Fighting LHB for surgery...help needed

[tiggywinkle2009]

Hi all,

 

I wonder if anyone can help me please, as I fear I am going to have a battle on my hands very soon and I want to go into it the best equipt that I can.

 

Last year, I developed severe pain in my shoulder, saw my GP, who suggested physio, being in so much pain, she recommended I pay to see a physio, which I did, at a local private hospital.

 

Whilst there on my first visit, the physio was quite concerned and brought in an orthopaedic surgeon who specialised in shoulder disorders to see me. He agreed there was something severe going on inflammation wise, and gave me a cortisone injection into the joint, then instructioned to come back to see him in 6 weeks at the physio session, so I wouldn't have to pay to see him.

 

6 weeks later, I see him but I am pregnant at this point, so his plan of an MRI scan is out of the window, mutually agree with consultant to review 6 weeks after baby is born.

 

I went back to see him 6 weeks ago and was told that he was 99% certain I would need surgery, but he would refer me for an MRI scan. Luckily my Mum offered to pay the £250 for the scan so I could have it done there and then. I also had another cortisone injection.

 

I went back after the scan and was told on the basis of that scan I did indeed need quite major surgery on my shoulder. I was told that I would be put on the waiting list on the NHS as the consultant said based on the scans, I'd be looking at £6k-£9K depending on what he does when I am asleep.

 

I had a letter this morning in which I have been advised that due to the consultant being based in a neighbouring health trust, my LHB cannoth fund surgery outside of it's own LHB at the current time.

 

I was not aware that the consultant was not based in the same health authority, it was never mentioned and I saw the consultant at the private hospital I went to first. The consultant never mentioned it would potentially be a problem.

 

Having spoken to him, he believes that without the surgery, my range of movement will get worse thus affecting my quality of life in the future, I already cannot raise my arm above shoulder height. He is a specialist in minimal access surgery which gives, apparently, a quicker recover. He has said he will write to my LHB to say that he does truly believe that it imperative I have this surgery.

 

However, he has suggested that in addition, I also start a fight with the LHB. Not being completely in the know about such things, what type of argument should I put forward?

 

Should I rely on the fact that I am in pain or mention that I feel in the future my quality of life would be affected, that seems a bit extreme given people get by with a lot worse conditions than a bad shoulder.

 

Should I involve a solicitor at this stage or would a letter from myself and the consultant by sufficient?

 

Any help or advice would be so gratefully received. By the way, I am based in Wales, as I believe this changes things in comparison to the English NHS way of doing things!

[Sali]

Well, I thought that the governement was promoting choice for the patient in the NHS, but perhaps that's the slogan and not the reality. Anyway, check out this web site. I see they also offer email advice.

 

NHS Choices Homepage - Your health, your choices

 

My advice would be to do as much of the leg work as you can rather than involve a solicitor who will only fleece you...and don't give up, even if the hospital's initial responses are negative. Write to your MP if necessary.

[tiggywinkle2009]

Thanks for your reply. I have had a look at the Choice website, unfortunately, most of the policies on there refer to patients resident in England

[Sali]

Email them anyway and ask them about who you should contact for help in Wales.