Methinks the gentleman is talking through his backside. What does he want, blooming great big erosions? You are acting on a strong suspicion of PsA.
Just politely tell him that you are going to Bath, you are self-funding and require the formality of a referral from him. If it turns out that you have PsA you will have saved the NHS a fair bit of money by getting the dx yourself.
Check out: https://www.nice.org.uk/guidance/cg153/ifp/chapter/assessment-and-referral
This current NICE guidance for dermatologists tells psoriasis patients: ‘You should be offered an annual assessment to find out if you have a type of joint disease associated with psoriasis, called psoriatic arthritis … This should be done in the first 10 years after your psoriasis starts.’
And as we know that the severity of psoriasis has little to do with the incidence of PsA this advice should really apply to anyone with psoriasis, not just those whose skin disease is bad enough to attend dermatology appointments. Therefore, even if this advice was followed, which it isn’t, many more people with PsA would still experience a long delay in diagnosis.
Child birth was my trigger; a fairly traumatic experience, on lots of levels! I know psoriasis popped up then because I remember thinking that I had developed cradle cap in sympathy with my little one! Difference being hers cleared up and mine only got worse!
And I’m getting angry on your behalf too. Let’s hope that GP soon leaves your surgery as quickly as he arrived.
His letter of referral for your intial privately funded rheumatology consultation isn’t costing him or indeed the NHS much at all. And as Sybil has shown you via the NICE guidelines such a referral is fairly mandatory for psoriasis sufferers, irrespective of how severe it is or isn’t. And your intial rheumatologist obviously didn’t know his backside from his elbow either, given your ‘OA’ appeared to be galloping along in its development instead of slowly like it should if it was all just OA given your just only 41. You are also entitled on the NHS of getting a second opinion anyway and here you’re saving the NHS the funds of doing that. I’d complain to the practice manager of your GP surgery too.
And whatever the outcome in Bath at least then you’ll know you’ve done all you should to get the bottom of it. That’s always worth its weight in gold. x
GPs can and do miss this all the time. I don’t think that it’s a reluctance to talk to patients about it. It’s just a basic lack if understanding. Plus it’s a bugger to pin down at times so I think they sometimes lack the confidence to call it. My GP miss diagnosed me for a year until we eventually had a frank exchange of views. Wait and see what your new Rheumatologist says. She seems to know her onions so if it comes back with a negative (as this condition is such a massive bummer) I kinda hope it does if that makes sense. It’s a relief to get a diagnosis but only for about ten mins. Then the anger and fear kick in lol. Good luck to you xx