To ask if you've ever successfully challenged a GP refusal to prescribe under a shared care agreement

[OptimismvsRealism]

Debilitating illness - NHS consultant waiting list 5 years - used up significant savings and went to a private doctor who set up a plan - GP says no it's got to come from the NHS and no they won't take your diagnosis and adopt it you go back to day 1 on a 5 year waiting list. The same private consultant btw works on the NHS team that would make the diagnosis.

Cost of the medication to NHS is actually not that much but cost to an ordinary individual on private prescription isn't within realms of possibility.

Is there any alternative?

Oh and the aibu, aibu to despair that the NHS seems to actively want people to suffer?

Why is it so much worse than every other northern European country?

I think in particular because Brits won't even pay a tenner for it (especially the older people who cost the most).

And yes I do think the NHS has an attitude of postwar "suffering is normal you big pain relief seeking slags".

It 100% does. I don't know why people are pretending that all hcps are wonderful. I'm sure some are but I've been denied help by several and I'm not an over reactor. I was told my a midwife to stop being silly when I said I was about to push the baby out. I did push the baby out with no pain relief because they'd said I couldn't neednit yet, in induction suite. I ended up in a&e with my child struggling to breathe to be asked why i didn't know he had abnormally large tonsils and that was why. Oh that'll be because the go refused to see him and nobody had ever looked. I've had some utterly shite experiences with the nhs. Especially as a woman everything is blamed on the fact you're a woman. Oh you have breast pain? Are you sure its not just your period? Well yes because I'm not brain dead and that did occur to me.

Very interesting thread, I’ve learnt a lot from it and from the professionals who have taken the trouble to explain this aspect of healthcare provision.

However the OP statement
‘ I think in particular because Brits won't even pay a tenner for it (especially the older people who cost the most).’

is degenerating into mudslinging. Actually, even in ‘other countries’ everything is not available to everyone immediately. My experience from French friends (when we lived in France) is that the insurance which picks up most of the tab is fairly scrupulous and discerning about agreeing to treatment, which has to go through the medical professionals accredited by that institution.

I’m an ‘older person’ btw. I have had serious mobility problems for many years, which I address through private, mainly ‘complementary ‘ treatments and equipment. They are not cheap ( but really worth it). The NHS don’t supply these, although they do supply the anti inflammatories which alleviate the flare ups. So maybe hold back on the generalisations..

So it's a problem if it costs you 2k and it's a problem if it doesn't. OK lol
It is a problem if they don't follow the NHS guidance or policies and/or are not willing to be regulated similarly.

Although of course, it is only a problem for patients who want to transfer their care under the NHS. It's not a problem for those happy to continue with private treatment/have private insurance.

Why is it so much worse than every other northern European country?
There isn't half the drive for ADHD/ASD diagnosis in these countries as there are in the UK.

Yes. But you're assuming all private providers are doing the same thing. They're clearly not are they?

Again you're assuming they're not willing to be regulated similarly but by who? Who is regulating the whole of the nhs that isn't regulating private hcps?

And yes, indeed, and many people happily do pay privately but let's face it, they're only doing so because the nhs isn't fit for purpose. Nobody would pay privately for an adhd assessment if they had a cat in hells chance of getting an nhs one. My local trust would not disclose how long the waitlist even is.

You genuinely think people go private so they can get a diagnosis to pay ££££ every month. Do you not think they'd rather just simply not have adhd the first place, or would have happily gone via the nhs if that was possible?

Nobody fucking wants adhd. Believe me. Nobody pays for the label. They pay because they're desperate or their Iife is falling apart around them. It will be a small minority of people who pay for the label to "excuse bad behaviour" or whatever was said by a pp.

What evidence do you have for that?

There is no way I would want an American style health care system. The reason most people go bankrupt in the US is medical bills, the regulations over there are shockingly poor around payment and being able to shop around. Its not a health care system we want to model here in then UK at all.

I'd happily go for more French style system where everyone has to have a relatively cheap insurance. You pay a small amount when visiting the doctor, would probably stop a lot of the time wasters which we suffer with and I think clog up the system. Free at point of use is a great idea but I don't think it's working with such a large population anymore.

That's not how BUPA and similar chains work - they own or rent the premises. A consultant pays them to use the premises & depending on the clinic for equipment use, nursing time. The consultant then has to pay for the admin to be dealt with (typing and sending letters). There will be other models particularly in London where the doctor does own the business or is directly employed by a company, but most of the time they are essentially freelancel

@OptimismvsRealism if it's a chronic pain condition your suffering from I do understand that our current health service doesn't priorities quality of life. I've had exactly this problem, even my nurse specialist has said they don't provide enough funding for our clinic because quality of life it's seen as a high priority. Even though for a lot of us it's the difference between working or not working 😕.

I mean I'm currently off sick. If they would treat me I could go back to work, but no where in the NHS funding calculations is this taken into consideration. They seem to work solely on a life and death policy which when funding is tight seems understandable to a degree, but then it can leave people like you and me with no access to treatment which could seriously improve our quality of life.

Yes, but in that case the consultant also earns more the more patients they see and treat. Which is my point in my reply to that other poster who seems to think consultants in the private sector are just employees and therefore whether they diagnose someone or not makes no difference to the money they earn.

No I don't "seem to think" that, it is the case for some of the bigger companies. I never stated they all work like that.

Whichever way you look at it. It's unethical to pay anyone based on positive diagnosis. And if you think this is going on then you should be reporting the companies or individuals involved surely.

Its funny because on one hand we are supposed to trust nhs staff implicitly because they're doing the right thing and won't risk their registration to prescribe for you. But you absolutely shouldn't trust anyone who diagnoses you privately because clearly they don't give a fuck about their registration, even though a lot of these people in question are the very same nhs staff we should trust implicitly.

It can't be both so which is it? Or are we saying that everyone follows the rules in their day job but goes rogue whilst working privately and all their ethics go out the window?

Their registration isn't at risk though. Something like ADHD can't be proven with a scan or a blood test. A diagnosis is based on an individual consultant's interpretation of the results of questionnaires, forms, and interviews. So in "borderline" cases, the consultant can easily state that in his or her experience this patient fits the ADHD profile, even if their symptoms actually fit another condition better. They're not lying, they're just not interested in exploring an alternative diagnosis.

Which is why there have been news reports of online psychiatrists diagnosing people after a 30 min Skype conversation. You can't prove that they are not being genuine with their diagnosis or that the patient doesn't have ADHD, but anyone who knows anything will know that 30 mins is not enough time to conduct a thorough enough assessment to make a positive diagnosis.

Oh so they're not lying for financial gain? I thought that's what was being said that anyone can pay for a diagnosis?

They can't can they. They'd have to be at the very least borderline as you say. If someone shows no signs of adhd in their questionnaires or qb check and whatever else, if they got a diagnosis and especially if they receiver medication for it, their registration would be on the line. Wouldnt it?

It's baffling how we can be like oh gps cannot possibly prescribe something directed by a consultant because their reg is on the line but don't trust any private consultants because their registration isn't. Except it is when they work for the nhs. Doing the same job. Using the same tools.

I don't know what you expect people to do then? Live with it or?

Because we can't trust private consultants, apparently. Because they're only in ut fot financial gain.

We can't see those same consultants through the nhs.

Gps can't prescribe it at all because it's a controlled drug.

So what is it people should do if they think they have adhd and don't want to be apparently swindled by a completely unethical consultant?

No, its not. But again, that isn't all private consultants is it? It's some.

Who is being swindled? People go for assessment because they think they have ADHD. They're not going to be disappointed to get a positive diagnosis. And no, consultants won't diagnose people who have zero symptoms of ADHD. But they're not going to be seeing anyone with zero symptoms are they. People don't pay out thousands to go private if they don't have a symptom.

So, like I said, their registration isn't on the line.

But anyone who wants to be really sure should ask their GP to submit a private referral rather than go to one of those online services who are clearly after your money.

There will always be people who will exploit trends. Right now, ADHD and ASD are big money-makers.

Hahaha OK. So they're all diagnosing for financial gain, except they're only diagnosing people who have it. Makes sense.

No people don't pay out thousands if they don't think they have it. But yet apparently anyone can get a diagnosis. But oh wait no they can't.

Submit a private referral to who? Do gps recommend services? Mine didn't. Said they couldn't advise on any private services, including the RTC ones.

Stop twisting words. No one said "all". People have to have some symptoms that fit ADHD. But many of the symptoms of ADHD also fit other conditions. The people who don't get a diagnosis either saw a really good consultant or a really shit one. But if they keep shopping around (especially for an online service) they will find someone who will give them an ADHD diagnosis.

My GP practice will give you the names of the consultants they do shared care with and will put in a private referral if asked.

Someone did say nobody pays for an adhd assessment and doesn't get a diagnosis.

Nobody is advocating shopping around.

Good for you. Mine wouldnt. Plenty others don't either. So then what?

We are going round in circles here because essentially what you're saying is don't get a adhd diagnosis isn't it?

Eh? Nowhere at any point did I say people shouldn't get diagnosed. This whole conversation came about because you denied there is any financial incentive for consultants to give positive diagnoses in the private sector.

Because I do not believe that the majority of hcps act unethically for financial gain. The same hcps we should trust implicitly when they work their other jobs in the NHS. You do. That's great, but if they're all acting unethically how is that people should get diagnosed? Properly??

Because you're saying get your gp to refer. What do gps know if they don't specialise?

On the one hand you're saying they'll give you a diagnosisn if you pay regardless if you have it or not. On the other hand you're saying oh actually still do that, but the nhs won't believe your diagnosis Because private practice can't be trusted.

It's an impossible situation that people should not be put in. But they are because yhe nhs is so shit. But then they're basically told well if you pay for a private diagnosis it's no wonder nobody trusts it because they only do it fot financial gain. You can't do right for doing wrong.

You keep saying "all". No one is saying all are doing it. But no one knows how many are or aren't doing it.

If you want treatment NOW, you will have to pay. Do your research, find a reputable consultant in the private sector, get your diagnosis, and start treatment. But if you go private you have to be prepared to stay within the private care sector because you still have to wait your turn on the NHS waiting list if you want an NHS diagnosis followed by NHS treatment. Going private is not a way to jump the queue back into the NHS.