• Hi, If you cannot get into the site, be sure to Contact Us. Please be advised that the app is no longer in use!

Refusal for funding

dawn08

New Member
Hi I just wondered if anyone is refused by the NHS , what type of reasons are given ? I'm now on the road to WLS but worried I will get my hopes up to be dashed , sorry for the negative thinking

Sent from my iPhone using WLSurgery
 
Fed up

Hi all

Just wanted a moan if that's ok , it's so difficult this process everyone says a different thing it's a joke and I'm just at the start . So Gp referred me but took 4 attempts because they kept sending the wrong form to the health trainers . Health trainers on recieving referral past to their manager for approval . Spoke to manager who said they would send it to weight management for acceptance at Dewsbury hospital but doubt I would be accepted as I'm only 44 bmi and suffering with severe depression due to size isn't enough and I need co morbilities . Quite upset so rang the shape your weight and they said they wouldnt refuse anyone at 44 so not to worry but I am total roller coaster

Sent from my iPhone using WLSurgery
 
It really depend on were you live , from what I can gather . How about heading up a post with your area other more mature WLS who live locally might know . But best if luck you can alway google obesity care pathway of your heath authority !
 
The first time I was referred on the nhs for wls, back in 2011, I was refused outright due to 'not trying hard enough on my own' despite trying many many diets, diet clubs, medication, dieticians, counselling, exercise etc. I was then referred to weigh ahead (weight loss help groups/cbt dietician etc) then referred for wls when I finished my 12 week course with them. I don't quite know if I have funding yet, I am attending a seminar next week and will try and find out then. A few people say I should have got it if I am attending the seminar, but I'm still not sure... Good luck!

Kirsty
 
Hi Kirsty

Fingers crossed keep me informed please , can I ask at this 12 week management how much are you expected to lose ? Is it difficult and is the diet easy to follow

Sorry for all the questions

Sent from my iPhone using WLSurgery
 
Hi Kirsty Fingers crossed keep me informed please , can I ask at this 12 week management how much are you expected to lose ? Is it difficult and is the diet easy to follow Sorry for all the questions Sent from my iPhone using WLSurgery

They didn't actually give me a goal, just asked me to do my best. I did calorie counting, cbt dietician weekly, and gym Atleast 3 times a week. I lost a stone in 5 months (I started with the calorie counting and gym before the weight management started) I really struggled to lose the weight.. This is why I want the WLS to aid me in losing weight. Xx

Kirsty
 
Also, my BMI is currently around 57, I suffer with depression, asthma which is currently playing up and chronic back pain. That is all, BP is fine, ECG last year was fine, no diabetes or things like that..

Kirsty
 
Thanks Kirsty , if you don't mind me asking what procedure do you want ?x

Sent from my iPhone using WLSurgery
 
Hi Kirsty

I've just got severe depression too which I know will go when this weight does x

Sent from my iPhone using WLSurgery
 
Criteria for commissioning

Bariatric surgery is a treatment for appropriate, selected patients with severe and complex obesity that has not responded to all other non-invasive therapies. Within these patient groups bariatric surgery has been shown to be highly cost effective. Bariatric surgery is recommended by NICE as a first-line option for adults with a BMI of more than 50kg/m2, in whom surgical intervention is considered appropriate. However, it will be required that these patients also fulfil the criteria below. Selection criteria of patients for bariatric surgery should prevent perverse incentives for example patients should not become more eligible for surgery by increasing their body weight. Similarly the selection criteria should not forbid bariatric surgery for patients who have lost weight with non-surgical methods.

Eligibility for bariatric surgery

*Surgery will only be considered as a treatment option for people with morbid obesity providing all of the following criteria are fulfilled:

* The individual is considered morbidly obese. For the purpose of this policy
bariatric surgery will be offered to adults with a BMI of 40kg/m2 or more, or
between 35 kg/m2 and 40kg/m2 or greater in the presence of other significant
diseases.

* There must be formalised MDT led processes for the screening of co-morbidities and the detection of other significant diseases. These should include identification, diagnosis, severity/complexity assessment, risk
stratification/scoring and appropriate specialist referral for medical management. Such medical evaluation is mandatory prior to entering a surgical pathway.

* Morbid/severe obesity has been present for at least five years.

*The individual has recently received and complied with a local specialist obesity service weight loss programme (non surgical Tier 3 / 4), described as follows: This will have been for duration of 12-24 months. For patients with BMI > 50 attending a specialist bariatric service, this period may include the stabilisation and assessment period prior to bariatric surgery. The minimum acceptable period is six months. The specialist obesity weight loss programme and MDT should be decided locally. This will be led by a professional with a specialist interest in obesity and include a physician, specialist dietician, nurse, psychologist and physical exercise therapist, all of whom must also have a specialist interest in obesity. There are different models of local MDT structure. Important features are the multidisciplinary, structured and organised approach, lead professional, assessment of evidence that all suitable non invasive options have been explored and trialled and individualised patient focus and targets. In addition to offering a programme of care the service will select and refer appropriate patients for consideration for bariatric surgery.

These are the national guidelines since April 2013 when they were made national. If you meet the criteria ask your GP to apply/refer you to NHS England. I was rejected 3 times by my local PCT before the guidelines were changed nationally in April then I met the criteria and was accepted. :)
 
I've just got severe depression too which I know will go when this weight does x

Hi Dawn

Please, please, please don't take this as any sort of critical comment as it is not meant that way at all, but WLS can't cure any underlying problems.

If your depression is purely caused by your weight then yes, it will solve things for you (and I am lucky enough that that was the case for me) but if there is anything else that will still need to be worked on. Especially if a coping mechanism has been to 'hide behind' being large.

I guess what I'm saying is, if you get approved for surgery please carry on with any other treatment you are having for depression and don't rely on the surgery to solve everything.

And as I said at the beginning, I'm honestly not trying to be critical at all. I simply want you to be ready for anything as it makes the journey so much easier!!
xx
 
Hi Dawn

Unfortunately NHS route in some areas is a long and bumpy route. It took me over a year to get funding from PCT, having been refused once and having to see a dietician for a while. ..
My BMI a little more than yours and not any co-morbs but had depression, bad back, bad knees and lack of social life.

I wish you good luck, hang on in there and dont give up hope.. Eventually you will get there, for me it took 3 years but am sure it doesnt take that long now in some areas..

Nicky
 
Hi lincs lass

No Hun I haven't thought that your so right . I am seeing a psychologist since April and that's why I've come to the decision now having working through my issues

But thank you for your concern

X

Sent from my iPhone using WLSurgery
 
Thanks Kirsty , if you don't mind me asking what procedure do you want ?x Sent from my iPhone using WLSurgery
Hi Kirsty I've just got severe depression too which I know will go when this weight does x Sent from my iPhone using WLSurgery

Hi dawn, I am wanting the band, but I will consider the advice of my surgeon.
Also, without sounding horrible, you cannot be sure that the depression will go after WLS, this is a big thing, and it will take a lot of courage, will power and coping to get trough it, from what I've read from people from here is that is can be really tough at first, I am prepared for this, and I know that it will still take time to get better from the depression as I know mine is not all related to my weight. WLS is not a miracle cure, it is a tool, to aid you on your weight loss journey xx

Kirsty
 
Hi I just wondered if anyone is refused by the NHS , what type of reasons are given ? I'm now on the road to WLS but worried I will get my hopes up to be dashed , sorry for the negative thinking

Sent from my iPhone using WLSurgery
Each area has criteria for funding. I'm in east of England n you have to have either diabetes or sleep apnoea plus 35plus bmi. I have apnoea n have to use a Cpap machine at night and have automatically been accepted for a revision from band to by pass. Hope u get helped.
 
I’m not sure how the process works; I’ve found it so far to be really confusing!!

I was originally under Buckinghamshire PCT, they refused me – BMI was when 53, as I had not got diabetes and they said I couldn’t prove I have tried to lose weight, REALLY?! My medical records from the age of 8 should show my weight battle is well documented!! They also had no contact with myself, they wrote totally through my GP at the time… I gave up and hoped one-day I’d be able to save enough to get it done privately (bad credit, so can’t get loans etc). Too much going on in my personal life to fight the rejection.

I have now moved into London and fall under the Imperial PCT and St Mary’s Hospital, who have a dedicated Bariatric Team. My GP referred me on 6th November 2013, I had my group information session on 23rd December, bloods and heart tracing done at the same time. I now have an appointment to meet the Surgeon and an endocrinologist on 4th February 2014, but to be honest I have had minimal contact other than appointment letters, the process is still unclear and different people advise different things. A nurse advised me that the whole process can take 10-12 weeks, due to new centre self-funding, or something. I haven’t actually been told if I have been approved, but I presume - and hope, that all these appointments mean I have been!

I’m not sure if different PCT’s have different rules/guidelines, if the funding across the country has changed or if it depends on if your PCT has a dedicated Bariatric Team.

Good Luck!! xx
 
Back
Top