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Fibromyalgia Action UK
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Referral out of area?

Hi, I've just got off the phone with my GP and am rather befuddled! After a recent diagnosis of Hypermobility Syndrome my rheumatologist has asked my GP to refer me for hydrotherapy. Every time I try to do 'dry' Physio or exercise, I end up hurting myself hence the hydro suggestion. In our NHS trust we have self referral for Physio, so I filled out the request and asked for hydro but was contacted to say there was no facilities within the trust area. There is however a hospital just half an hour away in a different area with hydro facilities but this morning my GP has told me I can't access that because it is out of area.

I'm a little bit baffled as to the accuracy of this statement. Is it really the case with the NHS that if treatment isn't available within your trust area, you just can't have it? Thanks x

18 Replies

Yep.and if they were in your area and not NHS you woulf not be able to go there either.

1 like

Yes Shiny thats right. We live in West Yorkshire but close to the border with Lancashire. My husband was under a hospital with Lancs and when he needed home visits from a specialist lung nurse for his terminal illness the GP had to refer us to the health authority in our area for him to get this service. The Lancashire hospital is 7 miles away from our home and the West Yorkshire one 9 miles so not much in it but at the end of the day it all boils down to budgets I think.


I honestly dont know but wanted to say I hope you can get access to the help you need and wish you well.xx

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Hmnnnnnn hi there shiny1

This seems to be rather unfortunate for you :(

I don't know how best to answer your question but am sure that someone will be able to :o I have choose and book system where I am and am given a choice of where I can go.

I was of the understanding that we could could pick where we wanted to get our treatment from so there must be a way around it. It might be worth having another chat with your GP and contacting the NHS Trust about where you can get your treatment from!?!

Surely they must see the bottleneck here :o Can your regular physio refer you out of area perhaps? I'm the same as you I need hydrotherapy first before going anywhere near ground physio so understand fully your qualms :)

I hope you manage to resolve this problem, someone may have an answer for you :)

Keep strong and these fluffies are filled with sunshine smiles for you

:) xxxsianxxx :)


I would question this with your local health authority (not GP practice) as i have been attending a one hospital, then another for the past 52 years and neither one is local. In fact one is over 100 mies away and i have been going there over 34 years.

So if it were not allowed, how come i have not been stopped going?

I was of the understanding that you could choose and if both authorities agree then its ok, but its not down to you to have to organise. Esp if some treatment isn't available in your area you should be entitle to go elsewhere, otherwise its discrimination.

I hope you get it sorted soon as hydrotherapy is wonderful, i highly recommend it.


This is good to know, thank you. I asked to see a rheumatologist at a different hospital initially, under choose and book, as I didn't rate the previous Dr. I was told that the computer system that linked the trusts facilities couldn't be bypassed so had to be seen at this particular hospital. They have diagnosed me, and hydrotherapy is the only possible treatment at this stage which they can suggest...but they can't offer it to me. Ironically, If I'd been allowed to see the rheumy I wanted to see under choose and book (which is apparently my right), I would have had access to hydro at that hospital. Very galling that they insisted on keeping me but can't treat me :( xx


Contact your ccg to ask them


I will, thank you x


Hi Shiny1

I sincerely hope that you are feeling as well as you possibly can be today? I think this is very unfortunate. However, I would question this through your local health authority just to see what they say?

I genuinely hope that you can get fitted in somewhere for this as I am sure it would be better than the alternative physio that you have done previously.

All my hopes and dreams for you

Ken x


Thanks Ken xx


Hi Shiny

I am so sorry to hear that you appear to being denied treatment that could possibly help you cope with your condition. I have electronic acupuncture through an outpatients clinic run by the Royal Orthopeadic Hospital in Birmingham even though I don;t live in the immediate area but each time I know have the treatment my GP is informed so I am assuming that it is funded locally. It is good advice that you should contact your local CCG as they can be very helpful in telling you your exact rights. It might also be worth you contacting Healthwatch to see what their response is. I wish you the best of luck with this and sincerely hope you get the treatment you deserve.xx.


Thank you so much, I shall try both of these and hope I get somewhere! X


I am on the border of Sandwell, b`ham and Dudley.and although officialy under sandwel and brum It`s not unusual to be treated at a dudley hospital or clinic. Twice Iv`e turned up at the wrong hospital and then had a mad dash to get to the right hospital. :) It won`t happen again. Hubby won`t take me anywhere now without written proof :( sue


Heehee, Awwww Sue ;) xxx


I understand this is a fairly new policy; I talked it over with my (ex-)GP last year. The out of area referrals used to happen - I live in Somerset but because of my very complicated eye problems I go to Moorfields, no problem, at one time I could even refer myself to Moorfields because it is a national centre for specialised eye treatment. Now GPs' budgets are controlled in a different way and if you want an out of area referral then you can get one but you rely on the cooperation of your GP who has to first apply for permission to do so; I understand it is complex but not impossible. But even after your GP applies, it is possible that you might be refused - your only option then is private medical care. If you are already going to an out of area NHS centre then as long as that hospital says it is still necessary then that treatment will continue - until that is cut back too!


Hi, due to my rhuemotologist and the dermotologist consultants not being able to agree, my #GP said he was sick of being in the middle and not getting the right info to treat me. so he has referred me out of our area from Central beds to East Herts to a hospital some 30odd miles from us. I don't care where I go so long as someone does something!!!! Hydrotherapy is great for fibro, exercising in water with a physio makes sure u dont do too much but will help your muscles no end. I now go privately to a local special needs school which takes chronic condition patients who have done the hospital hydro. My understanding was that if the consultant deems it necessary then your GP practice has to do it. Contact your Rhuemo's secretary and ask for the consultant to write to your GP stressing this was what was required. It is to do with budgets but 'those who shout loudest and longest' do tend to get. Keep beavering away! Good luck in your quest. ps advise ur gp that on the fibro websites many people have praised the value of hydrotherapy in helping getting their muscles going. Heres hoping you get somewhere.


Yes I'm afraid so , but try crossing their hand with silver and see just how fast they move too have you on their list, I'm sorry but it seems it all boils down too money nowadays


Hi Shiny1

Great to see you back by the way, good decision!

I am sorry to hear you have recently been diagnosed with Hyper-mobile Syndrome on top of Fibro!

I have Hyper-mobility Syndrome and it is far easier to do these exercises in the Hydro-Pool with the buoyancy of the water, helping you!

I was denied a Pain Management Course because it was out of area and down to the funding of the Authority!

I think it absolutely appalling, you really need this facility!!

Have you thought about going to your Local MP and putting your case forward, so he/she can fight it for you? Maybe worth a try??

It is difficult enough to try and live with /fibro but if the facilities are out of Catchment Area, surely you/we should still be entitled to it?

Is your Gp Sympathetic and could fight this as a Priority Case for you? Maybe your GP could refer you to a Reumatologist in that particular catchment Area hospital, then perhaps you could gain assess to the Hydro-pool via attending this Hospital to see that particular Reumatologist!

My Reumatologist is out of my area, approx hours drive away! There certainly are ways around this as basically as I said it is all down to funding!

Sorry Shiny I don"t know what else to suggest but I can honestly tell you that the Hydro-pool is a way forward and you would definitely benefit from it.

It makes my blood boil!

I was refused Funding from the Welsh Office, living in Wales to attend a Pain Management Course in Wales (just 18 miles from where I live!). Only to find out later they were excepting referrals from patients in England (Not that I have anything against English people) but they had Funding in place for them to attend, it just does"nt make any sense, does it??!!

I hope you continue to pursue this, as I said even if you have to move to a different hospital to see a new Reumatologist to help you achieve, something that definitely helps with Hyper-mobility? Both myself and son have the same Hyper-mobile Syndrome, it was most definitely worth the upheaval of moving!

I sincerely hope you can find a way around this and have the correct treatment for Hyper-mobility. Wishing you luck with this.

Sending positive healing energies your way.

Good luck, Lynn


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