Doctors!

Good point Muffin. My surgeon was at great pains to tell me that any direct complications would be covered and I could be re-admitted. I think there was a time limit.

The advantage of ‘going private’ was that I could choose the surgeon. I asked my GP, friends and anyone I met who’d had replacements who’d done their operation, and made an appointment with my choice. My GP happily forwarded all my notes and x-rays to him. I don’t know if that was because he also did NHS operations - some surgeons don’t. Plus, I was then able to ask for him when a year later I went for the other knee on the NHS.

I do have a good GP, but the problem for me was the system. I expect I would have got to see a consultant - eventually. But goodness knows what state I’d have been in by then.

Some GP’s are good. My husband went with hip pain on Monday. GP sent him immediately for X ray to check for fracture and arthritis. He went back yesterday and she told him it was not a fracture and although he has some arthritis it was not causing pain. She then gave him a thorough physical and finally diagnosed sciatica. He had been saying all along that it was a nerve pain. He is now taking Amilcriptyline.

I went private for a fairly major surgery because I didn't meet NHS/NICE guidelines for it.

It was a bloody disaster, and the one thing I would warn anyone having surgery privately to be wary of is to know what your follow up will be like, especially if there are complications.

My surgeon stated that "he didn't do follow up of private patients" to the nurses when I returned two days after discharge with a serious infection, and refused to come down and see me. I was eventually - to my shame - seen at A&E and treated for the infection. As a result of the internal and external infection, it has not healed property and I am left with quite a mess inside and out.

Because I had the surgery privately, I (very fairly) cannot have it revised on the NHS. They will only treat me if the organ operated on ruptures, as that is a proper full scale emergency.

So I am left scarred outside and in, with an operation that has failed, and left me with considerable pain and sequelae, and many, many regrets.

Please, please find out what your follow up will be like before you sign anything.

Don't you think a qualified GP is more likely to know what is wrong, rather than a chiropractor? I would go along with whatever your doctor recommends, and not spend any more money on private practitioners of any kind.

Private consultants are nhs consultants. They are the same people. They dont suddenly lose all their morals on their private days.

I've gone private for a surgery which is not offered on the NHS. The surgery was relatively "conservative" and did what was needed. No more no less.

I agree that the NHS seems to have an algorithm for hips and this starts with physio - they do not have the power to reverse osteo-arthritis - would that they did! If the x-ray is unequivocal then best to just get on with it.

My x-ray showed lots of osteophytes and my hip was locking in place - I do not think a physio could cure that!

See a different GP - definitely do not go back and battle with the same one. She/he needs to look at the x-ray results and act on that.

I do not think private consultants do unnecessary surgery - they would soon be sussed if that was what they were doing. And orthopaedic surgeons are not short of hip customers!

You can get trapped going private ad its not always possible to switch back to NHS without going back to the start of the referral process.

I dont think you should go private anyway. I think you need to "work the system". Go see the physio, go for second opinons, go back and back and back until you do meet the criteria

I said I was going to go for a private referral to a consultant and GO just shrugged and said if I was prepared to pay of course consultant would say that new hip would sort the pain as it was money in his pocket
Mrs JamJam that’s a disgraceful, unethical and totally unprofessional remark by that GP.
I agree with muffin that you should complain. And then don’t see that GP again.

I am so sorry to hear about all those who are being fobbed off when they are in pain.
I think if you can afford it, it’s well worth seeing a consultant privately because you will get an honest opinion, unfettered by NICE guidelines, which, it is becoming increasingly clear, are nothing to do with ‘clinical excellence’ and everything to do with clinical rationing.
MrA was fortunate to have a hip replacement on the NHS 3 years ago, after forceful badgering of his GP for a referral.
The consultant said that early intervention would be best, so that the pain on the affected side wouldn’t lead to abuse of the ‘good’ side, which could lead to unnecessary damage and the need for subsequent surgery on the other side. The physio he had seen completely agreed with this approach. DH has been able to resume all his walking, cycling, tennis etc & surely that is healthier, and saving the NHS money in the long run, than becoming increasingly immobile and sedentary.

MrsJJ I hope you get on ok with the consultant next week and you can agree the way forward. Good luck

Definitely get a second opinion before paying to go private, I was also dismissed by my GP initially and sent to our local hospital for physio when I went to see her about my painful knees.
It was awful as the things the physio was recommending were impossible for me to do and caused me more harm than good!
Second GP I saw was much more understanding and referred me to a specialist who initially did X Rays then an MRI which diagnosed me with severe arthritis which no amount of physio was ever going to cure!

With the correct management now including steroid injections which have been so helpful I am coping much better, I know eventually a knee replacement is on the cards but for now I can function and am happy to have been taken seriously, I have an open appointment next to go back to the specialist if I feel things are deteriorating further.

I had to fight to be heard but it’s well worth making a fuss when you know there is something serious going on, good luck X

The surgeons here basically use the physios as a triage service.
It must be SO frustrating for the physios but thats the way it is at the mo. You have to fail at physio before you can get an initial appointment with the surgeons. So GPs are sending people to the physios who are not physio candidates! (and people who DO need physio can barely get seen due to physios inflated workload!)

Physio is a "hoop" you have to jump through here before you can get NEAR an orthopaedic surgeon.

I would go, bring your xray, and ask the physio to re refer you to the surgeons.

The only other alternative is to pay. This is what I had to do for my first knee replacement as deformity meant the x-ray didn’t show much arthritis, I have a high pain threshold and I could more or less walk a little way (on the flat, no slopes, no stairs and no distance with a stick). Worse examples and people who shouted louder were leapfrogging me in the consultant queue so I never got to see one.

I paid £150 initially to see the consultant privately and get his opinion. That’s worth it alone. It was then my decision to take the leap and use my “dementia fund” for a new knee in a couple of weeks rather than wait six months. I was very fortunate to have the savings to allow me to do this. It gave me a summer I wouldn’t have had otherwise and my choice of surgeon for my second knee. (I asked my GP for a Named Referral.). That was done this year on the NHS so I count it as a BOGOF!

My brother had a similar issue. He had been in hospital for a week on a morphine drip and sent home with codiene and oramorph for the pain with sciatica. When he came home he was sent to physio via his GP. The physio said he couldn't work with him as he was in too much pain and he wrote a letter to the GP advising a MRI scan to find out what was causing the problem.When my brother went to see his GP she refused to send him for a MRI and just handed him a script for more codiene pain relief.!!!

This is quite a common attitude among a few GPS. I had exactly the same thing with one at my own GP surgery. I felt I wanted to shout at him he was so ‘off’ and could understand how a less controlled and more physical individual might have reacted violently.

Do what I did. See a more sympathetic GP. Generally I find woman make much better doctors.

Lazigirl - thank you for the pointer to Oxford scale. Have just done this and scored in the severe category so have saved page to show the GP as further ammunition. The thought of being this crippled for the next six weeks before I can even see the physio is filling me with gloom.

Physio is also the first line of referral here for those with suspected hip problems. You used to be referred to orthopaedic consultant, but not now! If you have an arthritic hip it just delays the inevitable. Many hip problems can present with pain in the groin initially, and not in the back at all. To satisfy the criteria for referral here you also have to score high enough on the Oxford Score for knees and hips. You can check this on line, and they also keep moving the goal posts on that here, to save money.

Complain to practice manager. After complaint acknowledged, state you want to see another of the GPs in the practice. Then ask them to look at the x rays taken, and either repeat the investigations, or refer you to the hospital.

If the "diagnosis" is wrong, you need to know that, and if it is correct or seemingly correct, you need to have your function and pain assessed to make a decision on how your condition will be managed going forwards.

The first step in getting any replacement joint around here (Norfolk) is always a course of treatment with the physio. I believe its done to weed out the non-urgent cases. It doesn’t work of course, the pain is still there and back to the doctor you go to say the pain is still bad, the painkillers aren’t strong enough and you want a referral to a consultant please.

There is a lot of pressure on the NHS for replacement joints and it does seem that doctors will try to postpone operations for as long as possible. I would say persevere. Do the physio - it won’t make any difference but keeps them happy - then keep going back and be a nuisance!

My friend was told she needed a hip replacement by her gp a few months ago.
She left things, but the pain has been terrible again.
She saw a different gp who says he thinks she has a hernia, and definitely not a dodgy hip.

My GP insisted I had bursitis and gave me Anti-inflammatories , which ended up with bleeding internally , limped on with Paracetamol and every one but me could see I needed help . DD1 dragged me to see GP and it was a temporary Doctor , she sent me for assessment and I was put on the emergency list . I can't tell you how it changed my life . At my last review I was told I did have bursitis but it doesn't bother me since I got my new hip . The x-ray showed my hip was non existent

My friend could almost have written the first post. She helped a relative move house and thereafter was in acute pain. Was fobbed off by GP for some months but eventually got an appointment with a consultant who booked her in for a hip replacement within three weeks. Such a transformation! Worth persevering.

I had a similar issue with my knees needing replacement, kept being told only slight degeneration, so why was I in so much pain? Happened to bring my knees up in conversation with my auto immune specialist as the degeneration was caused by my condition. She referred me to a trauma specialist at guys, I was seen quickly xrayed and Mri'd and informed I had zero cartilage left in my knees, given date for operation. Saw my gp who tried to dismiss her view as her being young and gung ho etc because he's worried for me, I know that but I'm in agony so decided to go ahead. Trouble was life intervened and i was admitted to hospital in August with internal bleeding so the Operation due in September had to be postponed. You can and should ask for a referral to an orthopedic surgeon and let them decide. GP's are trying to protect their budgets as well as treat you and conservative treatment is their preferred option. Persevere with it and insist they help you.

I would keep the Physiotherapy appointment , they are very good at sending scathing letters to GP and will want to see X-ray and scans

Think I’d ask to see the practice manager and register a complaint then see a different GP. Having an x-Ray already should save NHS money. When referred for physio for osteoarthritis two years ago the physio wouldn't treat without seeing an x-Ray. I was told first step is always physio then consultant if needed. There’s no reason you should have to pay for this, please complain and persevere.