Have you been refused a referral or test, for what seems to you like no good reason?
If so, this tactic may help:
> Book an appointment with your GP specifically to ask for a referral/test. Take someone with you who is aware of what you want from the appointment and what you intend to do.
> Ask the GP to refer you [e.g. to the pain management clinic] or run the test and state why you want this referral [e.g. "my Fibro symptoms are not under control and I need specialist input to help with this"].
> If the GP says "no", then ask them to explain why this referral is not an appropriate course of action.
> If you are not happy that this decision is being made on satisfactory clinical grounds, then say "please write in my notes that I have requested a referral to [e.g. the pain management clinic] because [your reason(s) why you want the referral], and that you have refused this request".
> If the GP does not change their decision, leave and arrange to see another GP.
GPs have a responsibility to refer if a patient's issue requires specialist care. If there is not a good clinical reason to refuse a referral - e.g. sometimes a referral would make more sense after the GP has run further tests, or a referral elsewhere would be more appropriate at that time - then they will not want to write this down.
I have had this suggested tactic unofficially "endorsed" by a number of NHS healthcare professionals over the years. I hope it may help some of you.
It may happen that the reason for the refusal is that your local NHS does not fund the test in question or will not easily fund that referral (e.g. if it is to a specialist clinic out of area). If so, it is worth finding out if this is only the case in your area, or is across the NHS. If it is only the case in your area, then you would have to approach the local trust or commissioning group. Your local PALs (Patient Advice and Liaison Service) or LINk (Local Involvement Network) should be able to help with this.
hi I just aske dif I could have another scan and was told "I CAN'T"with no further explanation and when I recently asked for an xray was asked "why?"again and when gave a reason said couldn't arrange one
Hi! I found your information very interesting and relevant to myself at present.My new GP has refused to refer me to the pain clinic despite me initially then separately my NHS Occupational Dr recommending for a referral objectively.He states fibromyalgia has no physical cause and can not be treated hence his reason for no referral to pain clinic or no other medication.I continue on my previous regime of CO-CODOMAL 30/500MGS which I was commenced on by my previous supportive GP who I had to leave as I moved areas.I am appalled by his attitude and lack off knowledge.I have been a mental health nurse for over 20yrs and I am trying my best to keep my job but fm has impacted on my life severely over past 18mths.I have had fm for nearly nine years.I can not change gp as he works alone and do not want to go to another surgery to get same response.Totally disillusioned by NHS.
Xiola, have you tried using the above technique, along with information from the NHS website on Fibro (which makes it very clear that there are treatments for Fibro!)?
If you can't go private, and this GP won't budge, you will need to change GP practices to get anywhere unfortunately.
My GP suggested a referral back to the Rheumatologist who diagnosed me as my symptoms had gotten worse. It was the Rhuemy who came back and said not interested as there was nothing she could do - this is in spite of her last words to me at time of diagnosis being a long the lines of "If you need to see me again just ask for another referral"!
My GP would like me to have an MRI scan but says she doesn't have the authority to ask for one - not entirely sure I buy that excuse though!
If your GP thinks you need an MRI, then a referral to a neurologist is probably in order.
There are also other rheumies out there. Fibro isn't really a rheumatological condition, so many rheumies are stumped at how to treat it. Possibly a referral to a Fibro clinic would be of more use, even if it means travelling.
My GP has refused to refer me to a Rheumy the reason given was why do you need the Rheumatologist? You already have a diagnosis!
I have been told that PIP does not accept GP diagnosis only specialist ones does anyone know if that's true?
I'm ready to give up now, even the consultant at the pain clinic was quite dismissive gave me a tens machine and told me to see someone about my depression! I hadn't mentioned being depressed as that came after the fibro and with medication isn't much of a problem
Don't let them grind you down. We all know the depression comes afterwards. Due the pain and lack of sleep. These doctors seem to think it's your depression is causing your imaginary pain. Don't give up I got the dreaded brown envelope this morning another thing to add to my worries. Good luck. Mark
Thanks this is really useful. Sometimes I do not know how to approach GPs. I am just getting frustrated and cry. This does not help the communication.
I will try it next time I need a referral.
T
Hi my doctor refused to send to a pain and sleep clinics. Cant sleep because of the pain. When I finally get any sleep straight away I start having paralysis dreaming and muscle spasms down the right side of my face and neck. sometimes I wake up choking and cant breathe. Its my 3rd night now without any proper sleep. about 4 hrs on an off in total. It drives me mad. I think I will be going over the off license at 8 am it beats the amitriptyline hands down. By for now
I have asked to see specialist as I can no longer manage pain from my fibromyalgia and what I now also think is arthritis in several places.i want to see specialist to clarify which is which and treatment I can get to help..have never been offered pain clinic in 15yrs.nurse practitioner who I saw said had I given up on help as have been self medicating and seeing to myself for last 6yrs... I burst into tears...no one has wanted to help me since my doctor retired who was helpful with my problems.i have had to see a physio and she said I have to cycle 30mins every day and be able to stand on one leg for 2 minutes before she will refer me..if no improvement in hips it's no as she says the grinding and pain in my knees is coming from my weak hips.i also told her of all my other pains.. arthritis in fingers...right hip ..I believe my knees and the disc inright jaw is damaged or popped out and is agony...too much info she said you only here for your knees...
I also asked if on NHS page phisio department offers other yelp for fibro reki.accupuncture. ect..yes she said but I will not refer you for any of these...I didn't bother asking her why as her manners and attitude were not nice and I just felt like crying ..do I left...I am seriously consider asking my husband if he would pay for me a private consultation as I do not work and have very limited money from him for myself...I am back on antidepressants as I am finding it hard to cope..
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