Hi, does anyone have advice? We got a diagnosis quickly via a RTC provider however I didn’t realise they don’t offer titration yet. I now find myself stuck: I’ve been told I can’t use RTC for titration if I already used it for diagnosis. Is this right? That would mean we have nowhere to turn - no titration unless I go back to the GP and wait 4 years. Even the private companies I called say I’d have to start the whole process again and get diagnosed by them. My GP doesn’t know anything about options and say they can’t help. Any advice gratefully received. thank you
Hi, yes that’s a really tough situation to be stuck in. If a provider doesn’t offer titration and you wasn’t made aware of this, in you shouldn’t have to follow the usual guidance of sticking with the same provider, and a titration referral (in principle) should be allowed.
However, it’s all dependant on your ICB (Integrated Care Board) and your local situation. If you’re happy to share which ICB your local area falls under, I could send some links on this which you can consider when speaking with your GP, and using your specific ICB guidance when discussing it with them.
The alternative is NHS wait list which of course is much longer, or private funded titration.
If you don’t find a suitable route you could also make an individual funding request to your local ICB asking them to consider your case as you were not informed about the titration issue. This again though would be based on what your local ICB guidance currently states.
Feel free to share more if helpful 
Hi Joe, I am with North Yorks ICB and have written to them to compain as the NHS England guidance clearly states a provider should accept the assessment of another provider if both have NHS contracts. Clinical Partners said they would but their RTC titration wait is 10 months. Paloma said they wouldn’t so I have emailed pointing out this doesn’t match NHS guidance and asking on what basis - will update with any reply. Def seems a grey area but means if a clinic forces you to do another assessment the NHS gets charged twice which is crazy. At the moment I am reduced to private route as only option while we wait. I have sent assessment to Clinical Partners who annoyingly waited until after triage assessment call to tell me they take up to 30 days to review the dianositic report, so I might wait a month and be refused. Ready Health reviewed the assessment in 10 mins and accepted it so I am probably going to go ahead with them. I’ll share any useful info and any reply from ICB.