The Consultation

Your consultation is a dedicated appointment to understand your symptoms fully and discuss the best next steps for your care.

During the consultation, time is taken to explore:

  • your current symptoms

  • your medical history and relevant background

  • any previous treatments or investigations

It is very helpful if you come prepared with an up-to-date list of your medications.

A clinical examination will be performed. Depending on your symptoms, this may include procedures in clinic such as ear microsuction or nasoendoscopy. In some cases, other minor procedures under local anaesthetic may also be performed.

For some patients, simple in-clinic procedures may be helpful at the same appointment. For example:

  • Ear microsuction is a method of removing wax or debris from the ear canal using a fine suction device under direct vision (with magnification), rather than flushing the ear with water.

  • Nasoendoscopy is a common examination in which a thin flexible camera is passed gently through the nose to look at the nose, back of the nose and throat, and the voice box.

These procedures are usually performed while you are awake in clinic. If needed, a local anaesthetic spray may be used to make the nasoendoscopy examination more comfortable.

Following the assessment, a joint management plan will be discussed with you, taking into account your symptoms, diagnosis, preferences and individual needs.

Sometimes a hearing test may be requested before your consultation (and this may be arranged on the same day where possible), or at a later date.

Additional investigations may also be recommended, such as:

  • blood tests

  • scans (for example, ultrasound, CT or MRI)

If further tests are arranged, the results will be reviewed and relayed to you either in writing or during a follow-up appointment, depending on what is most appropriate.

Clinic Availability

Clinic availability is mainly as follows:

  • The New Foscote Hospital, Banbury: Fridays and Tuesday evenings

  • 150 Harley Street, London: Monday afternoons

As I also have a busy full-time NHS practice, appointment availability may vary from time to time.

If you require an urgent appointment, I will do my best to accommodate this where possible.

If you would like an appointment outside the currently available times, please contact my team, as there may be some flexibility in my schedule and I will do my best to accommodate your request.

Surgery

If surgery is recommended, this will be discussed with you in clinic in detail, including whether the procedure is best performed under local anaesthetic, general anaesthetic, or local anaesthetic with sedation.

Your preferences and past medical history will be taken into account when planning surgery.

In some cases, surgery may need to be performed at a different hospital. This may be due to factors such as:

  • the equipment required for the procedure

  • the need for an overnight stay

  • support from other specialties

  • age-related restrictions at certain hospitals

The risks and benefits of surgery will be discussed with you in clinic and then reviewed again on the day of surgery.

If your procedure is planned under general anaesthetic, you will usually meet the anaesthetist on the day of surgery. In some cases, you may also require a pre-assessment appointment beforehand to check that anaesthesia is safe and appropriate for you.

On the day of surgery, you will usually be given either a morning or afternoon admission slot. Please be prepared to wait, as operating lists can vary and timings may change on the day.

You will be given fasting instructions in advance where required. In most cases, procedures under local anaesthetic do not require fasting.

The order of the operating list is usually decided based on factors such as age and medical comorbidities, to ensure patient safety and appropriate planning on the day.

Any post-operative care instructions will also be reviewed with you.

If you require a sick note, please ask on the day of surgery.