intervention and also means again no embarrassing chat with the GP so possibly a higher uptake on the service.

There are other areas where this could be implemented too such as running clinics in the same manner as sexual health clinics - so diabetes, asthma and blood pressure checks could be run as self referral drop in services.

I realise a lot of this is probably finding restricted but you know when you have a thought and you want to mull it over?

AIBU with this?

[BeyondRepair]

Good idea First.

I was trapped by a stupid doctor, it took two years to find out small thing wrong with me, by time I actually got an endoscopy. I thought I had cancer he kept telling me nothing wrong..now after that I dont trust them...

I know my body

[turgiday]

eurochick - Whenever I see people talking about the idea of top up payments in the UK, it is always people like yourself that rarely visit GP's or the hospital. You are not actually the people who use the NHS the most. Most services in the NHS are used mainly by people with chronic and often multiple health conditions. But their needs are usually ignored in these discussions.

[turgiday]

Surely any health system should be built round the needs of those who rely on it? Those like me who would have died very young without it? Those who have to use it frequently? It makes no sense to model the NHS around someone who goes once a year to get some minor symptom checked out.

[Owllady]

There would be too many time wasters in specialist clinics

[Theodorous]

I couldn't imagine living in a place where you have to beg cap in hand for a referral. I couldn't live in the UK again it would do my head in. Africa, India, Middle East and US where I have lived, if you have a eye problem you see the eye doctor and so on. The NHS is awful, you don't realise until you live elsewhere.

[TequilaMockingbirdy]

I've never begged cap in hand for a referall. Obviously there's going to be GP's who are arses though.

[BeyondRepair]

it took two years to find out small thing wrong with me

Just want to add here, small thing in my mind compared to the cancer I thought I had.

Condition that requires medication, but is moderate but that could develop into something nasty.

IE something that was rightly checked out, found out and should have been much sooner.

[wobblyweebles]

Because of hereditary health problems, I have to pay really high fees for travel insurance. I doubt I would get private health insurance. That kind of system would cripple me financially.

Even in the US you can no longer be charged more for health insurance board on your health history. Nor can they refuse to sell you insurance.

[LeapingOverTheWall]

but what if you don't know which speciality you need? DD has a condition which can be dealt with by a cardiologist, a rheumatologist, and electrophysiologist, a neurologist, possibly a gastro-enterologist and in some areas an older persons clinic. Or in our case a paediatrician with a special interest. How would I as a non-medical person have a clue where to start?

[CoteDAzur]

If you don't know which specialty you need, you go to a GP. As has been said numerous times on this thread.

[RevoltingPeasant]

Tequila that is the thing though, it doesn't bother you till it affects you.

My husband has erectile dysfunction, a problem which is often psychological but can have physiological (cardiological) causes. It took him six years to get a referral to an andrologist. During this time, no GP ever physically examined him or explored the heart aspect other than to ask if there were any history of heart disease in his family. This also delayed our ttc massively as he cannot take Viagra and the GP did not know about a similar drug which was suitable for him. Can you imagine how frustrating that is?

I do agree that in the NHS, as it is set up now, GPs need a gatekeeping role. I personally don't think the NHS is the most efficient and best way to run state-provided medicine, but that's another thread :) However, my point earlier was, gate-keeping is fine but GPs should not be financially incentivised to do so.

I am fairly confident that the GP just didn't refer my husband on because he was early 30s, otherwise healthy, it was probably fine--and it would have cost to do so.

We still don't have DC :(

[LeapingOverTheWall]

Cote my post was to the OP's original suggestion of self-referring, not to how it works in France, sorry not to have been clearer.

[wobblyweebles]

The A&E argument is a little spurious. People generally incorrectly self-refer to A&E because they can't get to see their GP.

Our A&Es here are almost empty by comparison because you actually can get to see your GP.

One reason you can get to see your GP is because they're not wasting their time seeing people who should really be seeing specialists.

[CoteDAzur]

Leaping - In the UK as well, if you don't know which specialty you need, you would go to your GP.

You don't just forget about your GP if you are suddenly able to go directly to a dentist or a gynaecologist.

[Stevie77]

What Theodorous said. Just that. Until you have experience of other health services, you don't know how awful the NHS is.

Best example; children. Children should really see a paediatrician. Children are not mini adults, they are a health specialism for a good reason.

As it is, GPs are required to be specialists in everything, which is of course impossible so most know little about a lot. Some are indeed very good, but I fear the majority are not.

The fact they are incentivised to not refer or prescribe some examinations is, frankly, outrageous.

[BornFreeButinChains]

wobblyweebles

Very funny.

[Booboostoo]

turgiday sorry I don't understand your question. Is it what would happen in the French or Greek system if you had this condition later on in life? In France you would get public health care and your insurance would pay the small amount allocated to them. If your income was below the threshhold the state would pay for everything. In Greece you could chose to go to the, no frills, public health care, or have private insurance. Everyone who can afford it has private insurance which does take the burden off the public health care system.

[turgiday]

Boo - Surely my insurance premium would be sky high? Travel insurance for 2 weeks in Europe is very high for me.

[Booboostoo]

Well I can't swear to this about French insurance but my Greek insurance for example is not sky high and it is comprehensive. It covers me in Greece or on holiday or a move to a hospital abroad if the facilities are not available in Greece. The trick is that I was insured very young and kept up the payments so the same contract - as long as I do this they can't refuse to pay or put up my premiums beyond the normal yearly increase. My DD was insured at birth and stays under my contract until 18yo. If she has an on going condition the premiums cannot go up because of this, the sector is regulated by law. My suspicion is that French insurance is tiny and almost everyone can afford it.

I think the trick is in large numbers. If almost the entire population is insured, it makes sense, financially for the insurance companies and with appropriate legislation they cover people with long term illnesses. If insurance is something the minority take out, or just for a trip, or unregulated then insurance companies can make a killing and exclude certain people they deem too costly.

I know this type of insurance, i.e. unlimited with respect to long term conditions with no increase in premiums, is available for pets in the UK (not comparing humans to animals of course, just suggesting that the model is available in the UK already).

Idealogically I think the NHS is the most brilliant idea ever, to everyone according to need, not according to desert or ability to pay. That is how health care shoud be, but I am not sure it works in practice.

[Sallystyle]

You would get people like me with severe health anxiety referring themselves for a tiny spot thinking it is skin cancer

[Theodorous]

Better than the thousands if people the NHS kill every year through negligence and neglect

[Theodorous]

And you get to see a properly qualified physician rather than a a nurse with a little training course. I did a nursing degree and it was pathetic, half of the people I knew were barely literate morons

[Sallystyle]

Oh and if I was going through a bad patch I would actually believe that the spot was cancer and would probably describe it as looking like cancer because I have a mental illness that sometimes makes me see things and a lot worse than they really are.

Perhaps people like me shouldn't be allowed to self-refer and people without health anxiety like me can.

I admit that when I am ill I would abuse a system like that, not for the fun of it but out of sheer panic and illness.

[Sallystyle]

Sorry for the typing mistakes in my last post.

[CoteDAzur]

"You would get people like me with severe health anxiety referring themselves for a tiny spot thinking it is skin cancer"

Well, several years ago, I was suspicious about several moles and got an appointment directly with a dermatologist. Two were fine but one looked suspicious, so was taken out & biopsied. She said there are a few on my back (which I had never even seen) that needs to be checked every year so I go back to her once a year. She takes a photo of those moles with a special camera and compares them to the photos from previous years to see if they have grown or changed in any way.

Is this not better than going to a GP? What was a GP to do when went to him with my initial concerns? Either send me away because he doesn't know any better or refer me to a dermatologist.