Mr Vivek Dhukaram

Frequently Asked Questions


Do I need a referral letter from my G.P?

You don’t need a referral letter to make an appointment, but you do require a referral letter for consultation. This is because the referral letter will have vital information about your general health and previous treatment. You can bring the referral letter or ask your G.P. to post or fax to the hospital.


What are the Payment terms?

Uninsured/ self-paying patient:
New patient or first consultation costs £160 to £200.
Follow-up consultation costs £90 to £120 depending on the consultation time.
The invoice will be sent in few days after the consultation. Payment should be made by cheque or BACS transfer within 30 days of receipt of the invoice. For investigations like blood tests, xray, scans and surgical procedures payment should be made directly to the hospital. 

Insured patients:
The insurance policy number should be handed over during your first consultation. The authorisation procedure may vary depending on whom you are insured with but, be advised to keep the insurance provider informed. Before any investigation takes place, such as: scans, physiotherapy, surgical procedures or further follow-up appointments, get approval from your insurance provider. If surgery is planned, you will be given a surgical code to inform your insurance provider.


What do I need to bring along for my consultation?

It would be very helpful if you could get
-    A referral letter from your G.P.
-    A list of regular medications
-     Any relevant Xrays or Scans taken elsewhere
-     You insurance provider and policy number


What are the possible outcomes of a consultation?

-     Referral for Physiotherapy or Orthotics
-     Recommendation to undergo surgery
-     Referral for further investigation
-     Given an advised injection into the foot/ankle joint
-     Reassurance and advice to arrange a followup appointment if the condition changes.

Further investigation or an injection into the joint can be performed on the same day or at a later date, if required.


What treatment can you get from GP before considering referral to a foot and ankle specialist?

A range of non-operative measures can be tried for foot and ankle problems before considering surgical intervention. You can find more information here.
In a referral letter please mention: previous treatment undertaken, any significant past medical history and current medication. 


What is the procedure for follow-up after surgery?

You can find all the post-op follow up information in the document here.


What X-rays are needed for foot and ankle problems?

With the exception of acute trauma, weight bearing radiographs (standing views) are preferred for all foot and ankle conditions.
For ankle, hindfoot and midfoot conditions such as: arthritis, flat feet, tibialis posterior tendon problems, the following X-rays are required: 
• AP weight-bearing of ankle
• AP weight-bearing of foot
• Lateral weight-bearing of whole foot including ankle
For forefoot conditions such as: bunions, hallux rigidus, metatarsalgia and lesser toe deformities, the following X-rays are required:
• AP weight-bearing of foot
• Lateral weight-bearing of whole foot including ankle

A non-weight bearing oblique view is recommended for problems involving the 4th, 5th metatarsal or Tarso-metatarsal joints.


When do I request an ultrasound? 

An ultrasound is useful in diagnosing soft tissue conditions and guided injections for diagnostic and therapeutic value. However, the efficacy is operator dependent. So please refer to a radiologist with more knowledge and experience in musculo-skeletal radiology. An ultrasound can be arranged prior to referral for the following conditions: 
• Achilles tendon problems
• Soft tissue swelling, 
• Mortons neuroma/ Inter-metatarsal bursitis and guided injection
• Plantar fasciitis and guided injection