Private Medical Insurance (Bupa) through work - Please help with few questions

tasticz

Abit of a long thread. Need advice on what to do. 

I just found out for the first time in my life I have private medical insurance with Bupa through my workplace since early 2020 while going through some paperwork. I have unfortunately been having some problem with my throat and neck since October 2020.

1. I contacted my GP as soon as the problem started and they gave me antibiotics following telephonic consultation which I reacted to so I had to stop after first day.
2. Following that I had a follow up call when they told me to feel around my neck and I found a small lump on the right side but they said it was negligible but would carry out some blood tests which all same back normal. 
3. I then left it as it is for 4 weeks till end of November to see if my pain would go away but it didn't - the symptoms got gradually worse. The lump was still there and I phoned my GP back who called me in physically to attend for check during middle of December. They checked my throat and said there was a small red dot (which I have had since last year) and felt the lump on the right side of my neck which they said was a lymph node and as it is only a single one there is nothing to worry about. During my consultation they did a swap test for bacterial infection? and also asked me to do stool test which all came back normal.
4. Following the result, the doctor wanted to try out acid reflux medicine (omeprazole) for 1 month to see if my symptom would improve. I have taken the medication for nearly 3 weeks now but the pain around the lymph node is still there. I have follow up appointment in next 2-3 weeks (not sure exact date yet). 

My GP has been fantastic so far but I am really worried about this lymph node as the pain flares up and down, radiates down to my chin and sometimes over to left side of my neck. It is also rock hard. I do not have any problem swallowing but there is sometime pain in the throat also. I am really worried about Cancer due to the lump. I am having to clear my throat all the time. I really want to see a consultant to put my mind to ease or if there is really something wrong then I would like it to be found sooner rather than later. 

My Questions
It seems I have access to Babylon digital GP for free through the private medical insurance Bupa.

1. Can I undercut my GP and use/speak with Babylon? Can I ask Babylon doctor to refer me to a consultant for throat and neck while on the call? Has anyone used it?
2. Does Babylon have access to my medical record from my GP?
3. Does Babylon send my discussions with them to my GP or is it only stored in their system and is between me and them?
4. What happens if I ask my GP to refer me to consultant? If they agree and refer me to NHS consultant, can I just give this same letter to BUPA and request they send me to a consultant or does my GP need to write a letter to BUPA?

Thank you.

lisyloo

You can certainly get a second opinion, but the new GP won’t have all the history.
whilst NHS referrals are rationed, your GP should be quite happy to give you a private referral (they get paid extra for this). Make sure you mention you have private medical insurance. 

TELLIT01

You need to let your GP know that you have just discovered that you have private medical cover.  A different situation, but some years ago I had a major knee problem and my GP was going to send me for physio until I told him I had private cover.  I was referred straight to a specialist and had surgery within 3 months.  We are in a very different position currently but a GP is unlikely to refuse the opportunity to pass you on.

tasticz

Hi guys quick update.

I downloaded the babylon digital app and spoke with a GP yesterday (Sunday) evening. I told the Babylon doctor of my problems and he provided me with an ENT surgeon/specialist referral letter instantly.

I spoke with the insurer this morning and they gave me the authorisation code. I have a small excess to pay but I have now booked a face to face appoint with specialist for this Wednesday which I am really grateful for. 

Although, I had praised my GP above. I am now kind of p***ed off. I spoke with out of ours GP (111) back in October when I had an allergic reaction from the antibiotics and it seems from my summary notes that the out of ours GP had actually sent a letter to my GP saying to consider carrying out swab tests and if negative consider referring to ENT. I wish they had sent me this letter instead as I would not have waited this long.

I will let you all know how the appointment goes.

csgohan4

lisyloo said:

You can certainly get a second opinion, but the new GP won’t have all the history.
whilst NHS referrals are rationed, your GP should be quite happy to give you a private referral (they get paid extra for this). Make sure you mention you have private medical insurance. 

NHS Gp's DO NOT get paid for making private specialist referrals. They get paid for doing private medical reports such as for employers, fostering e.t.c. 

ic

Whenever I've told my GP I have private medical insurance, they've been happy to refer me.  At the end of the day, it means you go away and get specialist care, and they don't have to pay for it from their budgets, meaning they have more time and money to focus on other patients!