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.