GP's not referring to specialists

Esme

Esme

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Staff member
I've had knee problems for two years now and I still can't get a referral to a specialist! 18 months ago I asked about MRI scans and a referral and was told - if it's musculoskeletal you have to self refer to physio and they assess you and decide if you need a scan or referral. So a year ago I did that - physio said take painkillers and gave me some exercises. Which haven't helped in the slightest. Said no need for a scan I can tell what it is.

Honestly - how can they possibly tell what it is without seeing what's going on inside. So it seemed I had to wait to see if things would improve - which I knew they wouldn't. A year later and I ask for a referral to a specialist. GP says - you'll need to come in for an assessment first. Really? I thought they didn't do that and you had to go straight to physio.

Anyway I've just googled this and apparently GP's are not obliged to refer you to a specialist. Not these days anyway. Of course I should have just seen a private one two years ago rather than have knock on effects - but didn't want to pay a fortune for private MRI scans. At this rate I might have to.
 
I am still pushing with the GP and have an appointment in a couple of weeks, but why does it have to be so hard? I may have to go private but that could be difficult without a GP referral as well.
 
I do not think you need to be referred to see a consultant if you go private, ring someone like BUPA and ask. As I understand it though, any test results that you have done privately will not be accepted by the NHS (in order to stop queue jumping), so if you need NHS treatment (i.e. can not afford to have the whole procedure done privately) then going private for a diagnosis would be a waste of money. As an example, when a friend of mine needed a knee replacement she was told the waiting time was 12-18 months, she went private and had in done within 3 weeks for about £16,000.
 
Thanks Linpet. Yes that is why I need to keep pushing for an NHS referral. If it was arthritis it would be simpler and I probably would pay the 15k or so for knee replacements. But it's mainly cartilage. Apparently - I think until it shows more arthritis they won't even consider me for knee replacements. 18 months ago I wanted to get on a waiting list for knee replacements and can't even get on a waiting list.

I suppose a private specialist could at least write to a GP recommending a course of action, after consultation and test results maybe.
 
I definitely think what you plan is the best way to go, private for MRI and equally push for a referral to a specialist from GP.
Once you have results from MRI you would know where you stand and what you can do about it.
It is always good to have a second opinion. I had to go private, because public healthcare failed me. I got my diagnosis by using both private and public.
I think nowadays it is the same everywhere.
I do hope you get relief soon.
 
I'm thinking the other way round now. Push the GP for the MRI scans and then get a specialist referral. I tried pushing for the MRI scans 18 months ago and GP wouldn't do it. Just told me to self refer to physio and said physio decides whether you need a scan or a referral or not. Shocking really as physios aren't Doctors. Of course phsyio said no I didn't need a scan - she decided it was cartilage and got me to do exercises - she had seen the scan on my left knee from 5 years ago. 5 years ago! And it's got worse since then as I put too much weight on it when my right knee went.

I have just heard that vets do laser treatment for guinea pigs with joint problems and arthritis! And it's supposed to help a lot. So I googled it and it is available for humans too. I'm so cross I've been left like this for so long. It seems cold laser therapy is classed as an alternative treatment so needs paying for anyway. So at the moment it's left I'm going to see the GP in a couple of weeks. I mentioned a referral (meaning specialist) and she said maybe you need further investigation. So Im thinking she might mean referral for MRI scans. Or maybe just x rays which won't show cartilage.

Two years ago I was wanting to get on a 3 year waiting list for knee replacements and can't even get a referral to a specialist!

Anyway - some thinking to do. The advantage of getting the MRI scans done via GP referral is I may know, from the results, whether I'd be eligible for knee replacements or not. It wouldn't be great paying for private MRI's only to be told there isn't much can be done.
 
So had a GP appointment and pushed and asked for a specialist referral - it's been going on for two years now. I got a similar answer. 18 months ago it was - you need to self refer to physio and they decide if you need an MRI scan or referral. Physio decided I didn't and sent me away to do exercises and said - it's degenerative - take painkillers. Which was demoralising. I said - it's not age related, it was caused by injury. Like talking to a brick wall.

So saw the GP and said - I really would like a referral to a specialist. She said - we can't do that. There's a process. So I am starting the process from scratch again. X rays first. They won't show anything because it's not arthritis, it's cartilage. Well they might show a little bit of arthritis as just about everyone has a little bit by my age. She said they can't do an MRI scan until they've done x rays first.

So I'm having x rays next week. I "might" get MRI scans after that but I've had one before, on one knee - about 5 years ago and was told - physio.

I need to find the right person to deal with/speak to because it is just not good enough! I have pain and restriction and if something needs sorting out I want it sorting out!

I suspect I will probably have to go private just to get someone to look at the whole picture and how it started. What I am trying to do is prevent general health deterioration and knock on effects of bending more - which is totally predictable if I continue not using my body properly. I guess the NHS aren't great at prevention.

There's not much point having scans if nobody is going to refer me to a specialist and just say - yes you have torn cartilage - do physio and take painkillers. But that is not helping! I just want to know whether or not knee replacements are a possibility or not - for cartilage damage. And I think only a specialist can say that.

One thing I'm not sure about though is whether I should see an orthopaedic specialist (surgeon basically, but they do do conservative treatment as well). Or a rheumatologist - where they might be able to do injections for pain relief etc.

I need exercise to keep a level of fitness and am not getting any unless something gets sorted with my knees!

What gets me frustrated is everyone isn't the same - they have no idea what it feels like!

I doubt very much whether the GP's will refer me to a specialist, even after the x rays and MRI scans, so I'm wondering if it's worth having them before seeing a private specialist (which seems to be the only option now) or not.
 
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Sorry to hear this.
I am in a similar situation. You may recall I love Covid and Covid loves me. I’ve had it 5 times and am some sort of record holder. I’ve had trouble breathing and since last year have not been able to recover.
I thought I was slipping into depression and loosing weight muscle and feeling weak.
I knew there is some issue with my lungs, but the X-rays last year didn’t show much according to my GP.
I kept on pushing and she finally referred my to a pulmonologist. I made an appointment at a place I know and had my appointment last week. The X-rays showed bronchitis and expended lungs, I am not the expert.
Anyway, I got more referrals and have to undergo CT and see another specialist, the doc’s colleague at a hospital. I have inhalers with corticosteroids and am undergoing therapy. I can see some changes already

I no longer feel depresses, I have some relief breathing, I feel less stressed, but still lacking in energy.

I hope the therapy will work and the results will be positive.

I didn’t realize I had such severe lung issue, being strongly suspected of having chronic obstructive pulmonary disease. I know how it can end, but I really do hope to regain some quality of life back.
I am tired of being tired.

So yes, I know how you feel. Let us both be patient and positive and work towards improvement. Pain is a killer and it wreck havoc on our health. I know heat helps, but painkillers are also necessary. Pain changes your physique and mental state.

My issue is the same, I already have atrophy of my muscles and I don’t want to go further down that line.
 
Here in Canada getting an MRI can take over a year too. And you have to push and push. I dealt with the NHS and always found it good but did have to hassle a bit for specialised issues. Here my partner is waiting for a hip replacement and we are waiting and waiting. I keep hassling him to keep hassling the docs. I did to get a polyp removed from my womb and only through callng my doc, getting him to keep referring me to different surgeons, and then we travelled to a lesser place out of the city. Not sure that is doable in the UK? Ugh I feel for you. So frustrating but keep advocating and hassling. No-one knows your body like you do...
 
No-one knows your body like you do...
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Exactly! And good Doctors know that. Some are very lazy and uninterested unfortunately but also I think they have instructions from on high not to refer people these days as the NHS is overloaded. That then affects the trust between patient and Doctor.
 
IT is not only in UK, we have the same problem, I had the same problem with referral to pulmonologist. I had to make it sound almost unbearable.
She should have referred me at least 2 yrs ago and I would not be where I am today.
I either have COPD or asthma.
In any case my lungs are full and I keep coughing up mucus.
The results are not in my favor. I have another checkup next month. And I am one of the lucky ones now that I am in the system.

I perfectly get you too. Can’t you just say it really hurts and you can no longer walk, flex and life has become unbearable and you have a teen stepson to take care and of, because he doesn’t want to live with his mother.
Use anything to appeal your situation.

I had to get real with my GP and told her frankly I am afraid of cancer or other serious issues and have trouble breathing. That did it and in my case was true.
She just blew me off before.

You are a nurse, so diagnose yourself and blow up the symptoms.
 
Maya said:
I perfectly get you too. Can’t you just say it really hurts and you can no longer walk, flex and life has become unbearable and you have a teen stepson to take care
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Done all that, twice and even turned up in a wheelchair at the last appointment (it was necessary as had a bad flare up). I just get - there are protocols. I've had xrays done now (first step in the protocol again) which don't show arthritis (because it's cartilage!) and protocol says I can only be referred if there is arthritis.

I have another appointment tomorrow and will push for new MRI scans and then a referral.

It seems that the pain and lack of mobility doesn't count - what counts is protocol and what shows on x rays and scans and what protocol says the solution is to those scans. There is a distinct lack of humanity! But the NHS are hugely overloaded and I do suspect surgeries are told not to refer anyone unless absolutely essential. ie life threatening. They have never been good with chronic conditions. Brilliant with acute conditions though.

But yes, as a former nurse, it's frustrating as it's obvious that the longer something is left, the more knock on effects there will be, causing more health issues.

Having said that I'm also aware that knee replacements have a lifespan and timing is a factor. If they need doing again when you're 90 eg then you might not be fit enough to have the second surgery. So the later they're done, the better, I guess.

But I would at least like options and specialist opinions.

I'm actually thinking of changing GP surgery and asking around.
 
If you can, my parents advice as both doctors, would be to change the doctor, get new advice. I had to do that 3 times and I still have to push, but much less now.
I just got more diagnosis and further treatment coming up today.
There is by all means a way to get things done and changing your GP would be my first advice to you.
Not all doctors are good ones, that is a fact! Just like everywhere else.

By the way, my last year’s ex rays didn’t show anything drastic according to her and look at me today.
I don’t have an option to change her at the moment, she has quietly read my results and no longer objects.
 
I'm sorry I forgot to mention your breathing issues in my last post. That does sound awful. I hope they find some treatment that helps.

I'm now on the next protocol step and waiting for an appointment for MRI scans and blood tests for inflammatory markers.
 
I am glad you are finally moving forward with being properly diagnosed.
I am on corticosteroids and antihistamines. It helps, but slowly.
I have further tests.
 
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