When the pieces don’t seem to fit
How Long Should You Wait Before Asking for a Second Opinion?
Waiting for a second opinion? Learn what waiting is really for, when it stops being sensible and what to ask for when nothing is being decided.
There is no waiting time that fits everybody. What matters is whether the question you are waiting on has been clearly stated, and whether anybody is working on it.
Waiting for an answer and waiting for a decision are not the same thing.
Waiting for an answer and waiting for a decision are not the same thing. A wait is reasonable when somebody is working on your question and will review it.
It stops being reasonable when the question has never been written down, or when the plan has been repeated without anyone checking whether it still makes sense. The useful question is not how long to wait. It is what you are waiting for, and who is checking.
Most people who feel stuck are not waiting for time to pass. They are waiting for a question to be answered, and the question has never been stated in a way that anybody could answer. The result is that time passes without anything having been decided.
So here is how to tell the difference between a wait and a stall, and what to do about it.
What waiting usually means
After a referral, most people are waiting for a specialist opinion. What is often missing is any sense of what the opinion is for.
The referral may have been made months ago, the question inside it may never have been written down, and nobody has told you when it will be looked at.
That is why waiting feels worse than it is. You are not in a queue for an answer; you are in a queue for a piece of work that may not have been clearly specified.
A question that has been written down and is being worked on is a completely different experience from one that exists only as an opinion in someone's head.
When is waiting reasonable?
Waiting is reasonable when three things are true. There is a specific question being answered. Somebody is working on it. And there is a point at which it will be reviewed.
It is entirely reasonable to ask for all three in writing. Not as a complaint — as the most useful question you can ask: what is the question you are trying to answer, and who is reviewing it?
If you get a clear answer, waiting is waiting, and you know what you are waiting for.
Treatment plans work the same way. A course of physiotherapy is normally time-limited and built around a review. A plan with a review date in it is reassuring; a plan that is simply repeated is not.
When does waiting stop being sensible?
The signs are less about time passed and more about nothing being decided. The plan has been repeated without anyone asking whether it is still the right plan.
Nobody has asked what you want to be able to do again. You have been told to keep doing the same thing indefinitely. You were discharged without a plan for what happens next.
None of those is about elapsed time. A wait of two months with a question being worked on is fine.
A wait of two months with nothing being reviewed is not a wait at all — it is the absence of a decision.
Your symptoms changing also matters. If something is materially different from what was described at the start, the question that was asked may no longer be the question that needs answering.
What should happen next?
Ask for the question to be written down. It is the single most useful thing you can do, because everything else follows from it — what should be reviewed, by whom, and when.
If nobody can say what the question is, that is the finding.
Then ask for a review rather than a decision.
I am not sure this is still working — can we look at the plan again? is a reasonable request and easier for a clinician to answer than how many appointments you are entitled to.
And if the plan has been reviewed and has not changed, a second opinion is a reasonable next step. Not a criticism of anyone who has treated you, and not a rejection of treatment.
It is another pair of eyes on the whole picture, with one specific question: what is most likely going on, and what should happen next?
The bottom line
You should not be left in an endless cycle of appointments that nobody is reviewing. The objective is to understand what is going on, what should change, and by when.
The question to take away is not how long should I wait? It is what am I waiting for, and who is checking?
If you cannot get an answer to that, waiting is no longer helping you. That is a reasonable point to ask for an independent opinion.
When should you seek urgent help?
Seek urgent medical assessment for rapidly worsening or potentially serious symptoms, significant trauma, new progressive weakness, a hot swollen joint with fever, numbness around your groin, buttocks or inner thighs, new difficulty passing urine or new loss of bladder control, new loss of bowel control, new or worsening weakness in both legs, new difficulty starting or maintaining an erection, or if you are acutely unwell.
Project Sherlock is not an emergency or urgent-care service. If you think you may have an urgent medical problem, contact NHS 111, an appropriate urgent-care service or 999 in an emergency.
Please do not wait for a reply from us before seeking that help.