Changing NHS appointments

[croyde]

Sorry just need to get this off my chest.

After waiting for so long and making sure that I have no work for 10 days after the Op, bds have moved it to the next week just before I am due to work away for the weekend. Have called them but they say it's due to rescheduling.

Bet it is so that of a doctor can do more private work.

Rant over

[julian64]

croyde said:

Just an update, I have a date in September. They were loath to give it to me as it would mean it took longer than 18 weeks to be seen. Unbelievable!

When I mentioned going private, I was offered any Wednesday that would be convenient to me with the same doc but at £2000 plus a possible £3000 afterwards for plastic surgery.

I'm quite cross about this especially as I flagged it up back at the beginning of 2011 when it was just a tiny pimple. It took 3 months to be seen and then it was a young Australian doctor who said that it was just sun damage and zapped it with liquid nitrogen.

One of the consultants I have seen since said that there was no point zapping it when they were unsure what it was.

I feel that I should set a complaint in motion as the small problem back then is now a much bigger problem and involving a far more costly operation.

Bit of disinformation.

Patient presents with tiddly spot on head. Examination suggests nothing worrying. Choices are

1, leave alone and ask patient to return in a month or two to look for changes. Doctors like this because they can be more sure about the diagnosis before acting. Patients not so much.

2, freeze it. Good side is that it leaves virtually no scar, but doesn't allow the lesion to be correctly identifed by a laboratory, so always has the possibility of return.

3, chop it out, although this is the way most people who eventually have a cancer would have RETROSPECTIVELY liked to have been treated, it does involve chopping off and leaving unsightly scars in ALL patients who have no problem that required surgery. Plus the fact that a scar has a higher risk of developing a skin cancer than the original benign mole.

In truth I try to explain this to patients and then let them make the decision. The advantage of this is that you can record it in the notes that the patient was part of the decision making process.

When I do this MOST patients opt for the cryo, and are then advised that if it returns it will need to be chopped, which is exactly what happened to you.

The size of the scar usually has more to do with the fact that such a wide margin has to be left around the lesion once it is identified as a cancer. Even tiddly spots would have to have a fairly big op in relation to the lesion size.

Retrospect is a wonderful thing, and in your case, JUST LIKE MINE, early removal would have saved a lot of problem, but I think you have to decide how you felt when this first appeared. Whether you were allowed, or excluded from the decision making process, and knowing all this whether you would actually have done any different.

[croyde]

Thanks Julian, it's just that returning to my Doc when small cryoed area sprouted again, as the hospital said that I had to go through my GP again and not return directly to them, has taken from last Autumn 2011 to next month (if it doesn't get moved again) to sort.

[julian64]

croyde said:

Thanks Julian, it's just that returning to my Doc when small cryoed area sprouted again, as the hospital said that I had to go through my GP again and not return directly to them, has taken from last Autumn 2011 to next month (if it doesn't get moved again) to sort.

Hospitals seem to have very frustrating rules for referral. Sounds like your consultant formally discharged you. Otherwise within a year of last being seen by a consultant you should just be able to ring his secretary for an appointment.

Its partly our fault as GP's as we encourage discharge now as repeat routine visits to a consultant are very resource wasting for the NHS. But that only works if referral is met with prompt treatment by hospitals.

Some consultants insist on seeing the patient, some would automatically book for surgery with that sort of recurrence letter from a GP thereby speeding up the process.

A year from referral for a recurrence to actual removal does sound completely daft though. I'd be writing complaint letters by that time!

[croyde]

Thanks again.

I have just deduced that not only have you had a BCC but that you are also in the business. I hope you are well.

Cheers.

[julian64]

croyde said:

Thanks again.

I have just deduced that not only have you had a BCC but that you are also in the business. I hope you are well.

Cheers.

Yep I decided to pay because the NHS don't do the repair I wanted. The one on the NHS there would have caused a noticeable step in the level of the scar.

Can't argue with that as money wasted by the NHS making me look pretty would be much more effectively spent on something more important.

[croyde]

Currently having the surgery, but the words it's quite big I am afraid are not what I wanted to hear. That was with reference to the hole in my scalp and I have only had the first excision. Doh!