UK to US comparison

[puffing billy]

Hi All
Having read about the US system I thought it may be interesting to shed a little light on the UK system.

To get to see a specialist you need to get a referral from your own Doctor.
The wait to see the specialist an Ear Nose and Throat Surgeon at present you would wait 13-15 weeks. The wait for a sleep study in a specialist unit is about 18 months, but they do have home test units were they you give you the equipment with some instructions. The later option is about a week.
To get the results would be about 4 weeks and another couple of weeks to get fitted with a mask and get a machine.

The visit to the doctor, the Specialist and the Technician would be "free" (see notes later). I am also told that our local Hospital provides the machine and mask under prescription the charge is £6.50 about $11 for each item.

The word free is a bit misguided as we pay taxes on our earnings two lots in fact. Then we pay 17.5% sales tax, 70% on petrol (gas) plus a few others.

So what do you think of our "free" National Health Service.

Billy

[Wulfman]

Billy,

Thanks for the information about your health care system. Considering the costs (taxation) of everything, it illustrates that there's "no free lunch" (except for illegal aliens).

Best wishes,

Den

[JamesCPAP]

It really depends on which area of the country you look at and the severity of the complaint. I went to see my local GP with heart problems (frequent palpitations) and about 4 weeks later got to to see an ENT doctor. Who then referred me to the respiratory unit, never saw the respiratory doctor, but was requested to attend a sleep study (in 4 weeks) and all they did was monitor my oxygen levels along with a microphone and video camera hook-up in the room (ooer).

4 weeks later (4 weeks seems the norm in my situation) they said I had OSA and needed a machine.

Returned to hospital (again 4 weeks later) and was given a trial CPAP. Still never saw a doctor, only the nurses in the respiratory center.

My hospital wouldn't pay for the machine so I had to pay this myself. You shouldn't be requested to pay for a prescription in terms of machine or mask. All I had to do was get a signature from one of the nurses in the respiratory center on the manufacturers form and I then purchased the machine. If you can get it under prescription, they should just give you one. There's no fee to pay for prescription.

XPAP machines are also considered a requirement for continuation of life, so it comes under the umbrella of being VAT Free (so no 17.5%).

Even if you cannot get a machine under prescription, you can still get a mask free on commencement of treatment and a further one once every 12 months.

[puffing billy]

Hi JamesCPAP
Your referall would have been more urgent, mine was for snoring.
I was told that our local Hospital actually gives the machines away, but I think a benefactor may be involved.
I have to say the prescription prices were assumptions as I bought my machine/mask in the USA at about a third of the price.

Billy

[littlebaddow]

Hi fellow Brits

Seems the experience with the NHS & OSA varies across the country. I suspect this is symptomatic of the relative lack of awareness of the condition in the UK compared with our American cousins and elsewhere.

My admission to the community of xpap users began in 2004, so the situation may have changed in my area. Referral by GP to ENT specialist, who arranged the home test with equipment borrowed from the local hospital took several months, following which I would have had to wait a further 2 to 3 months for an appointment to see the sleep specialist on the NHS to get the results.

Inevitably, the same sleep specialist could see me privately within a week, so I paid the money to get the diagnosis and a prescription. It didn't take much research then to identify the significant savings to be made by purchasing on-line in the US, providing you can arrange delivery. In my case, I'm fortunate to have a brother who travels regularly to the US so everything I buy is delivered at no cost and without the hassles of Customs & Excise (good job this is anonymous )

Providing there are no other medical complications, I'm convinced that self-management of the condition using the software and the knowledge in this forum is an effective way forward.

[JamesCPAP]

Providing there are no other medical complications, I'm convinced that self-management of the condition using the software and the knowledge in this forum is an effective way forward.

I completely agree with you. One thing I found from my experience looking at what most had here and the MyEncore software freely available to expand on Respironics data reports, I was fully ready to go with a Respironics REMStar Auto, but Respironics said for the software and card reader, it would cost me over £900! There was no way I was going to pay £900 for software, so I looked at ResMed, they wouldn't sell me the software and reader either.

So in the end, I plumped for the S8 AutoSet Spirit due to the size and that I travel a lot. Still trying to get hold of the software and reader, but now have access to the clinician menu so at least I can manually document the AHI, AI, HI for my own purpose in an Excel Spreadsheet and plot graphs on a daily basis.

It's a shame CPAP.com won't ship ResMed stuff to the UK.

I really cannot see why the hospitals and manufacturers are against us self monitoring ourselves. Perhaps they feel that at the slightest wrong figure we'll be on the phone to the hospital or to the manufacturer as hypocondriacs? I don't believe this would be the case. Already I've gone from an untreated 140 AHI down to 20 AHI on the bulk standard 4cm to 20cm pressure under autotitration, and tweaked the machine to 8cm to 20cm and now dropped my AHI to a consistent 3. This is something the hospital wasn't willing to do with me and once on treatment it was good enough for them, but it must be better surely to reduce the AHI, so why not let us manage ourselves if they are not willing to do the job properly ?

<rant off>

Hey it's good to see other Brit's here!!!

[Snoozin' Bluezzz]

It's a shame CPAP.com won't ship ResMed stuff to the UK.

The shipping prohibition is NOT a CPAP.COM policy, it is a Resmed policy.

David

[puffing billy]

Hi James
If you know someone in the US that could buy your software for you and you reimburse them that could be a way round the problem.

I am fortunate (maybe) that my son lives in the US therefore visits normally involve picking pre-ordered items up, this includes my next trip. But it does have a down side with shipments of tea, biscuits chocolate jam etc from UK to US.

Billy

[littlebaddow]

Hey it's good to see other Brit's here!!!

Yes, there are a few of us lurking around

As Billy says, if you're lucky enough to know someone who lives in or travels to the US fairly regularly, then buying the kit from the US is not a problem.

Hope you keep making progress with your treatment

[sir_cumference]

Here is Leeds the situation is bad. I went via my dentist because of my awful snoring and was referred to an orthodontist. The appointment took 6 months to come through. When I got there and had the discussion I was convinced I had OSA and when I was told the waiting times (it would take between 2 years and never to get a machine and treated) I went private. (On that point, I just got my follow up appointment through this last week for the orthodontist - over a year later - telling me I can make an appointment for the next month or so.)

By going private it cost around £1500 but I was treated and up with a machine within a week!!!! A WEEK!! And I've never looked back!

BUT the really interesting thing is that when I was diagnosed and started with a borrowed private machine, I was then handed over to the NHS and now have a free APAP machine (S8) and mask (breeze). My machine is serviced every year and I get a new mask every year free of charge!

The issue for this area is in getting diagnosed and titrated. Once you are in the loop (so to speak) the service is wonderful! IN fact, at first they gave me a CPAP machine that I couldn't live with and because of that they changed it to an APAP - no questions asked etc. etc.

Lastly, I was diagnosed by a home kit which was nearly impossible to sleep with and they said my OSA was mild and if I had been under NHS care I would have been so low priority that my titration could have taken over a year to happen! It was only because I paid myself that the real extent was uncovered!

Well that's Leeds for you, great when you're in the system, but almost impossible to get into the system unless you're prepared to pay yourself or have another major problem like a heart condition.

Lastly, the specialist here in Leeds are the best, but the NHS funding for OSA treatment is very poor - they can't seem to see that by treating us they will actually win as we are able to work harder and pay more taxes etc ... short sighted is probably the best description.
sir_c

[apneaicinisrael]

Wow, it is sombering to hear of the long waiting periods for diagnosis. I live in Israel and have to say that my sleep lab apologized for a three week wait for a sleep test. On the whole, though, I think that if I had known what I now do, I might have just asked for a trial on an APAP and a follow up consult with the sleep doc. It would have saved us all time and money. If anyone hasn't read the article that Rested Gal has referred us to on a number of occasions, do. It discusses this subject, that maybe we can titrate ourselves a home without a sleep center study. I think that if I were faced with a long wait for diagnosis, I would push for an APAP home trial.

Good luck to you all, those waiting and those whose number has been called (as a figure of speech, of course, like, bakery number, never mind...)

AII

[sleepy in uk]

Well I must be very fortunate living here in Leicestershire as I only had to wait a few weeks for my study and then just a few more before I collected my first machine and mask which I have since changed, machine once to one with a heated humidifier but have had several masks till I found one that really suited (the Swift) all with no charge I think there are restrictions on how often you change masks but the system seems to work just fine for me in fact I cant really fault it. :

[sir_cumference]

sleepy, you chose the right place to live!!
sir_c