Costs

Insured patients
I charge rates that are reasonable and consistent with my experience. For the majority of insurance providers there should be no shortfall for out patient care or for surgery. If you are uncertain, please discuss this with your insurance provider before your appointment.

Self-funding: Hand and plastic surgery
Hand / Plastic surgery new appointment £225, and follow-up appointment £125.

New versus follow-up appointments

If you have a chronic condition (such as Dupuytren's disease), and were last seen more than six months ago, your insurance provider will expect you to obtain approval for a new consultation (you will be charged for a new consultation). This does not apply to skin cancer patients having follow-up in accordance with national guidelines.

Self-funding: Cosmetic surgery
New appointment £250 (cosmetic surgery patients considering surgery can return for a second appointment at no charge).
Cosmetic surgery patients usually have an initial consultation of at least 30 minutes. I provide a personal opinion, and will carefully explain the pros and cons of a procedure. (It is possible that the information may not always be what a patient wants to hear: for example I may need to explain why a procedure would not be in a patients best-interest.) I may suggest that a patient seeks the support of a clinical psychologist. If you are a smoker (or are unable to stop smoking) I am unlikely to recommend that you consider cosmetic surgery. If you are considering surgery to you chest, upper arms, or abdomen, I am unlikely to recommed surgery if you have a body mass index higher that 30. (patients can look at the NHS BMI caculator: https://www.nhs.uk/health-assessment).

Additional procedures and investigations in clinic
An additional fee may be charged for interventions or investigations performed during the consultation (for example steroid injection into a painful joint).
I may also charge an additional fee for the review of a large number of X-rays and scans (many of my patients have undergone previous investigation and surgery elsewhere and bring a collection of scans and notes needing review). Please feel free to discuss this with my office before your consultation.

My secretary can provide a quote for the cost of any procedure

• The quote includes the care of any complications such as the management of bleeding or infection in the first few weeks after surgery.
• The quote includes the cost of the usual number of follow up appointments in clinic. If a patient needs more appointments or needs to see another specialist there could be additional charges. 
• The quote will not include the cost of any private prescriptions, scar treatments, or hand therapy. 
• It does not include the cost of a clinical psychologist. 
• It does not include the cost of a plaster cast or splint (for some hand surgery I require the help of a plaster technician). 
• The total cost of a procedure is broadly proportionate to the duration of the operation, the costs of any anaesthesia, the length of hospital stay, the complexity of the surgery or after care, and the associated medical indemnity costs (charges levied by the firms that insure surgeons and anaesthetists can vary for different operations). The total cost is likely to include the hospital fee (which I have no control of and which can change at short notice), the surgeons fee, and when appropriate the anaesthetists fee (which can vary between anaesthetists). 
• The hospital fee can include costs associated with particular implants, and costs for patients with particularly complex or demanding background medical problems

Surgery can be complex, each patient has unique circumstances and challenges, the experience of surgery for an individual patient and the outcome can vary. Any patient considering surgery needs to reflect on the fact that despite the best-efforts of myself and the healthcare team, not all surgery is uneventful (for example some patients will have complications). The patient needs to consider how they would cope if there was a problem or an outcome that did not match their expectations.

The quote (unless specified otherwise) will include care for 30 days after surgery, it will not (unless specified) include long term care of a particular condition, it will not include care for problems caused by a patient deviating from the proposed aftercare (for example returning to sports, driving, or lifting too soon after surgery).

I have listed very approximate figures for the total cost of surgery, which were accurate at time of publication in 2023. These are merely a guide to the likely costs. Patients need to obtain an individualised quote before having a particular operation. 

Carpal tunnel release: £2800-£3000

Trigger finger release: £2800-£3000

Trapeziumectomy: £6900-£7200

Excision of basal cell carcinoma and skin graft: £4400-£4600

Bilateral breast reduction: £11800-12100

Gynaecomastia removal: £6800-7100

See and treat clinics
For self-funding patients the fee is £500 (the hospital will also charge a fee for use of their staff and facilities of between £200 and £300, please check with my office before your appointment).

If your planned surgery involves the histological analysis of tissue: the hospital will charge for this service: this is usually just under £300 per specimen (the hospital should be able to tell you the likely cost.)

See and treat clinics are most appropriate for small skin benign skin lesions. See and treat clinics are not suitable for anything other than very minor hand surgery (needle fasciotomy for Dupuytren's disease can be performed as a see and treat, but trigger finger surgery or surgery for cysts near the nail plate cannot be performed safely in this manner).

If at the time of our consultation I feel that your problem would not be suitable for "see and treat" and make the decision not to proceed with surgery, you are likely to be charged approximatley £235. This does not happen very often but common reasons for not going ahead with surgery include: lesions too large to be removed as a simple excision (for example larger lesions on the lower-legs or nose needing a skin graft), lesions close to the eye or on the hands of a patient wanting to drive home, and patients with pre-arramged important social or professional engagements within a few days of the proposed surgery. You can send me a photograph of the problem prior to the appointment in order to help plan your care. Please speak to my secretary who can provide you with an e-mail to send the image (ideally this should be well lit and infocus. it should give me an idea of the size of the lesion and its location).

Prices increase each year please check all pricing with the hospital.