Our PCT is extremely really reluctant to refer anyone out of area at all. I'm in a very remote area of scotland anyway, and for most specialist stuff we have to travel to Aberdeen. My GP wanted a second opinion neuro (out of area), and it has taken almost a year from when he first submitted the request to the appointment date. Having approved one out of area referral, I think they will be even more reluctant to give me a second opinion rheumatologist out of area.
I have asked GP if he can repeat some of the lupus blood tests, but he won't. He says that they are expensive tests, and I have had them done already once (two years ago though!), and he doesn't want to do them again unless a rheumatologist orders them. I haven't even had routine blood tests done since then. I have asked GP to refer me to the visiting rheumie at the local hospital (only comes up twice a year though) in the hope that I can get the blood tests done at that appointment. This rheumie is not a lupus specialist, but at least I might be able to get the tests done. Depending on what happens there, I will then probably ask for a specialist lupus referral, or just go for the private assessment at London Bridge Hospital.