UK Keratoconus Self-Help and Support Association

hi everyone

You know how things are like a postcode lottery?! Can you transfer out of area or are you stuck to where you live?

Ta Kathy

You can tranfer if you get a referal from your Optician, or rather; Doctor.

As long as the doctor provides a reason for the referal than there shouldnt be a problem..

There is also another way of basically proving that you have local residence in the area where you wish to be seen.......

Jay
I am sorry but it's very difficult nowadays for a GP to refer a patient outside the local PCT area.If a patient isnt happy with the service provided by a particular hospital eye clinic they can ask their consultant to be referred elsewhere for second opinion which is a lot easier than the GP referring directly to outside the local health authority.

Hmmm this must be post code lottery of the post code lottery....

I was under the impression that if the GP can make a valid reason on why to be reffered then there should not be an issue...in fact this has been done in other health issues with distant family members.......

wierd world

Yes a postcode lottery is here and dam unfair. I have always looked at where i live, as i tend to move around a lot, then find the hospital i want to be treated at and ask my GP to refer me. I am a patient at Moorfields because i asked to be, and indeed back home asked to be at the hospital i was even though i was outside the area, because i trusted the consultant and indeed my optometrist. When i left to return home after my training i stuck with them and had no problems, even though they had to send lenses half way across Wales!

There are issues about where you live and where you can be seen, but i have always found that if i have a valid reason for wanting to be seen at a certain place then it will be considered. Am not saying here though that it is easy as it really isn't! Moving from Wales to London, caused me so much hassle as i couldn't get a referral directly, then had to find a GP who was willing to refer me, and then wait a year and a half to be seen! But be patient and keep trying, because if you really want it enough your perserverance will pay off.

Just as the NHS is changing and in some areas patients can choose which hospital they are seen at for surgery etc, so hopefully it will for eye care.

I would like to add here that it is because i'm a nurse in the NHS, but you have to be kidding, as this has never washed with anything!! The only thing i seem to have with it, is a lack of holiday time as i'm always working!!! LOL!!

Love Sweet X x X

Post code lottery is really bad.

If we are working we all pay tax and national insurance and anyway the NHS is supposed to be available to all.

If you are ill with anything you should receive the same treatment no matter where you live.

All this discussion lately on the TV and in the newspaper about certain cancer drugs being unavailable in certain areas is really bad.

Does anyone have any idea what would have to be done to change this unfair system.

Susan

Susan Mason wrote:Post code lottery is really bad.

If we are working we all pay tax and national insurance and anyway the NHS is supposed to be available to all.

If you are ill with anything you should receive the same treatment no matter where you live.

All this discussion lately on the TV and in the newspaper about certain cancer drugs being unavailable in certain areas is really bad.

Does anyone have any idea what would have to be done to change this unfair system.

Susan

Yes....... and I think I may get into trouble for saying this here....
one of the main issues is that to remove the postcode lottery requires the enforcement of a national standard applicable to all hospitals, departments, and conpulsory for all consultants to abide by.
Consultants don't like this - they all like to see themselves as *the* health professionals and the guys who know best, and like to decide what is best for their departments and their hospitals and their patients using their vast repertoire of medical skills.
Follow a national standard? - laid down by bureaucrats? - meaning the "men in grey suits", or - horror! - non-medics????
That'll be the day!
Rosemary
who was once a "man in a grey suit" in the NHS and saw how this happened in that small part of the health service.

Just a note to add to this debate.If a patient moves out of the catchment area of a hospital, there is usually no problem in carrying on with their old hospital clinic no matter how far away they've moved. The difficulty arises when a patient isnt happy with their current treatment and wants to be referred outside their health area.In the good (or bad!) old days of fundholding,GPs could refer patients wherever they wanted as they were paying for the treatment.Nowadays, the treatment is funded by the local PCT (Primary Care Trust) and they need to be satisfied that the treatment required isnt available by local providers. As I said before, a hospital consultant could refer a patient anywhere in UK for second opinion or if the treatment isnt available locally, but it's not easy for a GP to do this although it does happen sometimes.

Ohhh....

The subject of the NHS and postcode lottery! This problem has been going on for years and there are actually several sides to the story.

While i agree with what has been said above, let me just play devil's advocate and explain why a centrally dictated policy also has its drawbacks.

We optometrists, although essentially private contractors to the NHS (as in we are not salaried NHS staff) we do have a central Govnt contract which sets how much we are paid for eye tests and also essentially how we conduct an eye examination. So for example, say you went to an optom with eye irritation, rather than just look at the problem you came in with, we have to do a full routine eye examination or risk being reported to the GOC for negligance. (the Grey suit beaurocrat interfering with the way we work that Rosemary complained of hehe....)

This actually leads to innefficiency and it is something that has just been abolished in Scotland.. their optoms can do a "needs driven eye exam" as in they can deal with what you actually came in for and get paid for follow up as as well...

Also, with a central contract, the payment for eye exams is the same whether you have a practice in central London with high overheads or one in more rural areas.

So, central contracts tend to be inflexible to local needs. The idea at the moment is that local PCT's contract out for services that properly meet the needs of their locality. Some areas may need more diabetic services than others for example.

Therefore the PCT's do want to make sure that they are not spending extra money sending you all over the place when you can be dealt with in their own catchment area.

If you imposed a central standard, it would mean half empty eye wards in some areas and horrendously overstretched underfunded ones in others. You cannot apply the same criteria to hospitals in urban areas as you do to more rural ones.

What you have here is the fundamental difference between an NHS where we "pretend" that all services are equal everywhere and everyone gets treated equally and has free access or a private system that has real patient choice, but then has a financial lottery instead of a postcode one.

Understandanly, people on this board look at this from their own point of view,... but keratoconus is a difficullt condition, so does not at all fit easily into either totally NHS or totally private situations. Those of you who have already paid privately for operations and contact lenses will attest this is not cheap at all.

What you are really trying to discuss is the whole concept of our health system - it goes much deeper than which consultant you want to see.

For example, from January this year you are supposed to have a choice of at least 4 hospitals in your area to which you can attend for any treatment. Well in my area alone you are hard put to find 2 never mind 4 because we are a remote area. People on these boards would find that difficult as well because there is simply not the choice for specialist eye centres. This is a centrally generated dictate which won't really work in practice becasue of sheer differences between areas.

There is no easy answer to all this. The Scots have shown what can be possible with some imagination. Their new optometric contract has a lot of inbuilt flexibility and common sense applied. And all their eye exams are going to be free for everyone to boot!!

Lynn

I think that life is easier in Scotland, and that it is more straight forward for a GP to refer to Scottish Hospitals that are remote from the PCT,

Perhaps the Scottish experience will lead the NHS in England and Wales to catch up.

Happy New Year!

Andrew