Many patients living with aspergillosis or allergic bronchopulmonary aspergillosis (ABPA) ask for a second opinion ā often from a national centre like the National Aspergillosis Centre (NAC) in Manchester or from another specialist elsewhere in the UK. But sometimes, hospitals resist sending your case outside their own department.
Hereās whatās happening, why it might occur, and what you can do.
š¤ Why Would a Hospital Refuse an Outside Opinion?
Itās understandably frustrating when youāve asked for expert help and your local hospital insists on keeping things āin-house.ā Here are some reasons this might happen:
1. Internal Referral Rules
Hospitals sometimes have a policy to refer to another consultant within their own department first. They may consider this a āsecond opinion,ā even if itās not truly independent.
2. Cost and Complexity
Referrals to another NHS trust ā especially across health boards or into England (e.g. to NAC) ā can involve extra steps and costs. Some hospitals prefer to avoid that unless they feel thereās no choice.
3. Professional Sensitivities
Some doctors may feel a national second opinion implies criticism of their care, even if your request is made respectfully.
4. Lack of Awareness
Some clinicians arenāt fully aware of what the National Aspergillosis Centre offers ā or may underestimate how complex aspergillosis, ABPA, or recurrent fungal infections can be.
š§āāļø But Isnāt a Specialist Opinion My Right as an NHS Patient?
Yes. If your GP or hospital team believes itās clinically appropriate, you have the right to be referred to another NHS consultant ā including one outside your local area.
The NAC is nationally commissioned by NHS England to provide care for people with chronic aspergillosis. They accept referrals from across the UK.
š· Why Private Care Might Not Be an Option
Some patients consider going private when local NHS referrals are blocked ā but private care often means:
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Paying for new scans, blood tests, and sputum cultures
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No direct access to previous NHS records
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Higher costs than expected, especially for complex tests
If you canāt afford this, you are not alone, and there are still NHS options available.
š§ What You Can Do Next
Here are practical steps if you’re being blocked from getting a second opinion:
ā 1. Restate Your Request Clearly
Ask your GP (or write yourself) to reply to the hospital and explain:
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You are specifically asking for an opinion from a national expert service (e.g. NAC or Dr Iain Page in Edinburgh).
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This is not a rejection of their care, but a request for specialist reassurance, diagnosis support, or treatment planning.
ā 2. Ask for a Tertiary Centre Referral
Use the term ātertiary referralā ā this means a referral to a national or highly specialised NHS service.
ā 3. Raise It with PALS
If you’re still being blocked, contact your local Patient Advice and Liaison Service (PALS) or NHS complaints team. Explain:
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You have a rare/complex condition,
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Youāve asked for a national review,
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And youāve been offered only an internal opinion.
ā 4. Get support on NAC Support Facebook Group
- https://www.facebook.com/groups/aspergillussupport/
š¬ In Summary
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Youāre not being difficult ā youāre advocating for your health.
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It is reasonable and often necessary to seek input from specialists like those at the NAC.
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If youāve been told āno,ā it may be due to policies or misunderstandings ā not a reflection on your need for better care.
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Keep asking, and if needed, involve your GP, or PALS.
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