just another newbie

[Bob parker]

Hi my name is Bob and after 1 year going through the usual hospital/dieticians checks have just received the news that my funding for nhs surgery has been refused, i am a diabetic with sleep aphnea and a bmi of 56, i have been on orlistat for years, it dont work for me, however i am now 64 years and feel that the chances of an op have passed me by but before i give up trying is there an appeal procedure i can send to my PCT any help gratefully received.

 

[Yvessa]

Ask your doctor why you have been refused. They have to state the grounds. It may be they want you to jump through more hoops, so you jump through those hoops and doc should refer again. Failing that, ring them to find out why you have been refused.
BMI of 50 plus comorbities, I suspect that you have been refused because they are saying there are still things you can try before surgery so find out exactly why and then start to push through with appealing. Push your GP to appeal on your behalf.

 

[Caren]

oh bob im so sorry welcome to the site and im sure someone will be able to help you soon. All areas are different so if you could tell us what area you're from and what pct you come under it would help a lot. And yes, you can apeal. Good luck xxx

 

[MissyMustDoIt]

oh bob, welcome to the forum, you'll learn more here than from your doc i can bet you that!!

as caren says, lets us know your PCT and where abouts you are and we'll do some research for you xx

 

[Bob parker]

Thanks ,Cambridgeshire PCT i thought that being on a cpap machine with diabetes was enough but i have serious lymphodema was on the original super fat busting drug trials at Luton & D hospital amost 20 years ago never worked for me, put forward for exceptional funding due to my age, maybe the 7 page application form put him off a bit

 

[MissyMustDoIt]

this is what i found on this page
BOSPA - The British Obesity Surgery Patient Association

im sure someone else will tell you if this is wrong or if there is a more up to date version around, you cold also contact your PCT directly and ask them too

maybe your age is the reason for refusal?

BMI over 40 with type 2 diabetes and/or severe sleep apnoea (hypertension is not an allowable comorbidity for surgery), are aged 18-60 and who have been receiving intensive obesity management of at least 6 months.

 

[Bob parker]

Ladies , many thanks for all your advice, have booked an appointment with my GP, and will ask him to appeal on my behalf though this time i have a blank copy of the funding form and i intend to compare with his previous submission, as i have never see any letters etc just verbally from the GP
Bob

 

[luckyla]

Welcome Bob xx

 

[snagglepuss]

And if you don't get a satisfactory answer from your GP, change your GP! It's what I had to do! Some GPs are obstructive or lazy for the sake of it, or allow their personal opinions get in the way because they dont agree with the surgery. Ridiculous, I know, but do whatever you have to. Good luck .

 

[pandora]

Good luck Bob , but I will just say ... take no notice of the bospa site , its years out of date (2007) if I remember . Google your pct to get up to date info x

 

[angiemason]

hi Bob i was refused twice for one reason or another they said i didn't fit different criterias but i kept on at my gp and dietician i also had diabetes sleep aponea high cholesterol and blood pressure , and cried like a baby when in sept 2011 i was funded and had my op 28th Nov xx keep going and do whatever they ask you to do good luck

 

[Tray3004]

Welcome bob n good luck wiv ur appeal chin up I'm sure ull get funding in the end x

 

[Peterborough Guy]

As do other PCT's, Peterborough PCT use the NICE Guidelines, but have there own criteria above and beyond the NICE criteria.

The first point of call Bob should be your doctor and ask for an appeal, and see what comes from it.

 

[Peterborough Guy]

You might want to read through this and maybe even tell your doctor about the link, if he/she isnt aware of it Bob.

Appeals Process

 

[Raynebubble]

Good Luck Bob xx

 

[TwinkleTwinkle]

Hi Bob, honey & welcome having read through Cambridgeshire's guidelines I can only assume it is your age as all other areas you meet their requirements. Surely in this day & age they cannot refuse on age alone That would not be allowed in any other field. Ask your doctor if this the case. Garry has already given you the link to explore the appeals process so hope you can put together a strong one to show them that lots of other PCT's do not operate an ageist policy. Good Luck, sweetheart xxx

 

[Bob parker]

Hi Guys Appointment Thursday, have sent my gp a request for any paperwork be made available, asked papworth is my cpap the same as others ie is there a high or low level assured that mine is the same as everybodies, also printed of the 7 page PCT form that my GP had to send off PLUS the 20 page guidence notes, just so i can compare a blank copy with his copy, also he was contacted asking for sleeo aphneoa info before 19 december board and i heard after that i had been refused, if my cpap is the same as every bodys why the request for info?.

 

[Bob parker]

I should point out that my funding was applied for on the Exceptional Funding Request form.
Bob

 

[angiemason]

Good luck on Thursday Bob and it sounds as if you are going ready prepared which can only be good

 

[Caren]

good luck bob xxx