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Post by random on May 17, 2017 23:23:17 GMT
Does anyone have experience of challenging CCG decisions. Will post more details tomorrow... Lets get some sleep.
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Post by vagueandrandom on May 18, 2017 18:25:27 GMT
Yes. . .I'm out tonight. .will reply tomorrow
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Post by random on May 24, 2017 8:36:48 GMT
Sorry - left this dangling... Basically have been told by CCG panel that I can't go to ADHD clinic to review my meds. To save money my local psychiatrist is to talk to the clinic and report back to me. Local psychiatrist rang me around 13:00 a few weeks ago. Strong suspicsion she was fitting in a job she didnt want to do in her lunchbreak. Told me to stop taken MPH immediately, no account taken as to whehter I was beneifing. Told there was no alternative.
Since had an appontment with Local psych that was so awful I stormed out. Fortunately my wife was able to tell her this is the behaviour I have wehn unmedicated.
Psych has agreed to reapply to CCG panel with more evidence (technically it isnt an appeal / challenge but it is going to appear like that). Sorry - in unconstructive rant mode today. I need to get some notes to the psych saying that we need to bypass her (rephrase, need to bee seen directly by the ADHD clinic). Could go private but dont want to end up paying for meds privately.
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Post by vagueandrandom on May 24, 2017 10:51:56 GMT
Thanks for details random I've been through the new/further evidence thing . . I think it's a way the CCG use to avoid making a final decision. ie. We're turning down your request, but will reconsider if you can provide further evidence the patient needs it more than anyone else . . Even when I've made a formal complaint about their decision, they still said that more evidence could be submitted to support my case. I'm presuming that the psych is applying for an Individual Funding Request (IFR) ? Your storming out was probably a positive thing for your case . . On what grounds did they turn the request down? Was it that they only fund treatment in clinically exceptional cases? . .did you get the psych to quote NICE about annual meds reviews? Do you know what the psych has said to the CCG? If not, ask for a copy and correct/add things you want to have included. .ask psych to write it up to send as more evidence, If it's anything like Hull CCG, whatever you say won't make the slightest bit of difference. . they're just like a broken record. .if they turn you down again, complain . . Sorry you're going through this too . .
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Post by roland on May 25, 2017 12:14:46 GMT
Hi randomNICE have got a note on their website saying that CCG's cannot choose not to follow guidelines simply because they disagree with them. The statement is actually in relation to a case concerning a lady (Lizzie Rose) with severe Crohn's Disease. Thanet CCG had denied funding for treatment for embryo cryopreservation saying that there wasn't enough evidence to show that it was effective. In addition, the CCG had a policy not to grant funding unless there were exceptional clinical circumstances and they reckoned exceptionality had not been proved in this case. NICE guidelines for fertility treatment did exist at the time but guidelines don't carry a legal obligation to make treatment available. But even though the guidelines don't carry a legal obligation, the court said that Thanet CCG is under an obligation in law to have regard for Guidelines and must provide clear reasons for any general policy that does not follow NICE Guidelines. CCG's need to have a clear clinical case as to why they are not following NICE Guidelines for providing treatment. In other words vagueandrandom is right in that you need to ask the CCG for evidence as to the grounds on which they turned you down for an annual review. Send them a letter and ask for a letter back and give them a specific date by which you want an answer. This is so that you have written evidence for their decision. Also ask them why they need more evidence when they already know that you've got a diagnosis because that does not make sense! At the same time send a letter to the psych who told you to stop MPH and ask for a clear reason for her decision and ask for a reply by the same date as your other letter. It would be interesting to get their take on the Rose Judgement, might not work but it would be interesting. Here's a link to the notice on the NICE website
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