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Author Topic: NHS (circumenting bureaucracy)  (Read 85 times)

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Offline Balaclava

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NHS (circumenting bureaucracy)
« on: July 30, 2020, 10:07:26 AM »
I damaged my knee (sports injury).  I paid for an MRI scan which produced a detailed report on various damaged areas e.g.  torn meniscus.  I need to see a knee specialist who can look at the report, look at the images and tell me that I need to have this or that procedure or I don't need an operation but need to do / not do etc.  Of course I could pay privately for that but having paid into the NHS for years I would like to get that service on the NHS.  So I went to my GP with that story and she put me back into the system which basically ignores the MRI scan (the evidence) and starts me back at the beginning the first step if being triarged by a physiotherapist 2/3 months into the future who (presumably) will then refer me to the person who will (6 months from now) look at the scan report/images and tell me what I need to know.

How do I (on the NHS) get past the physiotherapist and straight to the specialist?

Online Vickster

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Re: NHS (circumenting bureaucracy)
« Reply #1 on: July 30, 2020, 10:17:18 AM »
Unfortunately you canít if thatís how the system works in your area unless you have a severe traumatic injury that is deemed time critical. Itís not really bureaucracy, itís just how the system has developed to deal with increasing demand for in some cases scarcer or otherwise prioritised resource unfortunately. And Covid has put a massive spanner in the works on top!

Paying for an initial consult privately with a surgeon who also has a well developed NHS practice too can speed the progress to NHS surgery if thatís needed. They can move you to their NHS list.
You will have to pay probably £200-300 for that consult though and potentially get a referral from your GP. Whatís the issue with your knee?

Or does your GP practice have a doctor with a specialist interest in orthopaedics who may be better equipped to discuss the MRI? Ask them

Where in the UK are you?
« Last Edit: July 30, 2020, 10:20:29 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Balaclava

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Re: NHS (circumenting bureaucracy)
« Reply #2 on: July 30, 2020, 10:28:31 AM »
I am in Liverpool.  The critical injury (caused playing golf) happened on 18th July.  12 days later, after being unable to walk to walking on two crutches, then one crutch, I am now walking around the house without crutches and yesterday I mowed the lawn.  If I hadn't seen the MRI scan report I would have been planning to get back on the golf course next week.  The MRI scan report looks dire but that's why I need to talk with someone who knows what need knowing.  I need to get my GP could just send the info to a specialist and get an answer.  I knew the NHS was a 'basket case' but this is RIDICULOUS!

There is an oblique tear of the posterior horn of the medial meniscus and there is a partial tear of the posterior root attachment. There is a macerated degenerative tear of the body and posterior horn of the lateral meniscus.
There is chondral thinning in both tibiofemoral compartments which is maximally grade 4in the mid lateral femoral condyle over a length of 15 millimetres.
There is irregular chondral erosion on the medial patellar facet with relatively preserved lateral patellofemoral cartilage. The cruciate and collateral ligaments are intact. There is
popliteus tendonosis and there is a moderate joint effusion with synovial thickening and
a bakers cyst.


Online Vickster

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Re: NHS (circumenting bureaucracy)
« Reply #3 on: July 30, 2020, 10:48:16 AM »
Can you fully bend and straighten the knee? Does it give way? Is it massively swollen? Painful?
I think it was mentioned in another post that you have arthritis, degenerative meniscus tears often go hand in hand. If you have full range and stability, itís unlikely youíll be offered surgery anytime soon on NHS.

Iíd personally give it a few more weeks to settle before playing golf which involves walking and standing on lots of uneven ground presumably :)

Maybe see a private sports physio to get a rehab programme (might be by Zoom right now but thatís fine for assessment and discussion). One expert in knees will know far more about what the scan says than many GPs. They could also advise on a support or brace to use for golf if felt needed.

I have an arthritic knee with tatty and missing meniscus  (at 48) and it least likes uneven ground and downwards slopes!

Good luck :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Online Vickster

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Re: NHS (circumenting bureaucracy)
« Reply #4 on: July 30, 2020, 10:54:07 AM »
If you do de use to get a private consult, the forum has a specialist database
These two in Liverpool
https://www.kneeguru.co.uk/KNEEnotes/knee-surgeon/dr-mr-john-davidson (focus on arthritis)

Or https://www.kneeguru.co.uk/KNEEnotes/knee-surgeon/dr-mr-cronan-kerin
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Balaclava

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Re: NHS (circumenting bureaucracy)
« Reply #5 on: July 30, 2020, 10:58:11 AM »
Thanks for the helpful reply.

I've had no problems straightening the knee but bending it has been a key feature from the beginning and day by day, bit by bit it's bent a bit more so that now it's bends almost as much as my other knee. 

I have to say that 12/11/10 days ago I would not have believed that I would be mowing the lawn.

Online Vickster

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Re: NHS (circumenting bureaucracy)
« Reply #6 on: July 30, 2020, 11:07:01 AM »
Sounds like itís getting better without intervention (surgery is always best avoided or delayed for as long as possible).
The bending may be due to swelling in the joint which is receding, you can speed the progress with regular ice packs, elevation and compression :) anti inflammatory gel can help too

Do you want to come to London and mow my lawn too  ;D
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Balaclava

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Re: NHS (circumenting bureaucracy)
« Reply #7 on: July 30, 2020, 11:19:30 AM »
Do you want to come to London and mow my lawn too  ;D

Get the kettle on - I'm on my way  :)