Funding issues

[mrsguiseley]

Two years ago I moved out of my local health authority but I have continued to go back to my hospital for my Diabetes consultant and care, as I actually only moved 10 miles from where I was originally living.

I made my latest order for pump supplies as normal to be informed by Medtronic that my account had been suspended. When I contacted my local Diabetes nurse she informed me that as I no longer live in the health authority they will no longer fund my pump supplies and that, although I can still see my old consultant, I need to register with a new one in my health authority to get my funding approved and confirmed with Medtronic.

My issue is that I am 31 weeks pregnant, my supplies are running low and I am still waiting to be seen by a new consultant. Surely my old health authority have a duty of care to keep supplying/funding me until I'm set up with my new one?

Any links to official guidelines stating this would be very much appreciated please as I am very anxious and stressed about the whole matter. I have an appointment with my existing consultant/health authority on Tuesday so would like to turn up armed!

Many thanks in advance.

 

[catapillar]

1) are you in England? Local health authorities don't exist in England anymore, they were replaced by CCG's in 2013

2) there is an NHS England document called Who pays? Determining responsibility for payments to providers which should be helpful.

3) are you registered with a gp? If you registered with a new gp at any point since moving the new CCG should have taken over responsibility for paying. If you never registered with a new gp it is likely that your old gp has realised you have moved and de-registered you - this is why the old CCG have stopped paying as they are only responsible for patients registered with gps in their area (or not registered with any gp, but usually resident in their area).

4) however, it is possible that your old gp will re-register you - since January 2015 gp practices have been able to choose to register patients outside their area, but this is voluntary - I was certainly told I couldn't stay with my old gp when I moved.

5) the old CCG stopping funding for ongoing treatment without telling you or transferring to the new CCG. This does appear questionable. The rules in "who pays" are firm that "every effort should be made to ensure continuity of care" and the old CCG should have liaised with the new CCG to transfer responsibility for payments.

If I were you & had not registered with a new gp I would:
- call up the old gp to check if you are still registered. If they have de registered you why & when & did they make any effort to contact you before de registering? Will they re register you out of area?

- call up the old CCG explain what has happened, that it is ongoing treatment which is at risk of being interrupted, explain the point at 5 above.

This might not work. They might be slow to fix it, they might say that they did make every effort & now it is you new CCG's problem - in which case, get yourself registered with a new gp ASAP, get seen & get them to help sort it out.

Alternatively, if you have registered with a new gp then it already is the new CCG's problem - get seen by your new gp & get them to help you sort it out.

In the meantime, try speaking to the hospital pump clinic to see if the can source any spare supplies to tide you over - they might be able to help as an interim.

 

[catapillar]

You also might want to get in touch with input diabetes (a charity who deal with access to diabetes technology on the nhs). They will be super helpful, will be able to give you concrete advice & might even have dealt with this situation and the relevant CCG's before.

 

[CarbsRok]

What ever CCG area your GP is in is the one that is responsible for your pump supplies. Very naughty of your DSN to leave you in the doo dah like that.

 

[mrsguiseley]

Thank you for your replies - apologies for my terminology, I meant CCG when I said local health authority.

I'm registered with a GP in my new CCG and when my Diabetes care was discussed I informed them that I would be staying with my existing one and nothing further was mentioned. I now see that it was at this point that I should have been informed about continuation of funding.

Thank you for informing me about the "Who Pays" document, I will be using this to push for continuation of care until it is all sorted. I will also be contacting INPUT for support.

 

[Chas C]

This does not appear to be common across the UK, my hospital is in a different CCG than my GP (I live on the border). My funding has not raised its head yet, been 5 years.

 

[CarbsRok]

This does not appear to be common across the UK, my hospital is in a different CCG than my GP (I live on the border). My funding has not raised its head yet, been 5 years.

My GP is in Cornwall and the hospital that my pump care is now under is in Devon. Devon sends the bill to Cornwall it's that simple

 

[Chas C]

Mine is between Dorset and Hampshire and it seems to also work ok.

 

[CarbsRok]

Mine is between Dorset and Hampshire and it seems to also work ok.

Yes and so it should work ok

 

[iHs]

My GP is in Cornwall and the hospital that my pump care is now under is in Devon. Devon sends the bill to Cornwall it's that simple

Who pays upfront? Does Devon pay first and then get reimbursed from Cornwall or does Devon just pass the bill onto Cornwall to pay instead?

 

[CarbsRok]

Who pays upfront? Does Devon pay first and then get reimbursed from Cornwall or does Devon just pass the bill onto Cornwall to pay instead?

Devon pays and Cornwall is billed by Devon.

 

[iHs]

Devon pays and Cornwall is billed by Devon.

Lol what would happen if Cornwall decided not to pay and passed the bill back to Devon to clear?

 

[CarbsRok]

Lol what would happen if Cornwall decided not to pay and passed the bill back to Devon to clear?

Devon consultant wrote to Cornwall to secure my funding which Cornwall have agreed to do. We have it in writing