FAQs

a.  If you wish to arrange a private appointment with us and if you are already consulting your GP for the same condition, kindly arrange for the GP to send us a private referral letter by post or fax. As soon as we receive this letter, we will arrange a mutually convenient appointment.
b.  If you are unable to arrange a referral letter from the GP and/or wish to organize the appointment with us soon, we will be happy to accommodate your request.
c.  You can fill online appointment request form here (LINK TO BE ATTACHED HERE) or email us on privatepractice@hipkneesurgeon.org.uk. We will endeavor to get it touch with you as soon as possible and arrange the appointment for you.
d.  For the referral to be sent by post, the postal address of the hospitals are as follows:

1. BMI The Lancaster Hospital
   Meadowside, Lancaster, LA1 3RH
   Phone: 01524 62345 (switchboard), 01524597592 (secretary)
   08081010337 (National Enquiry Centre)
   Fax: 01524380465
2. Spire Fylde Coast Hospital
   St Walburgas Road,
   Blackpool, FY3 8BP
   Phone: 01253923034 (switchboard),
   01253923944 (self pay enquiries)
   07875073139 (Jayne Mann – private secretary)
   Fax: 01253397946

Once a request for appointment is received (or a written referral received), appointment can be generally arranged within a week in most cases. If you wish to expedite matters further, feel free to contact us using appropriate phone number (as mentioned above) in order to receive an earlier appointment.

You don’t always need an official referral from you GP for private consultation. We will be happy to accept referral letter from other clinicians like physiotherapists, musculo-skeletal practitioners, etc.  We can also accept triage letters from your insurance company as a referral.  If any of the above cannot be provided and if you wish to be seen directly by us as soon as possible, we will accept self referral and you can book and appointment directly wish us.  Following the consultation, if we need any specific medical information, we will be able to liaise with your GP directly.

There is limited number of NHS slots available in private hospitals. If you wish to been seen as an NHS patient in one of the private hospitals mentioned above, kindly arrange your GP to send a NHS referral letter to the address mentioned above.  Alternatively, when you receive choose and book paperwork, specifically check a slot for the hospital of your choice.

a. Please bring any relevant insurance details and authorisation code. This will be useful, when you fill in the registration form at the hospital

b. If your GP has sent us a referral letter, that generally contains comprehensive information regarding your presenting problem, previous medical history, allergies as well as results of any imaging studies already performed. You therefore do not need to bring any other specific documentation for your consultation.

c. However, if a GP referral has not been sent, it would be useful if you can bring a list of your medications (if any).

d. If you have any additional information (e.g. pain diary, log of events, etc.) that you may wish to discuss during the consultation, you are welcome to bring it along.

a. If you need any specific blood tests or imaging studies like X-rays, we will be able to perform these during your consultation. X-rays will be reviewed and results can be discussed on the same day.

b. If you need specialized tests like MRI scans, CT scans, Bone Density Scan, ultrasound scan or nerve conduction tests this will be organized for a future date. In most cases, these tests can be organized within few days.

a.You need some minor procedure like injection and if it technically feasible and mutually convenient, we should be able to perform that during your consultation. If this is not possible on the same db., a mutually convenient date can be agreed for near future.

b.If you need any other procedure/operation, we will make arrangements for the process to be started during your consultation. In most cases, you will need a pre-operative anaesthetic assessment.  The date fc. procedure/surgery is provisionally agreed between you and the hospital and once pre-operative anaesthetic assessment id.successfully completed, the date for surgery is confirmed.  Occasionally, if any medical/social issues are picked up during this assessment, they will need to be dealt with prior to surgery.

a.If you have private medical insurance, it is best to inform them prior to the consultation. They would assess your insurance cover and provide you with an authorisation code.  It is worth double checking with them, with regards to any excess, any treatment that will not be covered, etc. We deal with most major insurance companies like BUPA, AXA PPP, Aviva, CIGNA, Prudential (PruHealth), WPA, Health-on-line, Vitality Health, CS Healthcare, Exeter Health insurance etc. on a regular basis.

b.Once you have authorisation code/number, it can be given to the clinic reception team when you arrive at the hospital. Once, this is done, the process is seamless and you do not need to worry about anything else.

c.During the consultation, if it transpires that you need further tests/treatment/surgery, we will provide you with all appropriate details including procedure code.

a.If you are self paying for your consultation, you will receive an invoice following your consultation and it can be settled in due course.

b.During your consultation, if it transpires that you need further tests/treatment/surgery is deemed appropriate, private patient advisor at the hospital will be able to give you an approximate cost for the same. There are various payment methods (to the hospital) available including full upfront payment, interest free payment over a mutually agreed period, etc.

a.Following the consultation, if you have any minor queries regarding the treatment, most of these will resolve during your pre-operative anaesthetic assessment or by going through appropriate information leaflets. Any further minor queries can be resolved prior to your surgery/treatment (if appropriate) by having a chat with the surgeon and the anaesthetist.

b.If you have any queries regarding authorisation code/obtaining approval by insurance company, etc. my private secretary should be able to help you. Alternatively you can email us on privatepractice@hipkneesurgeon.org.uk and we will endeavour to resolve your query ASAP.

c.If there were some major clinical queries, that you forgot to raise during your consultation, it is best to call the hospital or my secretary and book another face-to-face consultation. Occasionally, a telephonic consultation can be booked.

a.Following your initial consultation, if you have been booked to have any procedure/surgery that cannot be performed under local anaesthesia (numbing the local area), you are likely to receive a formal face-to-face consultation with a pre-operative assessment team.

b.Timing can vary on case-to-case bases. It will depend on the duration between the initial consultation and the provisionally agreed date of surgery.  This assessment is generally carried out few days before the planned surgery.

A senior nurse, who works quite closely with the surgical and anaesthetic team, carries out this assessment.

a.This assessment includes a detailed evaluation of any pre-existing medical conditions, previous surgical procedures, any problems with previous anaesthetic (if applicable), allergies, etc.

b.Appropriate tests will be carried as applicable including MRSA screening swabs, blood tests, ECG, etc.

c.If any equipment is needed during post-operative recovery period, this can be organized during this visit.

d.General information about the type of anaesthesia, pros and cons of different types of anaesthesia, etc will also be provided to you.

e.If there any concerns regarding post-operative convalescence and the support structure, these will be discussed as well.

f.Occasionally, following this visit, if there are any medical concerns, you may receive further appointment for a face-to-face consultation with a consultant anaesthetist.

a.You will generally see the consultant anaesthetist on the day of surgery. Further discussion will be carried out regarding the type of anaesthesia, risks and benefits, etc. before a final decision is made.

b.Occasionally, if there are any specific medical concerns during your pre-operative assessment clinic visit, you may receive a face-to-face consultation with the anaesthetist prior to surgery, in order to optimize your health before surgery.

There are three broad types of anaesthesia:

1. 1. Local anaesthesia: Numbing the local area. This is commonly used technique for injections or small procedures like lump excision, minor foot procedure, etc.
   2. Regional anaesthesia: numbing the whole region around the surgery. A common example for this is spinal or epidural anaesthesia, which numbs your legs.  This is a very widely used technique for major procedures like hip or knee replacement.
   3. General anaesthesia: Putting you to sleep.  This is a commonly used procedure for a wide range of procedures.  With modern techniques and drugs, there are very few (if any) complications with general anaesthesia.

The pre-operative assessment team will give you a general idea about pros and cons of various types of anaesthesia. As a surgeon, I can also give you broad principles around the choice of anaesthesia best suited for your needs.  However, the final decision will be made following your discussion with consultant anaesthetist.

a.Following your initial consultation, you will generally be given a provisional date for surgery, either on the day of consultation or soon after that by the booking office.

b.Once your pre-operative assessment has been completed and no concerns have been raised, the date for surgery is then finalized (same as the provisional date in vast majority of cases). If there are any medical/social issues to be resolved prior to surgery, the date is amended accordingly.

c.An official letter will be sent out to you confirming the details of when and where to come on the day of surgery.

a.During the initial consultation and during pre-operative assessment, it will be reasonably clear, whether or not your procedure is being done as day-case or on an inpatient basis.

b.If the procedure is being done on a day case basis, it means that you can go home on the same day after the procedure (in vast majority of the cases). Very occasionally, you may need to stay in the hospital that night, if there are any issues like vomiting, difficulty in managing pain, etc.  It is advisable that you bring a small bag with some essentials in case you end up staying in the hospital longer than anticipated.  Don’t forget to bring your book/ipad or laptop to keep you occupied!!

c.If the procedure is being performed as an inpatient, you will be given a general idea about the anticipated length of stay in the hospital. You can therefore bring essentials accordingly.

d.Please bring all your regular medications to the hospital (along with regular prescription – if applicable).

a.If your procedure is being carried out under local anaesthetic, you can eat and drink on the day of the procedure

b.If your surgery is being performed under spinal/general anaesthesia, you will be given specific instructions regarding eating and drinking. This information will generally be provided to you during your pre-operative assessment.  The admission letter should also have information regarding this.

c.As a general principle, if you are coming to the hospital in the morning, you are allowed to eat and drink till midnight, the night before. You can have clear drinks only (i.e. water) up to about 6 am.  Please do not consume any milk-based drinks or eat chewing gum after midnight.  If you have been called to the hospital around mid-day for your procedure to be carried out in the afternoon, you should be able to eat and drink up to about 6 am in the morning and clear drinks till about 10 am.

d.Once you reach the hospital, further instructions can be given i.e. whether or not you are still allowed clear fluids.

a. Specific information regarding this will be provided to you during your pre-operative assessment.
b. Generally, you are allowed to take all your regular medications on the day of surgery, with sips of water.
c. If you were required to withhold any specific medication, the pre-operative assessment team would inform you.

a. Once you report to the hospital reception, you will be taken to your hospital room
b. The ward nurses will greet you. They will go through a set of assessments in order to complete your admission process.
c. I will be seeing you again on the day of the surgery and go through the consent and answer any queries (if applicable). Your limb will be marked with a marker pen.
d. Consultant anaesthetist will also see you on the day of the operation. He/she will go through pros and cons of anaesthetic options and a plan is formulated by mutual consent.
e. You may see other members of the team like ward doctor, physiotherapists, member of the kitchen team, etc.

This is entirely your choice. If you wish anybody to accompany you, they will be allowed to stay with you in the room, until you go to theatre.

You don’t always need an official referral from you GP for private consultation. We will be happy to accept referral letter from other clinicians like physiotherapists, musculo-skeletal practitioners, etc.  We can also accept triage letters from your insurance company as a referral.  If any of the above cannot be provided and if you wish to be seen directly by us as soon as possible, we will accept self referral and you can book and appointment directly wish us.  Following the consultation, if we need any specific medical information, we will be able to liaise with your GP directly.

a. If your procedure is done as a day-case, you will be allowed home generally few hours after the procedure. During your stay in the hospital, multi-disciplinary team will assess you and once you’ve passed all the assessments, you will be allowed to go home.
b. For a joint replacement surgery, you will generally stay in the hospital for about 3 days. Once you are comfortable and mobile, you can be discharged from the hospital. During your stay in the hospital, multi-disciplinary team (consisting of physiotherapists, nurses, ward doctor, etc.) will monitor your progress.

Depending on procedure you’ve had, you may get some medications to take home including painkillers, tablets/injections for reducing the risks of clots, etc.

You may receive a date and time for follow up appointment prior to your discharge from the hospital. If not, this will be sent out to you by post.

Prior to discharge, you can take details about the direct telephone number of the ward. If you have any queries once you go home, you can ring the ward directly. Ward team should be able to address/answer most of your queries. Occasionally, further medical input may be required.

Depending on the procedure you have, physiotherapist will see you in the ward after the surgery. Appropriate assessment will be carried out and advice will be provided. If further outpatient physiotherapy input is required, they will be able to make appropriate arrangements.

This will depend on the procedure you’re having. First follow up visit will be few days/weeks after the procedure. Based on your progress, further follow up arrangements will be arranged appropriately.

The hip and knee replacement implants that I use in my practice have long-term track record. National and international joint registry data show a survival of >90% at 15 years. Therefore, there is a reasonable chance that your joint replacement should last at least 15 years.

a. Although there are some initial precautions to be followed following hip replacement surgery, there are no specific long-term restrictions.
b. Following knee replacement surgery, some patients may struggle to kneel. However, if you are able to kneel, this will not be contra-indicated.

a. Following keyhole surgery (arthroscopy), most patients are able to drive within 2 weeks (if not sooner).
b. Following major joint replacement surgery, most patients are able to drive after about 4-6 weeks.
c. For any other procedures, please ask during your consultation, since the period may vary on case-to-case basis.