Frequently Asked Questions
Please find below answers to some common questions.
Why should I choose private treatment
There are several reasons why you may choose to receive treatment privately. The main reason may be that you have medical insurance which gives you access to prompt appointments, diagnostic tests and treatment if necessary. However you can choose to pay for consultations, investigations or treatment as a self-pay patient even if you don't have medical insurance. This may be the only way to specify a particular specialist that you may have been recommended by word-of-mouth from a friend/relative or following a recommendation from your doctor or physiotherapist. Most referrals to the NHS hospital are now unnamed referrals and it cannot be guaranteed who you will see at your appointment. Sometimes it proves frustrating trying to see a specific Consultant that you have been recommended at the hospital as you may have to have a triage appointment with another healthcare professional first and then get sent to see someone else based on shorter waiting times. Even some insurance companies are now directing private referrals to 'preferred specialists', often on the basis of them signing up for cheaper fees or agreements about rules or quotas regarding treatment, and not usually based on a Consultant's results or sound medical grounds. In fact several insurance company websites direct patients to Consultants who do not specialise in the correct area of the body. I find that many patients appreciate and value a 25-30 minute detailed assessment in an appointment that generally runs on time and at a date chosen by yourself to fully explain what is happening, discuss treatment options and strategies for the future. This is much longer than can be given during NHS appointments due to the number of patients that need to be seen in those clinics.
How do I choose a surgeon
Most studies confirm that surgery performed by a specialist who performs large volumes of a particular procedure will give the best outcomes and lowest complication rates. Although during training a Consultant gains experience in treating all areas of the body it is now commonplace to specialise in treating one or two areas of the body thus meaning that a large volume of a smaller range of procedures is performed which has been shown to improve results.
You need to feel comfortable with what your surgeon suggests to you regarding treatment. Most of the operations we offer are life-improving procedures and are not mandatory, so if you feel that you are not ready for surgery it is often better to wait. You should feel that your appointment allows a joint decision to be made with you rather than feeling you are persuaded into having a treatment that you are uncertain about.
How do I choose a hip or knee implant
There are several aspects to consider - the experience your surgeon has with particular brands or types of hip/knee; the long-term track record of an implant; your requirements in the future such as activities you wish to be able to do. There have been very few brand new hips or knees introduced in the last few years that have bettered the results of estabilshed implants. Articles mentioned in newspapers or magazines are often sponsored links and can be persuasive to suggest trying new procedures that may not have much of a track-record. I am a member of ODEP which is a national committee that evaluates the performance of hip and knee replacements and helps guide surgeons, patients and hospital purchasers regarding the results of implants sold in the UK. I am also an advisor to Beyond Compliance which studies and monitors the outcome and results of new hip and knee products to the UK market before they get widespread release.
How do I get an appointment
NHS appointments to be seen at Llandough can be requested with a referral letter from your GP.
Private consultations can usually be accomodated within 1-2 weeks. A referral letter is not always necessary but is usually stipulated by insurance companies so please check first.
Appointment helpline 02920 731112
Online booking for self-pay patients Click here
What is Arthritis
Arthritis refers to loss or wear of the cartilage in joints. Most people with arthritis will experience pain and stiffness. Around 10 million people in the UK have arthritis and, like them, you can take control of your symptoms and continue to have a good quality of life.
Osteoarthritis (OA) is the most common form of arthritis. It causes joint pain and stiffness. Several different joints can be affected, but osteoarthritis is most frequently seen in the hands, knees, hips, feet and spine. There are other forms of arthritis such as inflammatory arthritis, where swelling is more of a feature in the early stages, with cartilage loss occuring later.
I've heard that knee replacements don't work
You may come across patients who are not happy with the outcome of their hip or knee replacement but on the other hand 85-95% of patients find a great benefit following these operations. There are numerous causes for unhappiness including false expectations prior to surgery; rushing into surgery before the arthritis was too severe or without trying simpler measures; multiple previous operations; referred pain from the back as well as other causes. Unfortunately there are some risks with surgery, and although these are rare and we aim to have no complications, they can reduce the success rate of treatment. With attention to detail regarding the accurate sizing of knee replacement; use of an implant with extra sizes compared to many on the market; correction of presurgery risk factors; use of an enhanced recovery programme and careful decision making prior to committing to surgery, the success rate has undoubtedly been improved over the years.
I've been told I have a torn cartilage in the knee
This phrase commonly refers to a tear in the shock-absorber in the knee called the meniscus which strictly speaking isn't cartilage. It doesn't always need an obvious injury to cause it and it can be an age-related condition occuring when it occurs after the age of 35. In most cases an x-ray is normal and often an MRI scan is useful to make the diagnosis. Sometimes this can be confused with a ligament injury in the early weeks, but most ligaments heal after 6-12 weeks, so if pain is ongoing after that then this diagnosis is a possibility. When symptoms are troublesome and the problem is not resolving, then keyhole (arthroscopic) surgery has a very good success rate.
Why won't my insurance company allow me to see you?
I am registered with all of the medical insurance companies to provide treatment and if you are told otherwise that is incorrect. I am an fee approved specialist for BUPA, AXA PPP which means that I have rates agreed with those companies that are acceptable to them. However sometimes patients are told by staff at insurance companies that they are not allowed to see certain specialists. Sometimes this can just be down to undefined algorithms that computer systems prompt the telephone staff at the time of the call. Occasionally it can be related to certain policies such as corporate policies where the insurer has measures in place to keep costs down for the corporate client such as by directing patients to certain consultants that have agreed lower fees and reduced follow-up appointments in return for a share of open referrals. Whilst this in no way implies any difference in level of care, there can be no stronger recommendation than that by a physiotherapist, other specialist, general practitioner or former patient instead of an algorithm based on fees and follow-up practice. Occasionally patients have been directed to Consultants that do not even specialise in the body area for which treatment is required. There is an increasing trend for patients to have a telephone triage appointment with a physiotherapist from the insurance company to determine if a consultation will be approved.