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Ask your CCG to intervene- the referral will cost more than the USS, and if it’s a tricky diagnosis, they’ll get billed for the USS anyway. You might also ask whether they want every 50+ woman with bloating sent up as a two week rule appointment... From: GP-UK [mailto:[log in to unmask]] On Behalf Of Paul Bromley Sent: 15 December 2016 20:55 To: [log in to unmask] Subject: Best investigation for suspected inguinal hernia Thoughts on this please. Patient presenting with a possible hernia, but you cannot definitely demonstrate one. I have always thought it reasonable to refer these for Ultrasound. Have had a number of rejections from one provider stating that these are clinically inappropriate. What should I therefore do and what modality do I request? Have written to them to see what is going on. Have also had a few bounced for other requests - one being a 50+ year old female complaining of bloating to rule out ovarian lesion . Getting rather 'cheesed off'! One way to get their referrals down. I am partly told this is due to an overzealous clinican at their end who is vetting all referrals. -- Best Wishes Paul