NICE Guidelines

[Anastasia17]

Hi all,

Is it possible to complain to NICE? And also to CCG?

The NICE guidelines have not been respected by the Consultant in my case, so , in order to get an accurate diagnosis about my endo, I am currently knocking on all the doors to push and get the diagnosis, help and treatment that I have never received since lap 11 months ago.

Thank you for your help.

[KGDI]

Hello Anastasia17

NICE sets the guidelines only and isn’t a review body. They would look at research evidence to recommend a procedure, drug etc. CCGs are responsible mainly for delivery financial renumeration and some take part one research. If you want to complain about a consultant for clinical negligence then you have to report them to the GMC and their relevant Royal college (eg RCGP, RCOG, RCP, RCS etc). PALS will independently look at complains at trust level. All these steps take time and will not produce any results quickly as investigations take time to conduct and conclude. You can also complain the the Care Quality Commission (CQC) if you have concerns about a hospital’s care level and their staff’s behaviour towards you. Again, the CQC will also take time to investigate a department. All hospital now must display the CQC ratings which would have been awarded to them following an inspection.

Whilst you could complain, I would urge you to see a different consultant. Different consultants will have varied skill levels and experience. On the NHS it is much harder to have a specific consultant but you can tell them you want a second opinion. This could be done from the hospital or another hospital. CCGs have rules around this in that, some hopsitals are not allowed to make tertiary referrals if the service is already provided in the referral centre. But your GP could do this for you. But they could also refuse on the grounds that their CCGs have provided rigid rules to not pay for going outside of their allocated hub. There are 8 endometriosis “specialist centres”. Although these haven’t been badged as such officially, there are pockets of their outputs you can check where they have a lot of academic and commercial research going on for women’s health. Nationally, women’s health based research for conditions such as endo is next to nothing if you compare other health conditions. Almost all the consultants I’ve spoken to point out the funding arrangements for new research and sometimes even use tertiary referral centres is next to impossible because these are generally management decisions. Thus, doctors are sometimes told they cannot use a specific procedure or novel technique because they have no funding available and NHS England will not pay for these. It’s a very complex web. So, I would say keep pushing your GP and consultant to help you. If you want to complain then yes you can, but bare in mind you may have to wait quite a while to hear back and in some cases, it’s not even a meaningful response you will receive. I have experience with a particular hospital where I made a complaint against their A&E team who misplaced my ultrasound report and MRI scan, their PALS team tried to cover it up in a diplomatic way so that they can cover themselves against any lawsuit as there are certain things their liability insurance will not cover. They did nothing to rectify the issue and I decided I’m never going to use this hospital again because it’s not safe. Their A&E staff are incredibly rude! But their Gynae department is brilliant. I was treated by their SHO and registrar who put me through to my current surgeon. I decided to see this surgeon privately then because he had an extremely long NHS list.

I hope this helps.