/ Treatment for cyst on NHS

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JimR 10 Jan 2020

Since september I've had a cyst behind my ear which has repeatedly got infected resulting in 3 courses of heavy antibiotics for 2 weeks at a time. I asked the doctor if they could'nt just remove it and get rid of the problem, his reply was that the NHS treat it as a benign skin condition and would only do that in exceptional circumstances and it was likely that they would deem me not to qualify. Well, its been affecting my quality of life so much (constant infection and pain plus not being able to cycle or run plus muddled mind affecting work) that I bit the bullet and paid £944 last night (of which half was for the use of NHS facilities!!) to get it done privately. Anyone know if this is general NHS policy or just my GP's practice rules?

Jon Stewart 10 Jan 2020
In reply to JimR:

Don't know, but it sounds damn stingey to me. If someone had a cyst on their eyelid that was causing that kind of trouble, as a high street optometrist, I wouldn't think twice before referring them to have it cut off. But, it wouldn't come out of my budget... 

ClimberEd 10 Jan 2020
In reply to JimR:

I had an infected cyst on my back about the size of half a golf ball. 

Twice the GP told me to go home and keep an eye on it. The third time they told me it was about to burst and sent me straight to A&E with a worried look on their face. I pity the poor junior doc who had to scrape it all out. 

mik82 10 Jan 2020
In reply to JimR:

The GPs don't set the rules, it's the local health board or CCG, and these have become increasingly restrictive due to funding issues.

However locally that would actually fit the criteria for referral (>2 episodes infection) but you'd probably be waiting over a year to have it removed anyway! If it was causing you that much bother then I'd have probably paid privately too.

ste_d 10 Jan 2020
In reply to JimR:

Seems to depend on the doc, I had something similar, first doc told me not funded, second doc same practice said let's give it a go!

Reach>Talent 10 Jan 2020
In reply to JimR:

I have a large subcutaneous cyst on the back of my knee which is now big enough to be impeding the movement of the joint, it took quite a lot of convincing to get a referral and then 2 years to get to the point of a pre-operative assessment. I am waiting on a second pre-OP as the first one expired. 

I was actually referred privately as well but it turns out my local private hospital is pretty stunningly inept and kept trying to book me an expensive dermatology appointment despite having the word subcutaneous explained to them on several occasions. 

AlfaPapa 10 Jan 2020
In reply to JimR:

For the National Standard Contract in 2019-20 NHS England released a list of restricted procedures (Evidence Based Interventions, EBIs). Benign skin lesions are one of those restricted procedures and hospitals who accept and undertake any procedure on that national list don't get paid for it.

There are thresholds for a number of the EBIs that, should you meet, you are eligible for treatment and it will be funded.

https://www.england.nhs.uk/evidence-based-interventions/resources/

To add some complexity, there are also local restrictions that are layered on top of these Nationally restricted procedures. Usually these are simple enough to find if you know your responsible commissioner (the CCG your GP is registered to) by googling "NHS CCG Name, commissioning policies" as they are mandated to be published on the CCG websites in England.

For completeness, Scotland and Wales have a different system.

Thugitty Jugitty 10 Jan 2020
In reply to JimR:

Five minutes colouring-in with a marker pen and you’ve transformed it into a suspicious-looking mole which should speed things up. 

FactorXXX 10 Jan 2020
In reply to Thugitty Jugitty:

> Five minutes colouring-in with a marker pen and you’ve transformed it into a suspicious-looking mole which should speed things up. 

That looks painful, how did it start?
The mole replied: "It started off as a cyst on my bum".

Deadeye 10 Jan 2020
In reply to JimR:

> Since september I've had a cyst behind my ear which has repeatedly got infected

Stop picking at it.

captain paranoia 10 Jan 2020
In reply to Deadeye:

> Stop picking at it.

It doesn't work like that.

https://www.nhs.uk/conditions/skin-cyst/

I confess that I used to lance the cysts in my earlobes and behind my ears...

In more recent years, I have started getting chalazions near the tear duct. Warm flannel treatment seems to work on those, eventually.

DenzelLN 10 Jan 2020
In reply to JimR:

I have a long history of severe cystic acne, mostly clear these days but last year i got an enormous cyst behind my ear.

Sleeping was difficult, so was eating and i ended up at the GP knowing full well they would either a) do nothing b) The nurse on duty would "have a go" at lancing it c) Antibiotics which will do nothing.

I got b which failed and declined c.

I went to a private hospital and was fully prepared to have it excised for £850.00, the NHS waiting list for it was daft, it was getting bigger by the day.

Rang on Monday was in on the Wednesday, the plastic surgeon injected me with a local at which point i promptly passed out and he couldn't perform the procedure as i couldn't keep my head up! Anyway he didn't charge me and the cyst went away by other means shortly after.

I use private healthcare for a few things these days if i can afford it, brilliant service and no wait!

Edit: the point of the above is i have never had any successful treatment for my skin from the NHS, 3 courses of isotretinoin was a private affair also.

Post edited at 20:50
The Lemming 10 Jan 2020
In reply to JimR:

Here's a cheery thought, Little Miss Lemming had a cyst. She went to hospital, got kicked out and went back in the next day by ambulance. That night I got a call from the hospital saying she had an hour to live and I better get my skates on to see her.

There was a happy ending, but I had to wait two and a half months till she was released from hospital.

Fookin shit myself.

cb294 10 Jan 2020
In reply to The Lemming:

Sorry to hear that, and glad it turned out well in the end! Stuff like this* was one of the reasons we went back home, eventually, even though otherwise we loved our time in the UK. Felt a bit stupid to fly home every time you needed a quick dentist's appointment or, as happened to friends, did not want to wait a couple of months for the cancer treatment to start.

CB

* For example, I cut my wrist badly doing some DIY work after buying the house we had initially rented, and covered the wound in tons of soot. Went to the hospital and was given a sterile drip to wash the wound while waiting in A+E, which would be fine. No stand for the drip, though, so I ended up balancing the wate bladder on my head, and no dish or bucket for the soot/blood/water mix to drip into, so I used a rubbish bin instead.

After a while a surgeon stitched me up without further cleaning out the wound, and I went home with some antibiotic.

Two days later a was a meeting at some other university, and woke up with my arm the size of my leg swollen with pus. So I pulled the stitches and opened wound again under the shower, squeezed out as much of the pus as I could, and went to see the campus doctor and nurse who were brilliant, cleaned the wound professionally and gave me the correct antibiotic. That was rather close to a sepsis and possible amputation, and could have been easily foreseen given the shit initial treatment.


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