NHS Refuses to Offer Surgery

[AchatAVendre]

Wondering what people's thoughts are on this. My NHS healthcare trust is point blank refusing to offer me surgery for a condition that is normally fixed by surgery that almost everyone agrees that all the clinical signs are present for. They want to "do nothing". The problem is causing issues and pain and there is no way forwards from this opinion. I have reached the end point with my healthcare trust.

I have asked to be referred through patient choices for a second opinion but the issue is now causing so much pain and physical damage that I'll probably end up paying for surgery privately because its taken so long to get to this stage. Around £6k. I can afford it, but obviously I'd rather not take 6k out of my savings for something that just about anyone else would get surgery for. I should also point out that I'm not a smoker and not overweight, and even my GP surgery can't understand it. But no-one is doing anything about it. My GP is quite frustrated but can't really do anything. I had a private consultation and the surgeon said that the surgery in my case has a 99% success rate and he can't understand why I wasn't offered it by the NHS. It affects my mobility and therefore my ability to work. Yes, I will complain to the Ombudsman but realistically it will be many months before they even look at my case, never mind do anything about it.

What on earth do you do in practical terms if your NHS healthcare trust simply refuses to operate? I do think its probably a bit sexist as it appears that statistically men are more likely to get this (non-sex related) surgery than women in my trust and some of the written responses I have had display quite a bias and stereotypical thinking about women and at a couple of points, delve into the realms of fiction in inventing reasons for the issue (it occurred due to a an accident, they wrongly claim its because I'm peri-menopausal and I should just accept fractures and complications arising from them).

Complain to your MP ?
I hope you resolve it soon, you shouldn’t have to pay.

What reason have they given for not offering you the surgery?

What is the surgery?

Contact your local CCG and ask for their current Individual finding request policy. This should state what they do and do not commission and criteria for being considered for treatment. It is a bit of a postcode lottery I'm afraid. The policy should also contain reference to appeals procedure

What surgery are you wanting, and for what issue?

They haven't given a reason...

I made a complaint and did ask for a reason to be given but the response to that particular question was a bit of a rant about how I'd used what they thought to be the wrong terminology for the issue (arguably it is not) and didn't answer the question at all. It was really quite an odd response but then thats been in keeping with what I've received in response from them all along.

I second emailing the CCG and your MP

I’m presuming at some point you discussed this with a consultant and they must have explained the treatment options and why they are refusing surgery though?

Thats a great idea, I'll get onto it. Unlikely to give me any resolution but might prevent it happening to others.

I'd rather not be too identifying of the precise issue. It is however easily fixed by day case surgery and no-one, from my private physio, to my GP, to the other consultant I have seen, can understand why I'm not being offered it. Its definitely carried out by my trust but as I say theres clear numerical bias in favour of men getting it. I think they want to save money and thought I wouldn't make a fuss?

On a related note, has anyone ever gone abroad for surgery, eg Turkey and found it much cheaper than here.

Disclaimer: this is definitely not cosmetic surgery!

I did, and they were very much in favour of the "doing nothing" approach, which I queried. I didn't have as much knowledge then as I do now but even so, I made it clear that I would rather have surgery to fix it. Then I received a letter from the consultant saying that they were going to do nothing at all and they've refused to reconsider.

I honestly don't understand why they're not offering it. No-one does. My (private) physio used to work for them and another healthcare trust nearby who were much better and she said they were well known for this sort of thing and she left because of the misogynistic culture.

It's very difficult to make any kind of informed comment when you're being so vague. That's up to you, of course, but it will limit the quality of the feedback you get.

Raise with your MP.
Follow the appeals process and ombudsman process?

Ask for referral to another hospital for second opinion.
Being left in pain is unacceptable. Happens to women more than men all the time.

A few years ago my GP thought I was fine (and suggested I buy counselling instead 🙄). I then saw a private surgeon and he said I definitely needed the surgery and he wrote to the GP demanding I be referred to the private sugeon with the NHS to pay for it. He called it the ‘NHS Chosoe and Book scheme’. I don’t known if this still exists but it is worth asking about. NHS paid for my private hospital surgery 🤷‍♀️

I’m so sorry this is happening to you. The NHS is broken I think. In the last year I’ve had a child refused a small operation (this means they’ll need it when older and less likely to succeed), different child refused a mri for budget reasons which I do understand but am unhappy that the staff lied about why, and seperately a GP told me to go to A&E for x-rays and to lie and say I haven’t seen a GP, he said GPs used to be able to refer patients for x rays but if he does that the wait time is currently 4 weeks unless you have private insurance.

😕

Have you contacted PALS about it? I wonder if they could be any help.

I think it matters what it is. If the NHS have decided to see it as minor and stop offering it due to the strain they are under or if its a serious, serious issue that everyone but op will ve approved for.

In answer to your earlier question I would absolutely not encourage anyone to have surgery abroad. Unless I really REALLY disliked them

Without detail it is really hard to say.

Did they say no, never, or not now and watchful waiting/non surgical options? Do you have any conditions that mean the surgery is less likely to be successful longer term?

The latter is v common at the moment due to pressures, and the fact that there is only so much they can offer (and clearly others are deemed to be in greater need than you).

What treatment/management have they offered?

Without you saying what it is, it's very difficult to give advice.
But there may be reasons they won't operate on you against others that have had it.
For example if you are young and need a knee replacement - they will leave it as long as they possibly can. I know this as I'm in this position. Men may be getting them at the same age but it may also be dependant on what jobs people do. If you work in an office and are young - absolutely they will leave it until it's vital you have it. If a man (or a woman) has a very manual job which they can't do in their current state - they may get the operation.
Unless we know more details, it's very difficult to give an opinion.

I'm assuming something like excess skin removal?

Nowhere close! Its nothing to do with any way I've lived my life. Its just a common thing that could happen to anyone if they injured themselves in an accident/fall.

I'm guessing it's breast reduction?

Some Trusts will fund breast reduction if people meet certain criteria, but some will never fund it under any circumstances.

Why would I need a breast reduction as a result of being in a fall or accident?

Its a badly healed fracture that should have surgery to correct it and the plate has come loose as well as a piece of bone, so should be removed.

Can your other consultant not refer you again, if what they are treating is impacted by lack of treatment for the fracture repair.

I don't know. I saw him privately and the first question he asked after looking at my scans was "why didn't they just remove it?"

I don't know how to arrange seeing him privately. The Choose and Book is only for first referrals, I think, and the second referral has to be approved by the existing healthcare trust!

Its a really bogged down administrative system. This has already been going on for 18 months and I think I'm just going to have to pay for it to be done privately as I'm in so much pain. The other issue is that the joint is becoming damaged and is painful too, which it wasn't before this all started, and which is a known complication of "doing nothing".

I can't believe they have just refused to operate. I'm beginning to think I should take a hammer to it and break it again so I can go to A&E and get it fixed!

What are they proposing? IME of the system if waiting has not resolved the issue and you are in increasing pain they will refer you back to Consultant who may then refer for surgery. But you need to keep going back to Dr to say pain etc is getting worse.

I think trying to challenge the initial decision won't work, presenting with continuing symptoms and increasing pain may mean a new referral will result in surgery as all other options have been exhausted.