I have had a problem with my nose for many years and it is getting worse. How do I make an appointment to see you?

For NHS appointments, you will need to get a referral letter from your GP addressed to me at one of the hospitals where I see NHS patients. Please see the locations page for further details of hospitals including addresses where I work.

I have a particular preference as to which hospital I would like to come and see you. Can this be arranged?

Yes. I do run some private clinics in the evenings and on Saturday mornings. I am at the Nuffield Hospital, Brentwood, Essex on Tuesday evenings from 5.30pm, at the Spire Hartswood Hospital, Brentwood, Essex on alternate Thursday and Friday evenings from 6pm. Also on alternate Saturday mornings I can be seen at the Nuffield Hospital, Brentwood and and at The Spire London East (formerly Roding) Hospital, Redbridge, Essex.

I have a busy schedule and can only see you out of normal working hours. Is this possible?

Yes. I do run some private clinics in the evenings and on Saturday mornings. I am at the Nuffield Hospital, Brentwood, Essex on Tuesday evenings from 5.30pm, at the Spire Hartswood Hospital, Brentwood, Essex on alternate Thursday and Friday evenings from 6pm. Also on alternate Saturday mornings I can be seen at the Nuffield Hospital, Brentwood and and at The Spire London East (formerly Roding) Hospital, Redbridge, Essex.

If I want to see you privately, do I need to get a referral letter from my GP first, before you will see me?

This is not always necessary and very much depends on your insurance policy and the requirements of your insurance company. Some insurance companies insist on one, others are quite happy for you to see me without a referral letter as long as you have spoken with them before hand. It is always best to check with them as to their precise requirements. However, if further investigations or treatments are recommended after the initial consultation, most insurance companies require a GP referral letter at this stage.

My insurance policy only allows for the initial consultation and certain investigations. What happens if you recommend other tests or treatments?

There are certain policies which have restrictions either on investigations allowed or by means of a cap on allowable fees. If you are recommended to have a test which is not covered by your insurance policy, it may be possible to get authorisation from the insurance company on an individual basis, after the reasons for needing the test have been carefully explained. I am often able to help with this process and indeed the insurance company may contact me to clarify or confirm details as to why the test is needed.

If despite this the test is not approved, then your options are either to arrange the investigation through your GP on the NHS, or alternatively to pay for the test yourself.

I have come to see you as an NHS patient but would now like to go private. How does this work?

If you have a private insurance policy, all you need to do is to contact your insurance company who will probably require a copy of the original GP referral letter at some stage (please see 4 above – they may grant authorisation to proceed privately even before the referral letter is received). We can then arrange for any tests to be undertaken in the private sector in a hospital of your choice. If you are not medically insured but would still like to continue your treatment privately, you will be liable for the costs of any further investigations and/or treatment. Again we can help you to arrange these through my secretary.

You have recommended a particular operation for me but my insurance company has declined this. What should I do now?

This does occasionally happen, but do not lose heart! It is most often because the insurance company has insufficient information about the proposed surgery. If you are having difficulty in getting it approved, please contact my secretary who will take up the case on your behalf. She will initially contact the insurance company for you and provide them with additional details about the operation and why your surgeon has recommended it. Rest assured that the operation would not have been suggested to you if it was not necessary, so it is usually just a case of convincing the insurance company of this.

In some instances the insurance company still refuses to authorise the procedure. In such circumstances, you can formally complain to them directly to ask why their decision conflicts with that of your surgeon. If that fails, your options are to either pay for the operation as a self pay patient, or consider having the operation on the NHS. However this is rarely necessary.

I need an operation on my nose to correct the breathing, but have always wanted a reshaping of the external appearance of the nose. Will my insurance company allow this?

Most if not all insurance companies do not cover cosmetic surgery. The only exception to this is if the shape of the nose has been changed as a result of an injury or trauma, and if in the opinion of your specialist the deviation needs to be corrected in order to improve the breathing through the nose. If however the insurance company approves for the septum to be straightened, you can opt to pay an additional fee (a top-up) so that your surgeon can carry out purely cosmetic work on the nose at the same time and under the same general anaesthetic, which makes sense as only one surgical procedure is then performed. Your only other option is to have the cosmetic surgery done at a separate time, but the disadvantages here are that the stand alone cosmetic procedure will cost more than a top-up cosmetic work done at the same time as a septoplasty, and you will require two rather than one operation.

What happens if I am unfortunate enough to suffer a complication following an operation?

Minor complications such as pain, bleeding or infection can happen after almost any operation and are usually relatively easily dealt with. In most cases, further surgery is not required. More significant complications are thankfully also usually quite rare, and these would have been discussed with you prior to your surgery. If you think that you have suffered a problem after your surgery, you will have been given the contact number of the ward in the hospital where your surgery took place, who are happy to take your call 24 hours a day and will give you initial advice regarding what to do. It would also be a good idea to let your surgeon know of the problem at your earliest opportunity, as if something further needs to be done such as medications or possibly additional surgery, this can be organised with minimal delay. Your surgeon may also want to review you earlier than initially planned.

Do you accept children with ear, nose or throat problems?

Yes, we are more than happy to see children from birth with ear, nose or throat problems for an initial consultation. If surgery is required, most private hospitals are licensed to allow operations on children above the age of three. If your child is below three and the problem needs urgent attention, there are hospitals in central London and elsewhere which will accept such cases. If the problem is not urgent, your surgeon will advise as to whether surgery can wait until after the age of three. If the condition allows, there are instances in which there is good sense in waiting until your child is over three, as by this age the risks of a general anaesthetic and operation are much lower than in a younger, smaller child.

Are there any ENT conditions or treatments which are not covered by you?

We cover almost all ear, nose and throat conditions both in adults and children. There are some highly specialised services which can only be offered in larger centres, and mainly on the NHS. For example, patients requiring advanced skull base surgery will be referred elsewhere as will patients undergoing cochlear implantation and airway reconstruction work. Similarly, head and neck cancers, in accordance with guidance from the National Institute of Health and Clinical Excellence (NICE), now need to be treated in cancer centres which are organised according to region and are all funded through the NHS.

Are there any ENT conditions or treatments which insurance companies do not generally cover?

The two main categories relevant to ENT surgery are patients with snoring or cosmetic surgery. With regard to snoring, the situation is very much dependent on your own policy and insurance company requirements. In some instances, investigations and/or treatments are covered. With regard to cosmetic issues however, the vast majority if not all insurance companies do not fund this type of surgery.

In addition, most insurance companies will not cover pre-existing conditions present prior to taking out the insurance policy; others will allow such conditions in return for an increased premium.

I have an appointment to see an ENT specialist on the NHS but it is scheduled for 3 months time. I would like to pay for a private consultation to see you sooner but I know that I will not be able to fund any investigations or treatments should they be required. What should I do?

You are more than welcome to be seen privately for an initial consultation – please contact my secretary either by phone (0203 865 7225) or email (contact@london-ent.co.uk), or the hospital where you would like to be seen directly to arrange an appointment. If further tests or surgery are required, I can then arrange to have these organised on the NHS through your GP, bypassing the long wait for the initial review.

I have a medical insurance policy but have also received a bill from your secretary. Why is this?

There are two reasons for this. Firstly, if you have an excess on your insurance policy, most insurance companies will instruct you to pay the excess directly to the specialist. You may receive an invoice either from the insurance company or my secretary. Similarly, if your insurance policy has a cap on the amount you can claim and you exceed this limit, you may receive a bill for the remainder. Secondly, if during a consultation you are required to have a procedure such as flexible endoscopy of the sinuses or larynx or microsuction clearance of the ears, you should only receive a bill for this if you are a self pay patient without medical insurance. In such circumstances, the charge for this is usually sent to you in two separate invoices, one from the specialist for his professional charges in undertaking the test, and the other from the hospital to cover the equipment/room charges.

How do I make a private appointment to see you?

Please contact my secretary, either by phone (0203 865 7225) or email (contact@london-ent.co.uk). Alternatively you can contact the hospital directly where you would like to be seen, and they will make the appointment for you.

I would like to see you as an NHS patient. How do I go about arranging this?

You will need to ask your GP to send a letter of referral to one of the NHS hospitals where I work. Unfortunately, such appointments cannot be made through my private secretary.