"Arthroscopic femoral acetabular surgery denied?"

About: Oxfordshire PCT University Hospitals Coventry and Warwickshire NHS Trust

(as the patient),

For 12 years I have had a worsening hip problem in my right hip. Initially I was treated with physiotherapy, NSAIDs, activity modification but eventually after starting my career within the NHS as a physiotherapist i found that i was beginning to limp, unable to stay on my feet all day or to treat my patients due to hip pain of my own. I moved into the community role, where i was on my feet less and my hip settled and i was also referred on to an orthopaedic consultant. Due to being referred to a named consultant at Northampton General Hospital, I was not seen within 16 weeks, however as I had this pain for 6 years already i didn’t mind too much.

Following MRI, CT and arthrogram under XR, my consultant was unsure of my clinical diagnosis and referred me onto a doctor at Coventry and Warwick NHS Trust, a hip specialist. I received further investigation, MRI arthrogram and an arthroscopy, where i had a labral tear repaired. Due to the fact that, while all this was going on, i had a baby who was 4 months old at time of operation, and due to my age (26) the doctor repaired the labral tear and tried not to interfere with the rest of my hip joint to assess if this would be enough to reduce my symptoms and pain.

After 8 months of physio and 3 follow ups with his team, it was decided that a revision was required in order to carry out more extensive surgery to reduce the impingement i was still experiencing. That was in Feb 2009. Since then I have waited patiently. I have badgered his secretary who has been excellent at letting me know what is going on, despite me getting quite emotional about this at times, telling me that they were waiting for Oxfordshire PCT to agree funding for this procedure.

Yesterday I received a letter from Oxfordshire PCT stating that because the procedure was not deemed to be "the norm" and is not supported by NICE, that they are not currently willing to fund it on the information which they have about me. I rang and spoke with the public health department who gave me further information about the review process and then called the doctor's secretary at at Coventry and Warwickshire who was only able to tell me that there is a new document in support of this procedure, which will back up my case which should be with the PCTs commissioning team very soon. I also phoned the commissioning team at Coventry and Warwick who were able to confirm that this document should be sent out this week, as long as it is passed by the panel tomorrow. I am also going to my GP in order to get further "evidence" to support my appeal.

I don’t know what the outcome of this will be. The PCT commissioners did not sound convinced that the document from my doctor would be anywhere near enough to gain me funding although the Commissioners at the other end were confident that it would.

Apparently I am not alone in this matter and there are another 40 "young adults" awaiting Oxfordshire PCT's decision and I would like to hear from any of you via this forum. I feel very frustrated and from thinking that I was close to getting my hip problem sorted I now feel that I could be up against a brick wall. I am hoping for support from my GP but as I moved into the area with this problem it was not my GP who currently referred me to Coventry and Warwick. And just to top this all off my left hip is now becoming symptomatic. Oh and did I mention that I work for Oxfordshire PCT?!

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