FML, it's no wonder the NHS has no money.

[Topplace]

I have an issue that is causing me a lot of pain. I know what it is and I know what the treatment is. I've tried all the self management techniques, but I'm still in significant pain and it's been affecting sleep for 3 months now.

I know it's not serious or urgent but it is having significant impact on my quality of life.

I hardly ever use the NHS (touch wood) and being a responsible citizen, checked my GP's website and used their e-consult form to send all the details of what's happened to date, and ask for help.

They text back with an appointment at their "sister surgery" in the evening a few days later. I didn't ask for or want an urgent or out of hours appointment, that's what I was given. TBH I assumed it was extended hours rather than OOH iyswim.

I've been tonight to be told that the doctor (?) doesn't think it can be treated on the NHS but that I should see my GP to check.

So a complete waste of everyone's time and money, when they had all the information he's asked for tonight already. And now I have to start again and try and get a GP appointment, which is what I thought I'd already done.

I know it will be process etc, but what a wasteful process. The cynic in me thinks it might be a way of manipulating figures to show people get appointments within so many days, even if theyre no appropriate appointments.

What does an unnecessary and pointless OOH appointment cost the NHS?

Why do people think I already knew it wouldn't be treated? All the online NHS info says they do treat them if causing pain.

You need to insist for it to be treated and explain it causes pain and complain if necessary

OP this just isn’t correct - the NHS should treat it if it’s causing severe pain or interfering with function (the timing of that treatment though is a different matter). Not unusual experience though in the NHS that you get “computer says no” from one person and a green light from another.

I feel for you, not the same thing but I had a bone cyst in a wrist bone that burst and it was agony (couldn’t lie it flat at night in bed from the pressure of resting it or even sheets touching it). I went privately as I had insurance through work and couldn’t work. Mine was in a really hard position to operate but I had a steroid injection for mine that was a god send. 95% of pain went in a few days.

As a first step I would go back, see a different GP and express the severity of the situation and ask for a referral to a specialist.

if you’re feeling desperate and not getting anywhere fast on the NHS, it might cost about £200-£250 but you could try to see a consultant privately for their view alongside getting an NHS referral if it’s a long wait. The injection I had I think was about £350. But say if it’s a number of months to see a specialist on the NHS, and a private specialist tells you you need it removing long term, you could always have the injection to tide you over until you can get it removed on the NHS. I would have paid out of my own pocket to get relief from that pain

https://www.uclh.nhs.uk/our-services/find-service/neurology-and-neurosurgery/pain-management-centre-nhnn

You can look up the policy in your trust eg
Ganglion_Cysts.pdf https://share.google/nOzTMami998mURvHA

Frustrating as is, you can /need to go back to gp and ask for referral to general surgeon to see what they say. If you want surgery. Probably wait list.

Also investigate local private options might be <2000 but could be worth it.

YABVU

Definitely don’t try and burst it, no matter what the old wives tales say. I had one on the outside part of my foot and it was painful. Just the feeling of the sheet touching it in bed at night was excruciating. I did get a GP appointment for minor surgery as one of the GPs at my surgery has that as a speciality. In the end, it popped on its own and went away so it didn’t need treatment after all.

Thank you, this is what I was expecting. A discussion about what the options might me and a referral, with probably a lengthy waiting list. Then I would have considered any private options.

If she’s in so much pain she can’t sleep and it’s having a significant effect on her standard of life then they are obligated to treat her.

I have crps

complex regional pain syndrome

the official line from the nhs is that there is no treatment and therefore no referrals or ongoing healthcare for it,

I regularly cannot sleep through the night due to pain.

i’m in a number of disabled peer support groups and there are plenty of people in my situation with a dhole variety of illnesses.

I agree with you. When I broke my wrist I was seen at the clinic near where I broke it and was told to go to my home hospital fracture clinic too when I went home. So I did, but they told me I needed to be referred by my own GP or their A&E first. Who redid exactly the same tests as Clinic 1 before sending me back to the fracture clinic. Such a waste of everyone's time.

My GP surgery has a ridiculous, time-wasting, system for older customers.
There are nurses who "look after" those over 75.
So, after an in-house physio assessment, the referral goes through one of them before reaching a GP. Anyone younger, the referral goes straight to a GP & they get seen more quickly.

Is it not possible they were checking out the lump rather than taking it on trust from you that it was a ganglion?

And now you are back in the non-urgent system for a possible referral which will need justification from your GP

The system probably isn't set up for people who know their problem already and are sure they don't need it professionally checked, and working out a special pathway based on hearsay from a private physio might be inefficient and unsafe.

I am sure the NHS does lose money but I don't think this is a dreadful example. I hope you get the pain sorted.

I agree with you OP.

I had a pilonidal sinus. I knew what it was. I have had recurrent issues with it all my life.

I sent an e-consult and got sent an OOH clinic appointment. I went to the appointment (which was based in my GP surgery BTW) and the doctor said yes that looks like a pilonidal sinus, you'll need to see your GP to discuss a referral for surgery.

Is that not what I am doing right now, I asked. No, he said. I am just on the OOH roster.

I didn't book the OOH appointment the GP surgery did during normal working hours despite me sending a. A photo and b. A detailed explanation of why I think this is a pilonidal sinus!

Didn't get a GP appointment for weeks after that as it was when the 8am morning call rush started and they were always full when I got through.

You can't get chiropractic treatment on the NHS where I live, and I thought it was the same everywhere.

You can't get acupuncture on the NHS either, so I pay £40 for a session every 4 weeks, for knee pain and swelling following a less than wholly successful partial knee replacement. I don't begrudge it, it's worth every penny of £10 pw.

The NHS is happy to pay £168 a month for an injectable anti-statin I have though, so I don't begrudge paying a bit for treatment that the NHS won't provide for free.

Agreed. Several years ago my husband spent 5 days in hospital for heart problems, waiting for a scan. He wasn't seen by a cardiologist once during that time. He eventually got the scan and was discharged the same day. He was needlessly in a hospital bed for 5 days!

I sympathise. Have had this kind of experience a few times. I don't know why some seem to assume that OP would know the exact ins and outs of how the GP surgery online booking system would work, or expect her to find a private consultant just because she went to see a physio.
All you can do is try again - last time l found myself in this position, I phoned the surgery instead of using the online form.

I would still go to your GP
i had one on the top of my wrist and they wouldn’t touch it till it started affecting my job and driving. I didn’t have to wait long for it to be done, they drained it with a needle

My daughter has been referred to T&O for the removal of her ganglion which like yours is causing lots of pain and difficulties with wrist movements. However it wasn't easy. When we first went to the GP they said they wouldn't refer as NHS don't treat ganglion. We left it a while but it was getting bigger and she's a teenager so embarrassing for her. The GP then requested a scan to confirm it was definitely a ganglion and then after that did a referral with all the reasons it's affecting her life and it was refused due to funding.

We moved house and area not long after that and she was referred by the new GP and the referral was accepted in the new area so I think it depends on the trust. We have waited nearly a year to be seen now and she was finally seen last week. They tried in clinic to aspirate it but it didn't work so she's now on the list for surgery. They said that even with surgery the liklihood of recurrence is 60% so I think that's why they don't offer it on the NHS routinely.

You could have seen a PA instead of a Dr. The nurse practitioners would give a reply like that either.
I hope you get an appointment soon 🤞🏼

Yes…the nhs is fantastic…just wait til the woodbine wanker gets it sold to American insurance consortia…we’ll all be shafted!

Just wanted to add this might have been 'standard' working hrs if the person you spoke to was not a Dr. Several nurses, OTs, physios work a 7-7ish shift as standard (no pay enhancement) so no loss of NHS money. I understand that's not the entirety of your point. Lots of GPs use associated allied health professionals for initial triage, which it sounds like what this was. As you say - sometimes all that info you provided on econsult is lost and yes that is a poor use of resource but just wanted to raise the 'OOH' is quite possibly not!

My DH has kidney stones & gall stones. He was sent for 2 scans in the space of a fortnight because they refused to scan both his kidneys & gall bladder at the same time. It was the same type of scan both times. What a ridiculous waste of time & resources both for the NHS & DH who had to have 2 afternoons off work.
Theres just no common sense involved.
So you’re not alone in your frustrations OP & I hope you get sorted soon x

You should have just called the surgery for an appointment.

I always see a specific GP.

I get what you’re saying, you thought you were seeing a GP so were confused when you’ve been directed to see a GP, it must have been a Physician Associate. What a waste of everyone’s time.