NHS/Private diagnosis

What diagnositc tests has your husband already had?  is your husband having a Multiparametric MRI or MRI on Thursday - this would be the next step and once this has been seen it will show the area the biopsy needs to be taken from - though you say that they already know it is on the left hand side so presumably he has had an MRI?  Unfortunately I can't find your previous post on here so don't know where you are on the tests and scans journey exactly.  The next step would be a biopsy where samples are taken from the area and sent to a laboratory to be seen.  Usually in the NHS it takes about 2 weeks for the biopsy results to come back - one would assume that this could be cut down to days or up to a week - who knows maybe quicker when paying privately.  Then possibly other scans to ascertain if the cancer has spread outside the area or not.  If the scans he needs can be done at the private hospital you are going to then it is likely that they will be read straight away.  So possibly the only thing they would do that will take time is the biopsy but not having had this done privately I don't know how long this would take.

Whatever it is always the waiting for tests and scan results and Multi Disciplinary Team (MDT) meetings to ascertain a treatment path that takes the time and the waiting as you may have guessed from other posts on this website is the very worst thing but unfortunately it can't be avoided.

One caution with private referral is that it might be just one clinician deciding on his best options, whereas NHS diagnosis mandates MDT (Multi-Disciplinary Team) working, where a team of the urology, oncology, radiologists, CNS's pathologists, etc all meet together to agree the patient's best options. MDT working is to avoid a clinician pushing their own favorite procedures. Some private hospitals and private patients in NHS hospitals do use MDT working practices, but unlike the NHS, it's not mandated privately.

Aww thank you for your reply. I will check this out on Thursday thanks. I do know out consultant is one of the main ones at our NHS hospital and gas been highly recommended and have been told he will be dealing with husbands care start to finish. Even if any procedures are needing done he will be the one performing them too as he is a urologist surgeon. I suppose we just need to wait and see but so glad we have this opportunity as could be waiting a good couple of months on NHS  to start investigations. 
I believe we can get referred back to NHS at anytime so even if we can just establish wether cancer or not then the rest will just take time I suppose. 

Thank you for your reply. At the moment all that has been done has been a psa blood test and a DRE at our normal GP. On Thursday is just first meeting with consultant where they said they will prob do a urine flow test then I would imagine an MRI scan but would be a different appointment would imagine. 

Patients have the right to chose parts of their diagnosis or treatments to be done privately, while not losing their rights to NHS care too. This doesn't always work as smoothly as you might like though. One thing many private patients report is that although the procedure is covered, they find that anything ancillary isn't. That can mean they don't have a CNS (clinical nurse specialist) to talk with, don't get referrals for ED clinic or counseling or anything else needed, etc, and often find their private cover doesn't cover these things (e.g. BUPA won't cover psychosexual counseling). In theory you can switch back to the NHS for some of these, but in practice that can be difficult if you didn't go through the NHS pathway.

Aww ok that’s good to know. All good things to ask on Thursday. And to double check with our health insurance what is covered and not. As I do believe there is a prostate specialist team at our provider that know so can check out all these possible obstacles. Thank you again for your knowledge and advice greatly appreciated. 

Hello Skye, sorry to hear about your husbands diagnosis and it’s great to hear you’ve got private insurance cover.

just thought I would let you know about the Government targets for NHS hospitals.

patients with suspected cancer should be referred from  their GP to a consultant on the ‘two week pathway ‘. This means that their first hospital consultation should take place with two weeks of the GP referring.

the 62 day RTT ( referral to treatment) target means that any patient should start their first treatment within 62 days of their GP referral.

we all know that the NHS is under pressure and targets are not being met. However, when we got stalled along the diagnostic pathway, citing the 62 day RTT target to help to keep things moving.

also, we inquired about having the biopsy done privately to speed things up. We also told the hospital we were happy to take a short notice cancellation appointment. Result ? Two days wait for NHS biopsy, 2 week wait for a consultation with a private consultant prior to a biopsy. The NHS were quicker. 

the point I’m trying to make is that if you are politely assertive and proactively chase appointments   things can get done quickly on the NHS. If you patiently accept NHS delays you potentially have to wait longer!

good luck

Thank you for your reply. We have no diagnosis yet that was just what referal letter said. 
But we were referred on 31/1/23 and when I phoned hospital on Friday they said they are not pulling letters forward and it won’t be looked at for at least a month so that will definetly not be in tge 2 week time scale. 
and I did stress the psa and findings but they said was out of their hands so was just to wait. 
Husband also has slow flowing urine so also another cause of concern that investigation needed.

We do appreciate the nhs is pushed but I suppose it only natural to become anxious considering his age, symptoms and findings on examination.

The consultant we have chosen is also a consultant for our local nhs hospital. so we will see what he advises on times etc Thursday. 
they initially gave us an appointment for 23/3/23 however once we sent the referal letter the consultant looked at it and gave us an appointment on the same day for that evening but my husband was away with work so they then we got one outwith his clinic for this Thursday as he only does a Thursday at our local private hospital which we are greatful for. 

Hello Skye

I’m pleased to hear you have got an appointment so quickly. I hope it goes well for you x.