Frequently asked questions
Information all about clinic bookings, surgery, follow up and billing
Thank you very much for coming to see me in clinic, and I hope you found the consultation helpful. I have included some useful links below. If you have any particular queries, then please do not hesitate to contact my secretary Mari by email: info@danieltweedie.com
Coronavirus Covid-19
There is separate Covid-19 information relating to clinic and surgery bookings available here
Invoices and fees
If you have any queries regarding invoices, payments and insurance excess shortfalls, please kindly contact Nightingales Medical Services on 01342 316 239 or by email at: mail@nightingales-uk.com
Please note that from 1st January 2023, consultation and surgery fees have been be updated. Please click here for details
Patient Information
Further information about a variety of ENT issues is available under the ENT Patient Information section of my website
From the discussions outlined at the consultation, please kindly consider reading the relevant sections from the following webpages:
☐ Tonsils and tonsillectomy (including information about intracapsular tonsillectomy)
☐ Snoring and sleep apnoea in children
☐ Outer ear infections (otitis externa)
☐ Middle ear infections in children (otitis media)
☐ Glue ear
☐ Grommets
☐ Perforated eardrum (including eardrum repair)
☐ The nasal turbinates and turbinate reduction
☐ Keeping the ears dry (water precautions)
☐ Ear wax
Follow up
If you would like to arrange a follow-up appointment, then you are most welcome to book in directly at any of the hospitals where I run private clinics, or alternatively a remote telephone/ video appointment. These are all outlined under the Appointments and Enquiries section of my website. The booking numbers are as follows:
Parkside Hospital (Wednesday afternoons or Thursday afternoons/evenings alternate weeks) 0208 137 8431
The Portland Hospital (every Friday morning/early afternoon and second/ fourth Wednesdays of every month) 0207 390 8020
Portland hospital audiology department (for hearing tests) 0207 390 6573. If you would like to book a hearing test in advance for the day of the clinic, please book the main appointment first and then kindly call the audiology department to book a hearing test 30 minutes before the main clinic appointment time.
As with your initial consultation, please kindly arrive slightly early to allow plenty of time to book in, and please contact the respective hospital as soon as possible if you would like to cancel or reschedule your appointment.
Telephone and video appointments can be booked by clicking here
Second opinions
Making a correct and fully informed decision about your care, or the care of your child, can sometimes be challenging. I am always very happy to see patients for a second opinion myself, as is often the case. I also very much welcome patients to seek a second opinion from a colleague after they have seen me, should they wish: this can be very helpful. Please feel free to ask about this, and I can happily arrange an onward referral for you.
Arrangements for surgery
If you would like to book an appointment for surgery for you or your child, please kindly email my secretary Mari, and we will make the booking for you. I have appointments for surgery on most Thursdays at the BUPA Cromwell Hospital and on the third Friday morning of every month at the Portland Hospital.
Most of the surgeries are undertaken on a day case basis (unless stated otherwise in clinic), allowing children to return home in the afternoon or evening of the surgery. The recovery periods are generally short, and are outlined under the patient information sections (above).
When we have agreed on the date of surgery, Mari will formalise a booking with the respective hospital, typically two weeks or so before the date of surgery.
The timings may change a little as the operating lists are finalised. Please bear in mind that a number of patients are on each operating list, of varying ages, sizes and medical complexities, and so the list order and admission times will reflect this. We will be in touch one or two days before the surgery itself with the final fasting instructions, so please kindly wait to hear from me in this regard.
Codes for surgery
For insured patients, your insurance company will typically ask for surgical procedure codes. The commonest codes are listed below:
F3480 Adenotonsillectomy (removal of the tonsils and adenoids)
F3400 Child tonsillectomy up to the age of 16, without adenoidectomy
F3440 Adult tonsillectomy
E2010 Adenoidectomy (not in conjunction with tonsillectomy)
D1510 Insertion of grommets
D1530 Myringotomy and drainage of middle ear fluid
D0702 Aural toilet (removal of ear wax)
E0412 Reduction of the nasal turbinates
E3520 Microlaryngoscopy
E5180 Bronchoscopy
D1420 Myringoplasty (eardrum repair)
F2620 Division of tongue tie
W2620 Manipulation of fractured nose
My regular anaesthetist at the BUPA Cromwell Hospital is Dr Tahzeeb Bhagat and my regular anaesthetist at the Portland Hospital is Dr Devendra Mahtani. They are both very experienced in managing children and adults. On occasion, I work with other anaesthetists.
Like me, they are fee assured with all the main insurance companies: we invoice according to each company’s fee structure.
Surgery for self funding patients
For self funding patients, the hospital will make its own charges, and further information is available directly from the business offices via the following telephone numbers:
BUPA Cromwell Hospital Business Office: 0207 460 5770
Portland Hospital Reservations: 0207 390 6032
Please kindly provide the relevant code(s) detailed above, and the administrators will be able to give you a quotation for the hospital’s charges for the surgery: please ask for this on a day case basis (unless you have been recommended for an overnight stay, in which case extra charges will apply).
My anaesthetist and I will also charge separate fees for the surgery and anaesthesia respectively, and these are in addition to the hospital fees.
From 1st January 2023, surgeon and anaesthetist fees have been updated, as outlined here (this applies to booking requests which are made after 1st December 2022).
What to expect on the day of surgery
We recognise that patients and parents can be anxious about the prospect of surgery, and we will always try to be as helpful as possible, to put you at ease.
We will arrange an arrival time for you/ your child to allow plenty of time for the nurses on the ward to arrange the admission, basic observations (height, weight, temperature, blood pressure, etc) and simple screening tests such as skin swabs. We will contact you beforehand with the fasting instructions for surgery: patients can eat normally until six hours before surgery and then after that they should drink only clear fluids (water or diluted juice, but no milk) until one hour before the surgery.
Formal pre-assessment is not usually required, and we do not organise routine blood tests or allergy tests unless there are specific circumstances. Members of the hospital teams may contact you in the run-up to the surgery to ask about some specific queries.
The hospital may ask for patients to be washed prior to admission in Chlorhexidine (HibiScrub). This is a standard request, but is more relevant for patients having orthopaedic or general surgery procedures, and is not typically necessary for short ENT procedures. If you have any particular queries, then you are most welcome to contact the respective hospital admissions team directly.
My anaesthetist and I will come and see you/ your child on the morning of the surgery. We will go through the basic components of the anaesthesia and surgery respectively, covering any queries that you may have, and I will ask you to sign a consent form for the surgery.
The hospitals usually have play specialists available to help with younger children.
Parents are very much welcome to come with their child to the anaesthetic room, where the anaesthetic process is started. For younger children, we will usually start the anaesthesia using gas via a facemask, while for older children and adults we can use intravenous anaesthetic via a small cannula in the back of the hand (local anaesthetic cream is applied on the ward in advance to make this as gentle as possible). Once your child is asleep, we will ask you to return to the ward during the procedure itself, and will bring you back as soon as possible to recovery room after the surgery, so that your child can be with you both when going to sleep and when waking up.
Patients typically return to the ward within 15 minutes of waking up from anaesthetic, and can usually eat and drink soon afterwards. Discharge home is usually possible within 4 to 6 hours of the surgery. Depending upon the surgery, we will arrange a prescription for painkillers, antibiotics and nasal decongestants, as required.
After surgery
The post-operative recovery period for the different procedures is outlined in the Patient Information section of my website, detailed above.
I will telephone patients and their families on the day after surgery, and the hospitals themselves are usually in touch within 24 to 48 hours to make sure that all is well. If you have any queries regarding the recovery period, then please do not hesitate to contact me by email, or alternatively you may wish to telephone the respective ward of the hospital where the surgery was undertaken. In the unlikely event of a serious complication, such as post-operative bleeding, please kindly attend your emergency department as soon as possible.
I generally plan to see patients for follow up between two and four weeks after surgery. There may be specific circumstances where a different time frame is used, and I will of course discuss this with you at the time of the surgery. Please kindly arrange follow-up appointments directly via the telephone numbers detailed above.
Further queries
I hope that you have found this information useful. Please do not hesitate to contact us if you have any further questions or requests: info@danieltweedie.com