Clinical Commissioning Group refused funding for a diagnosis.

[ebichu64]

My GP forwarded me an email yesterday. Don't worry, I have an action plan ready and I'm just waiting for a bit of advice from the NAS before I go ahead, but I wanted to share this with you. They have pulled the same stunt on at least 3 other people in my area recently and I'm pretty sure what they are doing is illegal. I haven't said which CCG it is for that reason.

 

 

"we reviewed a request at funding panel for diagnosis of Asperger's.

The patient had seen a psychotherapist and there were some suggestions that might have aspergers.

We didnt approve funding as we werent sure what the risks would be to not diagnosing. (ie work, family etc)

I have found most patients are happy to complete this screening tool and then happy with this as a provisional diagnosis. There is very few occasions when a formal dignosis is required."

Corrections:

"there were some suggestions that she might have aspergers"

"There is very few occasions"
"Aspergers" spelled two different ways
no apostrophe in "didn't"
"diagnosis" misspelled

Fantastic! I thought it was just doctors' handwriting that was bad!]


The "screening tool" they attached was an insult. It was from another health authority, so they hadn't bothered to devise their own or even change the logo at the top of the page, and it was a word document, so not hard to do. It was actually less detailed than the questionnaire my GP gave me at the start of this, which rated me borderline but which I realised afterwards was aimed at men with Asperger Syndrome.

As I said, I'm waiting to hear from NAS before I take the legal route, but if that fails I'm spending £500 of the redundancy I'll be getting in July to get a private diagnosis. There's a Clinical Psychologist who lives in the next postcode that offers a diagnosis service for Adults Aspergers.

Angry but at least I have something real to focus my anger on now.

Good Day or Bad Day? I'll tell you once I've counted the cars.

Edited June 26, 2013 by ebichu64

[nippy sweetie]

Get your GP to check the NICE guidelines re diagnostic assessment for autism in adults.They were published last year and they have already produced guidelines for commissioners based on these. Its outrageous that you should have to pay privately for an assessment. Good luck

[Sally44]

Some years ago my GP asked for funding for my son to be referred to GOSH due to his problems with auditory processing.

 

It was turned down because "if a referal were granted there was evidence that others would seek a similar referal off the back of my son's referal."

 

Which is just a bizarre reason. My GP wrote to the OT department [whose advice had been not to refer him]. He said thatt "if" they had identified a population of children with these difficulties, why didn't they put forward an applicaton for funding to meet those needs within their department. I dont' think they even responded. So my GP wrote a letter saying that my son was falling inbeween two stools. Ie. there was no assessment, no therapy, etc for something that was having a huge impact on his education.

 

But I did manage to use this correspondence to demonstrate that my son was not going to have his needs met in a mainstream school or via the NHS when they did not assess or deliver therapy for the SEN he has. My choice of school did have SALT on site, who can work with auditory processing disorder.

 

It later transpired that my son was not one of "a number of children" with similar difficulties. It turned out he was the only one. So the reason they had given to refuse the referal was incorrect.

 

If you contact your local hospital "PALS", I think they can also give you advice on how to appeal the decision not to assess for a diagnosis.

[ebichu64]

Thanks to you both.

 

I've already done PALS. I have a contact there from my shoulder injury. However, they're in upheaval because they were restructured the same time the PCT was replaced with the CCG. They've moved offices and they're not even called PALS any more. I can't remember what the new name is.

 

Paying for a diagnosis really is the last resort, so don't worry. As I said I've written to my GP asking him to challenge it, and my contact at NAS is helping me fight it too. She's furious because she'd had a number of meetings with the Doctor who is the metal health lead for the area and the one who refused funding, and they've ignored everything she said.

Taking the legal route may only mean a £25 letter. Apparently this firm of solicitors has had success before.

I'm really feeling wiped out today - probably shouldn't have stayed up to watch Starship Troopers last night.... I'd never seen it but it was entertaining in a slightly (and manageable) gory way. Helps if you know beforehand it's meant to be satire though. I'm going to switch off the PC now and have a nap.
:-)