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?

[Sallystyle]

In that situation Cotze it does sound much better than going to your GP.

The thing with me is that something that no one would even notice can look like cancer to me when I am unwell. A little red acne scar I can blow up in my mind to look like something nasty when most healthy people wouldn't even think of waisting a GP's time over.

I can't even begin to list the things I thought were something serious that other people could barely notice. I have got help for it and I much better now though.

I am more than capable with my children of knowing when they need to see a GP or not, it is simply just me I have an issue with, I hate that this illness makes me come across that I have no common sense over medical issues when I actually do, the anxiety just happens to take over with myself.


I think after reading more it actually does sound like a good idea but I do think that people like me with well known hypochondria would abuse it and there would perhaps need to be something different in place for us so we don't keep waisting specialist time?


I think only a small minority of people would probably call for no real medical reason but in my hands it would be something I would abuse so if something like this was to ever come into place I would think there may be certain people who would still need to see a GP first.

[Theodorous]

I am really sorry that you have to live with that and I really mean that. But every single other country in the world pretty much manages so there must be ways for doctors to treat self referrers. I suffered with bowel disease all my life until I left the UK so called irritable bowel. Within a month of proper healthcare I had been diagnosed and treated. For the first time ever I could go out without fear of incontinence and I will be forever in the debt of non British healthcare

[wobblyweebles]

I think only a small minority of people would probably call for no real medical reason but in my hands it would be something I would abuse so if something like this was to ever come into place I would think there may be certain people who would still need to see a GP first

Whether you're self-referring to a GP or self-referring to a specialist you are going to be abusing an expensive system. A specialist will reassure you that it's not cancer immediately, and I suspect you'd be more likely to believe them.

[Theodorous]

And a proper system has a little more to offer to mental illness than the woeful lack of access to properly qualified psychiatrists rather than counsellors and people would get proper treatment

[Theodorous]

I self referred to a shrink and paid about 40 quid a week. Much better than 5 minutes with a frazzled gp

[RevoltingPeasant]

Cote I have exactly the same issue but as I live in the UK and cannot afford to have regular private consultations, I don't know how my skin may be changing.

It worries me.

I have two separate conditions which mean I am in a high-risk group for skin cancer and have had several minor surgeries for suspected nasty moles. When I lived in the US and in CH, I saw dermatologists who did just what you described. Because you can't really see your own back.

I just wear lots of suncream and hope I don't get any more dysplastic nevi.

And it is precisely the sort of thing that is so hard to treat here, as if I went to the GP for screening I am sure they would think worried well and middle class woman taking up my time with a non-problem. So I don't. But it won't be a non-problem if I develop melanoma.

[Normalisavariantofcrazy]

Surely if you know you suffer from anxiety and you know your triggers then you'd go to a GP over a specialist in these times?

I know for me it's frustrating as I have many specific conditions that are under the umbrella of my general condition. I could see the specialist for my condition for him to refer on or what would be nice is not waste his time and be able to ring a clinic say I have x y and z which are common effects of this condition and now need your input to help manage.

For those saying breathing issues, aren't those specialists cardiothoracic so deal with both areas, one doctor?

If you don't know who to call, ring your GP but for those who do know and have a very definite issue - joint problems, chronic headaches, bowel or bladder issues, fertility Problems, erectile dysfunction etc it would be very very useful especially if they operate a triage clinic/series of questions to ensure you're in the right place. At this point they could make sure you've had blood and urine tests as appropriate so results are in place for the appointment

Or is that too efficient?

[Nocomet]

I just wish you could Email the GP. An hour spent in the GPs waiting room with DD1 missing school, when all you want is a physio appointment because it's the fifth time she's sprained her ankle in nine months is a total waste of everyone's time. Ankle was better by the time we got an appointment.

Physio was great, in 15 minutes he taught her exercises she still does 4 years later. We have had no more missed school for sprained DD1 ankles. (DD2 does gymnastics and is forever in the wars).

[Sallystyle]

Maybe Wobbly but when I see my GP he also helps me with the actual issue of my anxiety so I don't feel it is a total time waste as I do get some support with my anxiety as well.


Like I said, I like the idea a lot now I have read more and a better system in general would probably help people like me get access to a psychiatrists because god knows no one wants to give me one. Not even my husband has one and he has bi-polar. It has changed in our area and he no longer gets one to see regularly, he gets referred to one once he is at crisis point and the damage has already been done, which disgusts me.

Anyway.. that's a different subject but the more I think about it the more I think it would actually work very well.

[OldFarticus]

When I could not afford comprehensive health insurance, I used to have a basic policy that would pay for a specialist referral but not much else. That just made sure that the GP could not refuse to refer me when I wanted to see a specialist. (It is still a totally inefficient system though).

Ironically for those struggling to access mental health services, I was offered a referral to a shrink for health anxiety when staggering repeatedly into the offices of various GP's clutching a hot water bottle to my guts and crying. The referral (to a "nurse consultant") came through the day I returned home after having a large malignancy removed from my bowel.

I agree with the posters up thread - you don't miss the NHS after moving abroad, you just realise how bad it is. I hope that people eventually realise that there are far better ways to deliver universal healthcare, as demonstrated by almost every other country in the developed world.

[AdoraBell]

Because most specialists working in the NHS are probably too busy to listen to my MIL demanding a hip replacement, having marched straight past any reception area and into their office to tell them why she needs new joints.

[Heebiejeebie]

OP - to answer your first question - if your ears are full of wax then a hearing test is useless. So the nurse sees you first, you clear the wax, hearing probably improves, if not then you see audiology (cheap)

OR you go to audiology, clear the wax, go back (expensive)

[Heebiejeebie]

Old Farticus - I'm sorry to hear about your bowel cancer.
Which countries provide better universal healthcare for a smaller proportion of GDP (including insurance costs)?

[candycoatedwaterdrops]

YABU, not all bowel conditions need a refer to a gastroenterologist. Lay people don't know the red flags, the reason why a referral might be urgent or routine or even if it's something that can be solved with medication given by the GP.

[CoteDAzur]

I think the better comparison is spending per capita, not proportion of GDP.

Many countries' GDPs are much lower than the UK's but they choose to spend more of it on healthcare. And less on invading other countries, for example. It's about priorities.

[meandcoffeeequalhappy]

Because some people like to visit their GP or emergency department on a super-regular basis, and they would abuse the system even more. Bad enough to rock on up to A&E dozens of times a week with nothing wrong with you, and apparently that really does happen. I am sure many people are competent to self-refer but there are many others who are also not, and are either neurotic or lonely or just plain odd. So for that reason YABU, it would stress the system and staff even more. Unless we make people pay for services which are overstretched and underfunded, and in fact you could do that go private and help yourself to all the specialists you want!

[Heebiejeebie]

Cote, Rich countries, on the whole, spend more on health than poor countries. What does that tell us about the nhs?

[CoteDAzur]

That's a gross generalisation and tells us nothing at all.

[Theodorous]

I had a mammogram yesterday. I just walked into the private lab and paid £70 for the test and the radiologist. What I am saying is the NHS is shit because it doesn't allow people to choose and pay for things they can't afford. Healthcare is expensive and the NHS makes people think it is a frivolous little thing that is free. If someone can afford to see a doctor rather than a nurse with a degree and wants to, they should have that right. Then maybe people wouldn't die unnecessarily all the time.

[Theodorous]

They being the NHS not the person

[Gripneededfast]

The odorous, you can see a specialist privately .£190 per visit not including tests.

[Theodorous]

Yes but it is hard without a gp referral and they are very snotty about giving it. Also then have to waste an appointment to get it. In fairness haven't had to do this for 8 years and in those days at least one could get an appointment without waiting a month or seeing a nurse

[Theodorous]

I like The Odorous, it's like I am an important smelly person, maybe even their leader! On the beach sweating profusely at the moment so you may well be correct!

[CoteDAzur]

All hail The Odorous!

[Gripneededfast]

Ha no offence intended!
You can phone a private hospital actually and arrange the appt via the secretary just like that. Google it or look on LinkedIn