The NHS usually works well
In most cases access to NHS treatment is smooth. The treatment you need is provided after a short wait - or no wait at all. You agree a treatment plan with your doctor, the plan is carried out, and hopefully you get better.
There are already agreements in place between the people with the money (Primary Care Trusts - PCTs) and the people who provide the treatment. You get the treatment, the providers get paid.
You never need to see what goes on in the NHS behind the scenes.
There are occasional problems
Sometimes your doctor recomends treatment which is either very new, very expensive, or both. In this case, those agreements might not be there.
The PCT has to decide whether to pay for the recomended treatment. It will do this by looking at the evidence of effectiveness (does it work) and evidence of cost-effectiveness (does it work for a reasonable price). It also needs to take into account government policy - for some treatment the government has decided that everyone with a clinical need should receive treatment.
Primary Care Trusts are always short of money. This has two effects:
They are sometimes motivated not to pay for your treatment - as it means they have to spend more of their limited resources.
They sometimes can't afford to employ enough highly skilled people to evaluate medical evidence.
When the PCT says 'no'
The NHS recognises that it can make incorrect decisions - hence there is an appeals process. This process will vary between PCTs, but the initial 'no' is not a final decision. If you act promptly and confidently it can be reversed.
We can help at all stages of this process.